The fashion of addiction
By RNW.nl – June 2001
“Heroin has had it’s day,” says to Roel Kerssemakers from the Jellinek Centre – a drug and alcohol treatment and prevention centre based in Amsterdam. “But,” he adds, “we have to be careful. That can change any minute.”
The Jellinek Centre, has it’s roots in an institution which began in 1909. The current organisation is named after Professor Jellinek, famed for his research into alcoholism in the 60’s. Funded by the government, the City of Amsterdam and the Ministry of Justice, Jellinek provides outpatient programmes, clinics, support and information to people with drug, alcohol and gambling problems.
There are currently about 25,000 heroin addicts in the Netherlands. 700-800 of whom come to the Jellinek Centre for treatment every year. Their average age, according to Roel, is around 39 or 40 years old. “The general attitude among young people about heroin is very negative. They see heroin as a drug for old people.”
Traditionally, as in many other countries, Dutch heroin addicts looking for help would be treated with methadone – a heroin substitute. “We wanted to make people drug free,” says Roel. “People came to us, we gave them methadone, but we tried to reduce the dose immediately, so in 6 weeks people didn’t get any methadone anymore.”
Not For Everyone:
In fact, this ‘reduction scheme’ was only successful in a very small group. The situation with the rest of the addicts deteriorated very rapidly. In 1980 programmes for more chronic users were developed. This saw the introduction of the ‘methadone maintenance’ scheme. The idea was to prevent drug users getting worse and worse, and to minimise the risks of their lifestyle. “People still get addicted to methadone, that’s true,” Roel admits, “but on the other hand, they don’t need to have heroin all day. Their life stabilises; they can do other things; take can take care of themselves. Their quality of life improves.”
But even with these maintenance schemes, there are still people for whom all attempts at treatment have been unsuccessful. And it’s this group that are being targeted in The Netherlands’ current ‘prescribed heroin’ trials. Trials which the Jellinek Centre and some of its clients are closely involved with. But Roel is keen to point out that prescription heroin is only viable for a very small group of addicts – only those who don’t benefit from methadone and who are chronically addicted.
He is, however, optimistic that a carefully regulated supply of heroin will help those who couldn’t benefit from other schemes. The theory being that they no longer have to indulge in their daily search for the next fix. “The chronic group of heroin users, who didn’t improve with the methadone maintenance, will pay more attention to their physical health, live in an independent way and take care of themselves.”
So if heroin has had it’s day, what are the problem drugs facing The Netherlands in the future? According to Roel the biggest problem is alcohol, and of course tobacco. But Roel is worried by young people’s use of ecstasy. “The problem with ecstasy is not addiction, but that it can be neurotoxic, which means certain nerves can be damaged, and that is underestimated I think.” He adds that cocaine is also becoming more popular. “The problem with cocaine of course it that it is really addictive – and these will be the problems of the future.”