Buying Ecstasy Maastricht

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Buying Ecstasy Maastricht

Official websites use. Share sensitive information only on official, secure websites. Email: jan. Concerns surrounding increasing MDMA-related criminality coupled with the possibly inappropriate scheduling of MDMA initiated a debate to revise the current Dutch ecstasy policy. An interdisciplinary group of 18 experts on health, social harms and drug criminality and law enforcement reformulated the science-based Dutch MDMA policy using multi-decision multi-criterion decision analysis MD-MCDA. The experts collectively formulated policy instruments and rated their effects on 25 outcome criteria, including health, criminality, law enforcement and financial issues, thematically grouped in six clusters. The experts scored the effect of 22 policy instruments, each with between two and seven different mutually exclusive options, on 25 outcome criteria. The optimal policy model was defined by the set of 22 policy instrument options which gave the highest overall score on the 25 outcome criteria. Implementation of the optimal policy model, including regulated MDMA sales, decreases health harms, MDMA-related organised crime and environmental damage, as well as increases state revenues and quality of MDMA products and user information. This model was slightly modified to increase its political feasibility. Sensitivity analyses showed that the outcomes of the current MD-MCDA are robust and independent of variability in weight values. The present results provide a feasible and realistic set of policy instrument options to revise the legislation towards a rational MDMA policy that is likely to reduce both adverse public health risks and MDMA-related criminal burden. Ecstasy 3,4-methylenedioxymethamphetamine MDMA is a widely used drug, mainly by urban, higher educated, young adults at dance events and house parties Nabben, Typically, ecstasy is used only a few times a year Nabben et al. The basis for this decision was unclear, and still is. Such benefits, as well as the adverse effects and health risks of MDMA, have been recently reviewed Van Amsterdam et al. One may therefore question whether the current scheduling of MDMA is justified. Faced with increasing public awareness of a possibly inappropriate scheduling of MDMA and the growing concerns about MDMA-related crime, many Dutch policymakers and influencers are currently considering a revision of the national MDMA policy. To provide a rational basis for this challenging task, a multidisciplinary group of 18 experts was invited to participate in decision meetings to develop a science-based and politically feasible MDMA policy Hall and Lynskey, In MD-MCDA, weighting factors are assigned to the outcome criteria which allow subsequent summation of effects on a set of unrelated outcomes e. The MCDA approach was previously successfully applied to rank four policy models for alcohol and cannabis Rogeberg et al. The present results may guide the development of feasible and realistic instruments to revise the legislation of a rational MDMA policy that considers both adverse public health risks and MDMA-related criminal burden. A consensus procedure using MD-MCDA was applied with different iterations, considering previously obtained information to reach the next rating; that is, with each iteration, this information is passed on to the next iteration. The different steps in this process are outlined below see also Figure 1. The six steps of the multi-decision multi-criterion decision analysis. Summation of 22 weighted selected policy options gives the overall score final score of a constructed model. The steering group J. The prerequisite for selection was that every expert had a specific expertise and was independent or acted independently, that is, they were not bound by or accountable to political parties or ministries involved in either drug policy or drug enforcement. The expertise represented in the expert panel included the following domains: pharmacology, toxicology, pharmacy, philosophy, ethics, anthropology, drug enforcement, epidemiology, neurobiology, medicine, philosophy of law, criminology, law, national and international drug policy, drug prevention and behavioral sciences. Every drug policy consists of a set of policy instruments with an impact on predefined outcomes. In step 2a, the experts selected 25 outcome criteria e. Table 1 , upper panel. In step 2b, the expert group formulated 22 policy instruments, each having between two and seven options, thus resulting in 95 policy instrument options cf. Table 1. A policy model is defined as a set of distinct choices for each of the 22 policy instruments, and the purpose of the MD-MCDA process is to identify the policy model that achieves the highest overall weighted score on the policy outcomes: the optimal model. To compare this optimal model to other commonly referenced policy proposals, we also defined four drug policy models by identifying how these would be defined in terms of our 22 instruments. These comparison models were a the coffee-shop model, b the adapted coffee-shop model, c the free market and d the repressive model. Models a and b reflect two drug models described in the current Dutch legislation: the coffee-shop