Trimbos-institute, Netherlands Institute of Mental Health and Addiction, PO 725, 3500 AS Utrecht, The Netherlands
We read with interest MacCoun & Reuter's (2001) report on evaluating alternative cannabis regimes. In The Netherlands, drug policy is a topic of great interest. A scientific evaluation of policy regimes would be highly appreciated. MacCoun & Reuter's paper illustrates that this, however, is not an easy job.
As the authors stress, cross-national scientific evaluations are hampered by a lack of comparability due to methodological differences. Nevertheless, many studies summarised in their Table 1 are not methodologically comparable. MacCoun & Reuter compare the results of Dutch school surveys with those of population surveys in the USA. However, school surveys yield higher prevalence figures of substance use than population surveys do (Gfroerer et al, 1997). Furthermore, the age group "approximately 18" from the Dutch school survey is compared with the 18-year-old age group in the American national study. In The Netherlands schooling is compulsory until the age of 15-16 years, so 18-year-old high school students cannot be considered as representative of all 18-year-olds in our country. Among high school students aged 12-18 years we saw an increase in cannabis use in 1984-1996, but this had stabilised in 1999. The arguments that the rise may be associated with the coffee shop model and with a phenomenon the authors describe in terms of commercialisation and glamorisation do not quite convince us.
Clearly, trends in drug use are influenced by a complex interplay of factors.
REFERENCES
Bieleman, B. & Goeree, P. (2000) Coffeeshops Geteld, Aantal Verkooppunten van Cannabis in Nederland. Groningen/Rotterdam: Bureau Intraval.
European Monitoring Centre for Drugs and Drug Addiction (2000) Annual Report 2000. Lisbon: EMCDDA.
Gfroerer, J., Wright, D. & Kopstein, A. (1997) Prevalence of youth substance use: the impact of methodological differences between two national surveys. Drug and Alcohol Dependence, 47, 19-30.[CrossRef][Medline]
Hibell, B., Andersson, B., Ahlström, S., et al (2000) The 1999 ESPAD Report: Alcohol and Other Drug Use Among Students in 30 European Countries. Stockholm: Swedish Council for Information on Alcohol and Other Drugs, and the Council of Europe Pompidou Group.
MacCoun, R. & Reuter, P. (2001) Evaluating
alternative cannabis regimes. British Journal of
Psychiatry, 178,
123-128.
de Zwart, W. M., Monshouwer, K. & Smit, F. (2000) Cannabis use among Dutch students has stabilised. http://www.trimbos.nl