It was in the 1990s when the Netherlands started a program that provides long-term addicts with free government heroin.
In practice, this means that addicts are allowed to inject or smoke heroin three times a day in a solemn, no frills room in a building run by municipal health services.
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Combined with a specified care program, it has been responsible for almost the complete disappearance of heroin addicts from public view.
In the United States, heroin is on the rise like it’s 1983, while an ever-shrinking group of Dutch addicts is only getting smaller and older.
In a 2002 study, there were an estimated 25,000 addicts in the Netherlands (out of a population of more than 10 million), but only about 2,000 were considered hardcore addicts, according to the Central Committee on the Treatment of Heroin Addicts.
Heroin use under the age of 40 is practically non-existent, according to Amsterdam‘s health services.
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Age development of all patients who are in the Amsterdam methadone program from 1985-2012. Yellow to orange is under 40. The blue age groups are over 40 and now comprise almost the entire patient population. Multiple health services tell VICE heroin use under 30 is virtually non-existent.
But some addicts who are actively supplied with free heroin are now openly complaining about the program. Using free heroin has become so easy for them, they feel like society has given up on them.
Far from public sight, they are supplied with lab-synthesized heroin, more pure than anything they’ve ever smoked or injected before.
Criminal behavior among the group has plunged since the start of the program, but the addicts feel like they’ve been flushed down the toilet by the Dutch public — addicted forever, out of sight and out of mind.
Heroin: The Most Feared Drug
In the Netherlands, heroin is so thoroughly feared that it even scares people under 40, who weren’t around to see the heroin epidemic of the 1980s and early 1990s with their own adult eyes. In those decades, heroin abuse and the crime that came with it was about the biggest city nuisance thinkable. Every large train station in the Netherlands was sprawling with junkies.
But the Netherlands fought the problem head on. Needle exchange programs were set up. Addiction was being treated as health problem, not a criminal one. Methadone buses showed up in areas with high abuse. Slowly but surely the situation came under control.
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In 1992, more than one million needles were exchanged for clean ones in Amsterdam alone, according to the city’s Department of Health. In 2013, it was less than 200,000.
In 1985, nearly 100 percent of methadone patients were aged below 40. In 2014, almost all of them were older than 40. Aid programs are so abundant, it’s now hard to find an addict who hasn’t been in touch with one.
It took the Swiss to come up with the idea of giving out free heroin — the real deal — to all addicts who could convince the program that they had tried kicking the habit but were unable to. The Netherlands perfected its pragmatic approach and adopted the program.
Beating Heroin Addiction With Heroin
Heroin users who want to participate in the free heroin program have to show that there’s no clear indication that they are ever going to be clean if they kept on going down the same road. The men — nearly all of them are men — must be able to indicate that they’ve been addicts for a long time, and have attempted to quit their drug abuse numerous times. And they have to be over 30.
If all those boxes are checked, then they can go to their local health service at strictly scheduled times to get high, and go on with their day.
Karien de Ridder of the Netherlands’ Municipal Health Services (GGD in Dutch) gave VICE News a tour in one of the three locations in Amsterdam, where 70 people are enrolled in its free heroin program.
The waiting-room looks like any other waiting-room in the Netherlands.
“We call this an integrated institution,” De Ridder said.
The GGD is housed here, along other institutions that can be of help to heroin users, like a probation office and career center. Users are referred to as “patients.”
“We offer them a medical treatment here,” De Ridder told VICE News. “But you have to understand, we are very strict in our agreements with patients. It’s not like: ‘yeah let’s go smoke and get high.’ Patients are expected at set times and we hold them to it.”
The GGD keeps its doors wide open to any addict who needs help. Their main goal is to see how a patient can be helped — getting a roof over their head, getting them on welfare, and so on.
This is not seen as government intrusion but as easing pain for incoming patients.
“Sometimes they come in because cops get them. Not to throw them in jail, but to help them. Arresting somebody ten times for drug abuse is pointless,” De Ridder. “You’ve got to look at what a person really needs.”