model and the adapted coffee-shop model with legal production and delivery of cannabis to the coffee shop Commission Knottnerus, ; Dutch Government, c. Similarly, the free market and the repressive model models c and d with their typical characteristics were constructed by assembling the applicable policy options. After the scoring of all policy options and the weight factors see below , the optimal policy model was automatically generated by combining the 22 highest rated options per policy instrument. In a similar way, the worst policy model was assembled by combining the 22 lowest rated options. In some cases, two to three instrument options with the same score were applicable. The X-shop model was constructed by selecting the applicable set of instrument options which legally impose regulated distribution and sales of ecstasy. The overall score of the five policy models was compared with that of the optimal and worst policy model. Based on their own expertise, the selected experts rated the effect of the policy instrument options on the outcome criteria. In addition, experts shared their expert information with the other members of the panel, and they were provided with an extensive state-of-the-art document, covering the published and grey literature about the 25 outcomes related to ecstasy Van Amsterdam et al. Each of the 22 policy instruments has several possible options resulting in 95 policy instrument options, each of which may have a different impact on each of the 25 policy outcomes. Prior to scoring the 95 policy instrument options, consensus anchor values were set by the experts for each of the 25 outcomes, which represent the estimated maximal negative and maximal positive impact effect that a specific policy instrument can have on the outcome. As a rule, the anchors were set at zero for the current legal situation i. However, for 12 of the 25 outcomes, the status quo more closely approximated the worst or best possible situation. In such cases, the anchors were adjusted to reflect this cf. Table 2 ; e. Scoring was conducted over three days in two parallel groups of experts. To attain a good balance between the ratings, every set of the 22 policy instrument options was scored groupwise i. After the exchange of arguments and new information, consensus about the ratings was usually attained. If not, the average of the individual scores was set as the final score. Following each rating session, group members were asked to rate their confidence in the set of scores just given on a scale from 0 to Finally, experts were given the opportunity in plenary sessions to challenge and adjust the obtained scores at the end of the day. According to MC-MCDA, every outcome criterion within the outcome cluster and the six outcome clusters must be weighed against each other to account for their relative impact on the overall final score of the policy models per se, as well as to adjust for clusters with relatively many outcomes i. First, every expert selected the most important outcome in each cluster and set its weight on Finally, the same procedure was applied for the six weight values W1 of clusters A—F. Table 3. The weighting factor of the cluster with the highest mean value was set at , and the residual five cluster weights W1s were rescaled accordingly related to The mean W2 values were multiplied by the rescaled W1 of the corresponding cluster. The final scores per policy option were obtained by multiplying the option score by the corresponding overall weight factor cf. Consumption of MDMA is not prohibited. The following issues related to MDMA have not been described in Dutch legislation: packaging requirements, age limit for users, price, quality requirements and management and licenses for sale. The mean values of the overall weighting factors are depicted in Table 3. Based on these final scores per policy option, the overall scores of the different policy models were obtained by summation of the appropriate 25 final scores see below for results. Obviously, the worst model and the optimal model reflect the bounds that all possible models will always fall between i. The higher the overall score, the better the model. Tables 4 and 5. Table 5. Figure 2 shows the benefits of the optimal model per outcome compared to the current situation. In particular, the main benefits of the optimal model are gains in health and social benefits, better prevention of MDMA-related organized crime, as well as increased state revenues. These benefits are accomplished by selecting policy instrument options from those described in Table 4 see Supplemental Table S2 for the 22 selected options , including legal requirements for selling ecstasy, monitoring and quality requirements for ecstasy. In the worst possible model, certain policy instrument options had a strong negative impact on the overall score, whereas other options had little or no effect or even a small positive effect on the overall score heat maps are available in the Open Science Framework repository for this project. The 22 policy instrument options that collectively lead to the optimal model i. The final overall score of six policy models, the optimal model and the worst possible model compared to the current situation set as zero. Effects of the optimal policy, consisting of