This is an English translation. The original Dutch article is authoritative.
Regarding Submission of cannabis reports
Minister Bruins (Medical Care and Sport) is sending several reports in the field of cannabis to the House of Representatives. These include a report from the Rijksinstituut voor Volksgezondheid en Milieu (RIVM) and three reports from the Trimbos Instituut. He also provides his policy response to these reports.
Date: 29 June 2018
Subject: Submission of cannabis reports
Dear Speaker,
With this letter, I submit to your House three reports in the field of cannabis: the information brochure on the harmfulness of exposure to residues of plant protection products remaining on cannabis by the RIVM, the Factsheet on risky cannabis use in the Netherlands by the Trimbos Instituut, and the Strategic Exploration of cannabis, also by the Trimbos Instituut.
The harmfulness of exposure to residues of plant protection products remaining on cannabis
During the Committee Meeting on Coffeeshop Policy on 20 December 2017, Ms Buitenweg (GroenLinks) enquired about the harmfulness of smoking cannabis on which residues of plant protection products may be present. I subsequently pledged to investigate what is known about this. The RIVM conducted a literature review on this matter and reported its findings in the form of the attached information brochure.
In its report, the RIVM concludes that exposure to residues of plant protection products found in market samples does not constitute an additional health risk, over and above the existing risks of cannabis use.
Factsheet risky cannabis use in the Netherlands
In the Factsheet on risky cannabis use, the Trimbos Instituut reports national figures on the prevalence of risky cannabis use in the general population aged 18 and older and among 15- to 16-year-old students. The figures originate from two previously conducted studies: the supplementary substance use module of the lifestyle monitor and the Dutch data from the ESPAD1 study. To determine risky cannabis use, the screening instrument 'the CAST'2 was used. For adults, figures were collected in 2016; for young people, in the autumn of 2015.
Of the adult population, 6.6% used cannabis in 2016. For young people aged 15-16, this was 21% in 2015. The results show that a substantial proportion of last-year cannabis users (1 in 5) is a risky user. This applies to both young people and adults. A risky user pattern means that the user has an increased risk of cannabis abuse or dependence disorders.
Among adults, the following factors constitute an increased risk of risky use: men, those with lower levels of education, and cannabis users with a non-western migration background. Additionally, risky users are ten times more likely to use alone and relatively often use before noon.
Among young people, the percentage of boys and girls who are risky users differs little. However, a low education level is again a significant factor. Among young people, risky users also use relatively often before noon and experience memory problems and truancy much more frequently.
Based on the findings, the Trimbos Instituut makes several recommendations for prevention. They indicate that those with lower levels of education, in particular, are an important target group for prevention and treatment, as the risk of risky use is high in this group. There is already increasing attention for this target group, but they are currently not yet sufficiently reached.
Risky cannabis use often coincides with other health risks, such as daily smoking or the use of other substances. Furthermore, young people appear to play truant much more often and experience problems in their (social) environment. (Preventative) interventions should therefore not only focus on risky cannabis use but also on other potential risky health behaviours.
Strategic exploration of cannabis
In the Strategic Exploration of cannabis, the Trimbos Instituut has provided an overview of cannabis prevalence and the state of prevention based on existing reports and organised expert meetings. Subsequently, directions for thought were explored to prevent (problematic) cannabis abuse among young people and young adults aged 16 to 35.
In recent years, cannabis use among 12-16 year olds has decreased significantly, from a usage rate of 13.1% in 2003 to 8.2% in 2015. However, usage is significantly higher in, for example, REC-43 schools, youth care, juvenile justice institutions, and among (young) homeless people. Various risk and protective factors in relation to cannabis use have been inventoried, as well as societal developments related to cannabis use. Various factors play a role in the development of (problematic) cannabis use. According to the cumulative risk model, problems arise when multiple risk factors are present simultaneously and there is insufficient counterweight from protective factors. By mapping these protective factors, they can serve as a starting point for improving cannabis prevention and thus reducing (problematic) use.
For prevention, three main target groups have been defined in the exploration: young people who do not yet use cannabis, young people who already use cannabis and have no additional multi-problematic issues, and finally, young people who use cannabis and do have additional multi-problematic issues. The Trimbos Instituut makes several recommendations, including investing in the monitoring of cannabis use among risk groups; paying more attention to cannabis prevention within facilities such as special education, youth help, justice institutions, and institutions for the mildly intellectually disabled; encouraging schools to commit to a substance-free school environment and investing in early detection and early intervention for problematic use; and in information provision, paying more attention to possibilities for preventing the harmful consequences of cannabis use.
The findings and recommendations of both the Factsheet on risky cannabis use in the Netherlands and the Strategic Exploration will be included in further policy development. Both reports from the Trimbos Instituut indicate that preventing problematic or risky cannabis use requires an approach across multiple areas and target groups. A number of the recommendations are already being addressed. For example, a study will be started among vulnerable young people within education, residential youth care, and juvenile justice institutions. There is also ongoing attention to counteracting the normalisation of drug use. Furthermore, the recommendations will be taken into account in the further elaboration of the closed coffeeshop supply chain experiment.
Yours sincerely,
The Minister for Medical Care and Sport,
Bruno Bruins