The using spaces can be viewed through several large glass windows.
There is one small room for shooting heroin specifically, and one room that fits about seven people where the addicts can smoke the drug. Nutrical is provided, a small drink that contains most things a human body needs.
There is a basket with condoms and clean needles. There are even pre-cut tin foils, perfectly shaped in the most popular measurements.
“Some patients like small, square foils. Others prefer them in longer rectangles,” said De Ridder.
All That’s Left Is the Addiction Itself
The program can be hailed as a great success. Crime has plunged in neighborhoods where heroin use was endemic. Users have less trouble with the law, and their lives have stabilized and improved. They get a roof over their head, they receive welfare, and according to De Ridder, 80 percent of them have some sort of job.
The only problem they still have, of course, is their addiction.
Take Ghalid for example, who is hanging out under a bridge right across the building where he’s scheduled for his dose.
Ghalid is smoking cocaine and is content with the program.
“I don’t need to steal anymore. Back in the day I got caught several times for stealing a DVD player or a big stereo,” he said.“I only stole from big stores, otherwise I’d feel sorry for the owner, you know? It’s alright now, my life is more balanced these days.”
But Ghalid is not a success story.
That much is clear from the fact that he is hanging out under a bridge and smoking coke, but besides that, he’s also experiencing troubles with staying in the program.
He has a hard time arriving on time and keeping up with the rules of his assisted housing.
Ghalid has money problems too, like not being able to pay for its utility bills, and was forced to leave his apartment. But he is still excited about the free heroin.
Johan (not his real name) is a lot less jubilant about the program. In contrast to Ghalid, Johan is a success story.
“Of course, it provides stability, but you also grow dependent on it. Look, the only thing you do when you’re in that program is smoke heroin. You wake up. You go to the clinic,” Johan said. “You smoke. You go home, sit on your couch high as a kite. And when the high’s over, it’s time to go back for a new hit. That’s how your life looks like when you’re in the program.”
Johan soon couldn’t stand his own life anymore.
He quit the program and gave up heroin altogether. He still gets some methadone sometimes, which eases the urge to use, but it doesn’t provide the high that heroin does. Johan is the perfect example of someone who got clean thanks to the program after years of addiction.
But he sees the downsides of the initiative, and points to a younger guy (Rene, not his real name) who just returned from smoking around the corner.
“Look at René’s eyes. He’s unbelievably high,” Johan said.
René confirms Johan’s assessment by nodding and mumbling in approval, as Johan goes on about him. “All he does is smoke heroin.”
“Quitting is very hard,” Johan said. “Especially considering the stuff the clinic offers. Their heroin is so pure — everyone I know says it’s the best they’ve ever had. Nowhere in Europe you can find better stuff. The public may be content that al the junkies are gone, but over here, in these flats on the edge of the city, junkies still roam abundantly. What’s more, they feel like they’re stuck to it for the rest of their life and will never be able to get out of it.”
Johan’s point is especially interesting since he is the prime example of how the project can eventually result in kicking the habit and getting a better life. The free heroin he’s complaining about is also the thing that saved him.
By the time he made his point, Ghalid has returned and is now agreeing with the others.
“We’re all suckling from the GGD’s tits? That’s what we’re doing,” Ghalid said. “They make it way too easy for us.”
Dennis Lahey, who is the director of an organization that defends drug users rights, has seen countless people who have been in the program, and he understands the point they are making.
“The program has a very medicalized approach. Anything that could make it somewhat fun is banned. They don’t want people to have a good time in there. It’s a medical treatment,” said Lahey. “Arrive too late and you get nothing. The government acts like they’re handling plutonium, but it’s just heroin.”
Lahey said without the program, the “whole city would be full of junkies.”
“Now addicts can live more peacefully and start thinking about other things than just getting high. What remains after everything else has been taken care of, is their addiction,” he said. “If you get the dope for free, your only problem is that you’re addicted to the dope. It seems like a paradox, but it’s true. All that’s left when everything else is taken care of is the question: do I really want to keep on using this?”