the best-scoring policy instrument options, on the 25 outcomes. In order to position the optimal model, the characteristics of the optimal model and two legal drug models in The Netherlands the coffee-shop model and the adapted coffee-shop model were compared in terms of policy instrument options and overall scores. The characteristics of the three policy models with their applicable instrument options are depicted in Supplemental Table S1. Table 5 depicts the overall score of the optimal model and the two legal policy models, and shows that the optimal model scores better than the adapted coffee-shop model and the coffee-shop model. The characteristics of the optimal model and the X-shop model are described in Table 6. To accommodate both political feasibility and social acceptance of regulated ecstasy sales, the optimal model was slightly adjusted at six minor points to construct a new, a nearly optimal and a politically more feasible model: the X-shop model. Figure 3 summarizes the differences in outcomes between the X-shop model, the optimal model and the other four policy models at cluster level. It shows that the optimal model is superior at all cluster levels, except in some cases for international status. Furthermore, despite the six minor changes introduced, the scores at cluster level of the optimal model and X-shop model are virtually the same which is agreement with minor difference in overall score cf. Effect of six policy models on the six cluster outcomes. Highest possible scores refers to the optimal model. Two types of sensitivity analyses were conducted to assess the robustness of the findings to changes in the scores and the weights that were employed. To explore the first, all the scores with a confidence rating lower than a given threshold were replaced by the highest possible score for each policy option, zero or the lowest possible score for each policy option. Next, we repeated this procedure stepwise with steps of 0. This procedure revealed two clusters: a high scoring better outcome cluster containing the optimal model, the X-shop model, the coffee-shop model and the adapted coffee-shop model, and a low scoring worse outcome cluster containing the free market model and the repression model. The models sometimes changed rank order within their cluster when many estimates were replaced by the highest and lowest possible estimates, but the models in the high cluster never scored equal to or lower than models in the low cluster and vice versa. Inspection of the individual weighting factors shows that the experts ranked all six models in virtually the same way cf. Supplemental Figures S1 and S2. The current MD-MCDA based on experts ratings of 95 policy options on 25 policy outcomes has led to the development and description of an optimal model with the overall best outcome as basis for a new and science-based MDMA policy in The Netherlands. The optimal model proposes regulated MDMA sales and predicts decrements in health harms, MDMA-related organized crime and environmental damage, as well as increments in state revenues, quality of MDMA products and user information. The optional model was then slightly modified into the X-shop model — a model that is considered to be politically more feasible and will presumably lead to health and social benefits, although with a minor increase in the prevalence of use. Presumably, user health is most improved by legal obligations to formulate legal requirements for selling ecstasy, to monitor and to control the quality of ecstasy pills cf. Table 4. Another important element of the optimal model is the firm decrease in the level of MDMA-related organised crime cf. Figure 2. The latter is crucial to obtain societal and political support from the so-called law-and-order political parties that value reductions in crime highly, in particular crime intertwined with Dutch ecstasy production and consumption. Furthermore, the proposed X-shop model provides — based on the ratings given in the assessment — better protection of vulnerable users, although the incrimination of users will slightly increase due to stricter regulation under the optimal regime. According to the proposed X-shop model, the prevalence of ecstasy use will slightly increase because of the higher availability and the implicit governmental legitimation of ecstasy use. On the other hand, better pill quality rules and improved health education will in our view counterbalance the slight increase in ecstasy use and lead to a safer use of ecstasy with an overall reduction in adverse health effects. Figure 3. Despite a slight increase in prevalence of use, an increase in the level of ecstasy dependence is not expected mainly because of the low dependence potential of ecstasy Alderliefste and Damen, ; EMCDDA, ; Van Laar et al. A specific advantage of regulated ecstasy sales in the X-shop model is the modest generation of state revenues consisting of VAT, income tax, fees of license holders and excise duties. More relevant, however, are the financial benefits resulting from a reduction in costs of health care, environmental pollution and crime, including lower expenses for drug enforcement see below. The optimal model includes the inter se option for treaty modification, as provided by Article 41 of the Vienna