The Effects of Harm Reduction in Amsterdam

The Amsterdam drug policy is based on prevention, drug-free treatment and harm reduction interventions. This article focusses on the last aspect. Harm reduction is defined as ‘If a drug user is not capable or willing to give up his drug use, he should be assisted in reducing the harm caused to himself and others.’ Two harm reduction interventions are described: the needle exchange schemes and the provision of methadone (low-threshold clinics, methadone bus, police stations and through general practitioners). Besides general indicators, such as estimated number of heroin addicts and their average age, results of more specific evaluation projects are discussed to examine the effects of harm reduction interventions. It is concluded that the policy was effective in managing the drug problem (stable number of addicts, low number of new young drug addicts, low mortality rate), but that effective measures against the HIV epidemic were taken too late. Furthermore, harm reduction interventions have not discouraged drug users from making use of drug-free treatment facilities.