DRUGSFENOMENEN SAMENVATTING
Inleiding drugsbeleid .............................................................................................. 13
Wat begrijpen we onder drugsbeleid? ................................................................... 13
Ontstaan interfederaal drugsbeleid ...................................................................... 13
Enkele kernideeën uit het drugsbeleid ............................................................... 18
Quid legalisering ............................................................................................. 20
inleiding: PSYCHOFARMACA ................................................................................... 22
Ontwikkelingen ................................................................................................... 32
H1: PSYCHOLEPTICA .............................................................................................. 33
Opiaten .............................................................................................................. 33
Historiek, producten en gebruik ........................................................................ 33
Morfine ....................................................................................................... 34
Heroïne ....................................................................................................... 34
Opioiden ..................................................................................................... 37
Methadon .................................................................................................... 38
Effecten van opiaten ........................................................................................ 40
Werking .......................................................................................................... 41
Hersen- en zenuwstelsel .............................................................................. 42
Synaptische transmissie............................................................................... 44
Hoe beïnvloeden? ........................................................................................ 46
Opiaatverslaving ............................................................................................. 47
Hersenen hebben eigen morfine ....................................................................... 54
Snuifmiddelen .................................................................................................... 55
Gassen: N2O of lachgas ................................................................................ 56
Inhalatie van vluchtige oplosmiddelen........................................................... 57
H2: STIMULERENDE MIDDELEN .............................................................................. 59
1
, Cocaine ............................................................................................................. 60
Gebruik........................................................................................................... 61
Cocaïnebase ............................................................................................... 61
Risico’s ........................................................................................................... 61
Amfetamine(s) .................................................................................................... 62
wetgeving ....................................................................................................... 65
Cathine........................................................................................................... 66
Stimulerende middelen: effecten ......................................................................... 67
Ontstaan gevoel v welzijn ................................................................................. 67
Eetlustremming ............................................................................................... 67
tal van ongewenste effecten ............................................................................. 68
Psychosen door stimulerende middelen ............................................................... 68
H3: PSYCHEDELICA ............................................................................................... 69
De psychedelische ervaring ................................................................................. 69
Toepassing en effecten ........................................................................................ 71
Mescaline ....................................................................................................... 71
Methoxy-amfetaminen ..................................................................................... 72
MDMA/XTC .................................................................................................. 72
Magic mushroom – “paddo’s” ........................................................................... 74
LSD (Lysergzuurdiethylamide) .......................................................................... 75
Effecten psychedelica ..................................................................................... 77
Risico’s ........................................................................................................... 78
Risico’s specifiek voor XTC............................................................................ 78
H4: CANNABINOÏDEN ............................................................................................ 80
Cannabinoïden: wat? .......................................................................................... 80
Gebruik .............................................................................................................. 82
2
, Effecten ............................................................................................................. 84
H5: PARTYY DRUGS, LEGAL HIGHS, NPS .................................................................. 91
Wat? .................................................................................................................. 91
Legal highs ......................................................................................................... 92
Alkohol ........................................................................................................... 93
Mephedrone ................................................................................................... 96
Flakka............................................................................................................. 97
Synthetische cannabinoïden ............................................................................ 98
Party drugs ........................................................................................................100
De designer drugs ...........................................................................................100
Recreatieve drugs ...........................................................................................100
Ketamine ....................................................................................................100
GHB of gamma-hydroxybutyraat ..................................................................101
“nouveau riche” drugs ....................................................................................106
Roze cocaïne ..............................................................................................106
H6: De vraagzijde ..................................................................................................108
De bril ...............................................................................................................108
De vraag ............................................................................................................109
Middelengerelateerde stoornis ........................................................................110
Sociale kost ...................................................................................................116
Het antwoord.....................................................................................................117
Het doel van interventies ....................................................................................119
Gedragsverandering........................................................................................119
Herstel: brede invulling ...................................................................................120
H7: PREVENTIE .....................................................................................................123
Algemeen ..........................................................................................................123
3
, Hoe? .............................................................................................................124
Universele preventie ..........................................................................................126
Sensibiliseren ................................................................................................126
Informeren .....................................................................................................127
Aanleren persoonlijke/sociale vaardigheden.....................................................127
Focus: scholen ...............................................................................................128
Selectieve preventie ...........................................................................................129
Geïnduceerde preventie .....................................................................................129
Preventie in beleid en praktijk .............................................................................130
Uitdagingen .......................................................................................................132
H8: VROEGINTERVENTIE .......................................................................................133
Vroeginterventie (VI) strategieën .........................................................................133
Twee centrale componenten VI .......................................................................134
SBIRT .............................................................................................................135
Inzicht in effectiviteit VI-strategieën .....................................................................135
Overzicht van VI in beleid en praktijk ....................................................................136
knelpunten en uitdagingen voor VI .......................................................................137
H9: HULPVERLENING ............................................................................................140
Trends en barrières in hulpverlening (HV) .............................................................140
HV strategieën ...................................................................................................142
Ambulant vs residentieel.................................................................................143
Welke HV interventies zijn effectief? ....................................................................144
Nazorg ...........................................................................................................148
onder justitiële druk ........................................................................................148
HV in beleid en praktijk .......................................................................................150
Beleid ............................................................................................................150