Convention on the Law of Treaties. The inter se modification is a procedure specifically designed to find a balance between treaty regime stability and the need for change in the absence of consensus, whereby a group of two or more like-minded states could reach agreements among themselves that permit the production, trade and consumption of scheduled substances for non-medical and non-scientific purposes, while minimising the impact on other states and on the goals of the drug conventions Boister and Jelsma, Following international consultations and negotiations through the inter se option, neighboring countries may implement comparable legislation. Legal producers in The Netherlands can then supply high quality MDMA products to consumers in those countries and vice versa. The more countries adapting such legislation, the more effectively MDMA-related organised crime is sidelined. One of the proposed elements of the optimal model is more efficient confiscation of goods and finances obtained by the illegal production of and trade in MDMA, including better coordination with foreign partners. An even more important element of this regime is prioritisation of fighting crime intertwined with the production of and trade in MDMA. However, it is beyond the scope of this investigation to outline initiatives in the frame of more efficient and smarter investigation methods in drug enforcement. Moreover, a number of innovative targets have already been mentioned by the Minister of Finance and the Minister of Justice and Security in their letter to the Dutch parliament describing initial contours of the broad-based offensive against organized, subversive crime Dutch Government a , b , d. The main strength of the current study is that the expert panel consisted of experts from a broad range of expertise domains. Their specific expertise was extended by supplying them with an extensive state-of-the-art literature review about ecstasy, covering all outcome criteria Van Amsterdam et al. Moreover, rating of the policy options was performed in an efficient manner using a structured decision-making model with a broad range of policy instruments and outcomes as the building blocks for a revised national ecstasy policy model. Compared to some other consensus models, the current approach is fully transparent. The judgements and weights currently used by the expert panel can be varied, so that the effects of theses variations on the outcome best model can be easily tested a publicly available website fully disclosing the data facilitates such testing. Moreover, the sensitivity analyses performed indicated the high robustness of the outcomes. For instance, the outcomes of the current MD-MCDA exercise were robust against extreme changes in judgements and weights. However, the impact of this potential bias has been mitigated by a deliberately including experts from law enforcement agencies and experts with a relatively conservative attitude towards the liberalisation of drug laws, and b regularly challenging the experts during the rating sessions to give science-based arguments for their rating. Furthermore, the selection of policy instruments and outcomes was not idiosyncratic but rather based on previous studies on similar issues Nutt et al. Finally, sensitivity analyses showed that the outcomes of the current MD-MCDA are robust and independent of both the uncertainty of the ratings and any extreme position s taken by individual experts. Therefore, we believe that the proposed models represent the currently most adequate evidence-based estimation of benefits and risks of different national ecstasy policies, including The Netherlands and other countries. Given the robustness of these models, it is likely that this will also be true for the MDMA policy in other countries. Supplemental material, sj-pdfjop These results have been obtained thanks to the experts who have carried out their work with great dedication, expertise and enthusiasm. Without them, this result would not have been achieved. Supplemental material: Supplemental material for this article is available online. This section collects any data citations, data availability statements, or supplementary materials included in this article. As a library, NLM provides access to scientific literature. J Psychopharmacol. Find articles by Jan van Amsterdam. Find articles by Gjalt-Jorn Ygram Peters. Find articles by Ed Pennings. Find articles by Tom Blickman. Find articles by Kaj Hollemans. Find articles by Joost J Jacobus Breeksema. Find articles by Johannes G Ramaekers. Find articles by Cees Maris. Find articles by Floor van Bakkum. Find articles by Ton Nabben. Find articles by Willem Scholten. Find articles by Tjibbe Reitsma. Find articles by Judith Noijen. Find articles by Raoul Koning. Find articles by Wim van den Brink. Issue date May. Open in a new tab. Policy instruments Policy instrument options Nr. Outcome Maximal negative effect Maximal positive effect 2 Magnitude of use frequency and dose — 50 3 Use by vulnerable groups —50 8 Shift to other more harmful drugs — 25 11 Criminalisation of users — 50 12 Small crime — 50 15 International trafficking of MDMA —10 17 State revenue through VAT 0 18 State revenues through other taxes 0 19 Health-related costs — 50 23 Damage due to international economic