 Crack supply one bridge too farThe Netherlands moves further towards facilitating drug use for certain drug user groups. Institutions in the cities of Amsterdam and Rotterdam, for example, have discussed the possibility of creating rooms in which crack can be supplied under supervision - apart from the already existing methadone and heroin programmes.The Netherlands should start an experiment with crack supply on medical grounds as soon as possible. This was said by S. Czyzewski, director of the addiction care institute in the province of South Holland the Boumanhuis, in the newspaper Volkskrant. He is not the only one, however, who feels this way. At the beginning of this year, outgoing Amsterdam chief prosecutor J. Vrakking argued that the experiment with heroin supply on medical grounds should be expanded to include the supply of crack. He also had a name for the rooms designated for that purpose: city opium dens. Society and the addiction care sector face many serious problems. The latter is being confronted with an alarming and ever-increasing number of cocaine and crack addicts seeking help. Partly due to the contamination of ecstasy pills, cocaine use has gained popularity in the out-going scene over the past years. More use will eventually cause more people to get in trouble because of their cocaine use. Cocaine, crack especially, creates a feeling of energy which causes the user to feel great and to think that he can take over the world. However, when the effects wear off, the user can become depressed, irritated and even paranoide. The user could also become aggressive and physically exhausted. These effects are especially prevalent when the use of cocaine and crack is combined with the use of alcohol. The wish to also begin with the supply of crack under supervision is rooted in the confrontation with extreme cocaine and crack-related nuisance (violence, aggression and crime) on the one hand and the fact that many of these people are poly-drug using addicts, i.e. addicts who use different kinds of drugs at the same time, with psychiatric problems, the so-called double trouble addicts. Many of them do not seek help. This calls on judicial as well as care authorities and institutions to adopt an adequate approach and working method. Czyzewski's plea for made-to-measure individual care without adopting a sentimental attitude seems to be a symphatetic one. Every addict is different and every addiction problem requires a different approach. We agree with Mr Czyzewski that a more restrictive approach (and sometimes more repressive) is necessary in certain cases. The fact that certain members of the Dutch Lower House argued for amending the Psychiatric Hospitals Compulsory Admission Act (Wet Bijzondere Opnemingen in Psychiatrische Ziekenhuizen) in order to be able to have degenerated and ill drug addicts admitted by force, is a good thing. In certain cases, it could also be beneficial to prescribe medication. However, the addiction care sector seems to be heading for a complete medicalisation of the addiction problem in which addiction does not seem to be much more than a biological-medical problem. The supply of crack is one bridge too far and we feel that crack cannot be considered to be a medicine. Addiction problems cannot be solved by prescribing substances. This especially applies to crack or cocaine because the use of these substances often creates the compulsory need for more. Unfortunately, Czyzewski disqualifies politicians and care workers who oppose his view as being ‘moralistic'. There is nothing wrong with moralism. The debate about addiction even lacks moralism. Furthermore, the addiction care sector should not give up so easily. It should have the guts to keep on searching for innovative ways to help this group of addicts on the road to a healthy life free of addiction. Published in De Hoop Magazine, no. 3, 2001 |
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