4
Inleiding drugsbeleid .............................................................................................. 13
Wat begrijpen we onder drugsbeleid? ................................................................... 13
Ontstaan interfederaal drugsbeleid ...................................................................... 13
Enkele kernideeën uit het drugsbeleid ............................................................... 18
Quid legalisering ............................................................................................. 20
inleiding: PSYCHOFARMACA ................................................................................... 22
Ontwikkelingen ................................................................................................... 32
H1: PSYCHOLEPTICA .............................................................................................. 33
Opiaten .............................................................................................................. 33
Historiek, producten en gebruik ........................................................................ 33
Morfine ....................................................................................................... 34
Heroïne ....................................................................................................... 34
Opioiden ..................................................................................................... 37
Methadon .................................................................................................... 38
Effecten van opiaten ........................................................................................ 40
Werking .......................................................................................................... 41
Hersen- en zenuwstelsel .............................................................................. 42
Synaptische transmissie............................................................................... 44
Hoe beïnvloeden? ........................................................................................ 46
Opiaatverslaving ............................................................................................. 47
Hersenen hebben eigen morfine ....................................................................... 54
Snuifmiddelen .................................................................................................... 55
Gassen: N2O of lachgas ................................................................................ 56
Inhalatie van vluchtige oplosmiddelen........................................................... 57
H2: STIMULERENDE MIDDELEN .............................................................................. 59
1
, Cocaine ............................................................................................................. 60
Gebruik........................................................................................................... 61
Cocaïnebase ............................................................................................... 61
Risico’s ........................................................................................................... 61
Amfetamine(s) .................................................................................................... 62
wetgeving ....................................................................................................... 65
Cathine........................................................................................................... 66
Stimulerende middelen: effecten ......................................................................... 67
Ontstaan gevoel v welzijn ................................................................................. 67
Eetlustremming ............................................................................................... 67
tal van ongewenste effecten ............................................................................. 68
Psychosen door stimulerende middelen ............................................................... 68
H3: PSYCHEDELICA ............................................................................................... 69
De psychedelische ervaring ................................................................................. 69
Toepassing en effecten ........................................................................................ 71
Mescaline ....................................................................................................... 71
Methoxy-amfetaminen ..................................................................................... 72
MDMA/XTC .................................................................................................. 72
Magic mushroom – “paddo’s” ........................................................................... 74
LSD (Lysergzuurdiethylamide) .......................................................................... 75
Effecten psychedelica ..................................................................................... 77
Risico’s ........................................................................................................... 78
Risico’s specifiek voor XTC............................................................................ 78
H4: CANNABINOÏDEN ............................................................................................ 80
Cannabinoïden: wat? .......................................................................................... 80
Gebruik .............................................................................................................. 82
2
, Effecten ............................................................................................................. 84
H5: PARTYY DRUGS, LEGAL HIGHS, NPS .................................................................. 91
Wat? .................................................................................................................. 91
Legal highs ......................................................................................................... 92
Alkohol ........................................................................................................... 93
Mephedrone ................................................................................................... 96
Flakka............................................................................................................. 97
Synthetische cannabinoïden ............................................................................ 98
Party drugs ........................................................................................................100
De designer drugs ...........................................................................................100
Recreatieve drugs ...........................................................................................100
Ketamine ....................................................................................................100
GHB of gamma-hydroxybutyraat ..................................................................101
“nouveau riche” drugs ....................................................................................106
Roze cocaïne ..............................................................................................106
H6: De vraagzijde ..................................................................................................108
De bril ...............................................................................................................108
De vraag ............................................................................................................109
Middelengerelateerde stoornis ........................................................................110
Sociale kost ...................................................................................................116
Het antwoord.....................................................................................................117
Het doel van interventies ....................................................................................119
Gedragsverandering........................................................................................119
Herstel: brede invulling ...................................................................................120
H7: PREVENTIE .....................................................................................................123
Algemeen ..........................................................................................................123
3
, Hoe? .............................................................................................................124
Universele preventie ..........................................................................................126
Sensibiliseren ................................................................................................126
Informeren .....................................................................................................127
Aanleren persoonlijke/sociale vaardigheden.....................................................127
Focus: scholen ...............................................................................................128
Selectieve preventie ...........................................................................................129
Geïnduceerde preventie .....................................................................................129
Preventie in beleid en praktijk .............................................................................130
Uitdagingen .......................................................................................................132
H8: VROEGINTERVENTIE .......................................................................................133
Vroeginterventie (VI) strategieën .........................................................................133
Twee centrale componenten VI .......................................................................134
SBIRT .............................................................................................................135
Inzicht in effectiviteit VI-strategieën .....................................................................135
Overzicht van VI in beleid en praktijk ....................................................................136
knelpunten en uitdagingen voor VI .......................................................................137
H9: HULPVERLENING ............................................................................................140
Trends en barrières in hulpverlening (HV) .............................................................140
HV strategieën ...................................................................................................142
Ambulant vs residentieel.................................................................................143
Welke HV interventies zijn effectief? ....................................................................144
Nazorg ...........................................................................................................148
onder justitiële druk ........................................................................................148
HV in beleid en praktijk .......................................................................................150
Beleid ............................................................................................................150
4