boycotts — 0 24 Damage due to international legal counter measures — 0 25 Environmental damage ethical consideration —40 Cluster Outcome criterion cluster item W2 a Overall weight b 1 A Prevalence in the general population 74 3. Only license holders may sell MDMA to users. Possession of a user quantity of MDMA is tolerated and all advertising is allowed. Export of MDMA is legalised and an inter se position for the new model within international drug treaties will be applied for. Predominantly prevention organisations supply of information about health effects and is focused on harm reduction. Adverse effects of MDMA use will be extensively monitored. X-shop model Specifications deviating from the optimal model: a user quantity is legal and larger quantities tolerated, b all advertising is prohibited, c sales of MDMA to users is subjected to pharmaceutical legislation d age limit is 18 years, e export is illegal and f all governmental bodies are responsible for prevention policy. Click here for additional data file. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel. Tolerate user quantity, user quantity is legal and large possession tolerated, prohibit all or allow all. Age-related advertising, advertising on the packaging, only business to business, prohibit all or allow all. Trade in ecstasy between companies: regulated, in analogy with commodity legislation, in analogy with pharmaceutical legislation, prohibit or allow. Sales of ecstasy to consumers: regulated, in analogy with commodity legislation, in analogy with pharmaceutical legislation, prohibit or allow. Sanctioning of consumer, seller or none of the two in case of violation of age limit. For sellers of legalised ecstasy: no criminal record and high drug education level or no requirements. Sanctioning QA rules a. Level of monitoring product quality, prevalence and incidents: none, selective, regularly. National, regional, municipality or no governmental body is responsible for drug policy. Production of MDMAb: regulated, in analogy with commodity legislation, in analogy with pharmaceutical legislation, prohibit or allow. The Dutch position is an exceptional position, compliant, adjusted, tolerating, violating, inter se. Prioritisation of fighting crime: low, selective for serious crime, high. Increase efforts to seize profits gained through MDMA production and trading or not. State revenue through VAT c. Selective high priority for serious MDMA-related crime, but low priority for that of consumers. Which government b.

A Dutch city seeks to end drug tourism

Buying Ecstasy Maastricht

In the Netherlands, it is against the law to possess, sell or produce drugs. Soft drugs are less damaging to health than hard drugs. Therefore, in the Netherlands, coffee shops are permitted to sell cannabis under certain strict conditions. A coffee shop is an establishment where cannabis is sold but no alcoholic drinks are sold or consumed. This is part of the Dutch policy of toleration. However, the Netherlands has a policy of toleration regarding soft drugs. This means that the sale of small quantities of soft drugs in coffee shops is a criminal offence but the Public Prosecution Service does not prosecute coffee shops for this offence. Neither does the Public Prosecution Service prosecute members of the public for possession of small quantities of soft drugs. These quantities are defined as follows:. Coffee shops:. Municipalities determine whether to allow coffee shops to operate within their boundaries, and if so, how many. They can also impose additional rules. The objective is to combat the nuisance and crime associated with coffee shops. Coffee shops must become smaller and focus on the local market. This policy will make Dutch coffee shops less attractive to drug users from abroad. To combat drug-related crime and nuisance, the Dutch government introduced a new toleration rule on 1 January only 'residents of the Netherlands' are permitted to visit coffee shops and purchase cannabis there. A resident of the Netherlands is someone who lives in a Dutch municipality and is registered there. Whether this rule is actively enforced differs from municipality to municipality. Coffee shop owners are required to check whether all those admitted to the shop, and allowed to purchase cannabis there, are residents of the Netherlands aged 18 years or older. They should check these facts, for instance, by asking the person to produce a valid identity document or residence permit, in combination with an extract from the municipal population register. It is against the law to grow marijuana and cannabis plants. In cases where no more than 5 plants are grown for personal consumption, the police will generally only seize the plants. If more than 5 plants are found, the Public Prosecution Service will prosecute. In combating cannabis growing, the police collaborate with organisations including housing associations, the Tax and Customs Administration, and energy companies. Tenants found to be growing cannabis may be evicted. The energy company will impose an additional retrospective assessment on those who illegally tap electricity. Toleration policy regarding soft drugs and coffee shops In the Netherlands, it is against the law to possess, sell or produce drugs.

Buying Ecstasy Maastricht