Review on alcohol, drugs, and tobacco research in the Netherlands in 1995 and 1996
Annotated selective review of research projects in the register of research in the Netherlands and Flanders on the use, the users, and the effects of alcohol, drugs, and tobacco in 1995-1996
Prepared for: Ministry of Health, Welfare, and Sports (VWS)
Gerard M. Schippers
University of Nijmegen
Research Group on Addictive Behaviors
Date: November 1997
This paper gives an overview of the major important research projects on alcohol, drugs, and tobacco in the Netherlands in 1995 and 1996. Since 1979, every two years an overview is reported of all the research projects on alcohol, drugs, and tobacco in the Netherlands and Flanders. In the latest issue, over 1995 and 1996, a total number of 160 projects were registered, 150 of them being Dutch projects (Schippers & Broekman, 1997).
Over the 1980s and early 1990s, the volume of research on alcohol, drugs, and tobacco has grown substantially in the Netherlands, as is shown by us (Schippers, 1994). Traditionally, a considerable number of small-scale, local studies are carried out on an ad hoc basis. The subject matter and methodologies are highly diverse and reflect the particular interest of the individuals and centers concerned.
To give insight in the state of affairs in Dutch research we made a selection of the most significant projects from the above-mentioned register. We have selected those studies that took place on a reasonable scale, with solid methodology, and of which the results are or will be published for an international audience. The selected 68 projects are presented briefly in this paper. All selected projects are presented, mentioning the researchers, the research institution and a description of the project (goal, research questions and, eventually, results). In the next paragraph, a short overview of the projects in the diverse domains will be presented. The number of projects is given in brackets.
In 1997 the Dutch Organization of Scientific Research (NWO) in cooperation with the ZON (Health Care Research The Netherlands) launched a multi-million program for prioritizing research on addiction, to become effective in 1998. This program encompasses the following three themes: (I) Individual vulnerability, (II) Craving and relapse, and (III) Addiction care, prevention and monitoring.
Theme I focuses on factors of individual vulnerability for addiction, like genetic factors, sensitivity of brain systems, pharmacologically created euphoria, risk factors in the family, social networks and personality. Theme II focuses on the biological, behavioral and social determinants of craving and relapse and, as in Theme I, on new treatment methods. Theme III focuses on the improvement of prevention and treatment, with special emphasis on ethnic minority groups, and on the monitoring of alcohol and drug use in different subgroups.
The registration of the research projects in 1995-1996 provides an opportunity for insight in the efforts that are given already to these themes. In cooperation with prof. dr. W. van den Brink (1997) we surveyed the selected group of 68 Dutch projects of significance, presented in this review from the perspective of the prioritizing program. Strictly speaking, only 7 projects can be labeled as pertaining to theme I, and even less, 5 to theme II (of which two projects are the same as mentioned in theme I). So, only 10 projects, ca 15% of the total group, pertain to theme I and II. Theme III attracts far more projects: ca 31 (46%). Of these, half can be allocated as treatment or prevention projects, and half as prevalence and monitoring studies. In total a series of 41 projects of significance are in progress through 1995-1996 that can be considered as fitting in the prioritizing program. In particular theme I and theme II are underrepresented in and will can from the created funding possibilities.
The Rudolf Magnus Group (University of Utrecht) with Van Ree is well known for their animal studies on neuropeptides and their role in drug seeking behavior. Two projects at other centers are about animal research on modulators of drug dependence and on craving. At the Department of Pharmacology (Schoffelmeer, Free University Amsterdam) studies long lasting neuroadaptive changes as mechanism of craving and Cools group at the Catholic University Nijmegen the role of individual variations in the rats brain in craving.
2 Impact on offspring (5)
For the Amsterdam Institute for Addiction Research (AIAR), a cooperation with the Medical Faculty of the University of Amsterdam and the Jellinek, the area of children of alcoholics has become a topic of extensive research. It concerns neuro-cognitive determinants of psychopathology, and other risk factors, and consequences of parental alcoholism. There are also studies by TNO (Netherlands Organization for Applied Scientific Research) on moderate alcohol consumption and child development.
A series of projects from the University of Nijmegen (Institute for Psychiatry in cooperation with UNRAB) is concerned with factors and consequences of benzodiazepine dependency.
4 Policy research (3)
Although the Netherlands are internationally well known for its liberal policy on the use of illicit drugs, the number of studies on policy is still remarkable few. Three groups can be mentioned: the Centre for Drug Research (Cohen) and the Department of Criminology of the University of Amsterdam (Korf), and the Addiction Research Institute of the University of Utrecht (Van de Wijngaart).
The University of Nijmegen Research Group on Addictive Behaviors (UNRAB) investigates psychological mechanisms, and factors like mood and expectancies, on cue-reactivity and the effects of alcohol.
The University of Limburg Department of Medical Sociology (Knibbe) studies the social determinants of the development of smoking and drinking habits from a sociological point of view in order to gain insight into the natural development and distribution of these habits and life styles.
There are two large studies to mention. In both the University of Limburg studies the effects of stress and alcohol consumption on coronary heart disease. The Nutrition and Food Research Group (TNO) is involved in studying the effects of moderate alcohol consumption on health.
8 Prevalence (12)
The Netherlands Institute of Mental Health and Addiction (Trimbos Institute) Alcohol and Drugs (NIAD) and the Dutch Foundation on Smoking and Health (STIVORO) surveyed smoking, drinking and gambling behavior among youngsters and adults. The Addiction Research Institute Rotterdam (IVO) focuses on risky lifestyles in Rotterdam, and the Municipal Health Service in Amsterdam (GGD) on the development of the heroine epidemic in Amsterdam. Interesting data on the (mis)use of alcohol and drugs seen in the emergency room of a academic hospital are revealed by the department of Surgery, University of Groningen (Kingma). The well known longitudinal Amsterdam cohort study on HIV infection and AIDS among drug users continues to produces valuable information on the spread of the disease.
9 Alcohol and traffic (2)
Two projects should be mentioned, one of them from the Institute for Road Safety Research (Groningen), which performs a series of studies on drink-driving in the Netherlands.
Minimal interventions for smoking crack cocaine are developed at the Addiction Research Institute Rotterdam (IVO), and for stopping to smoke tobacco at the University of Twente. Cornel (University of Maastricht) links problem drinking in general practice to the presentation of vague complaints.
The AIAR street junkie projects evaluates an experimental intervention to reach street junkies while a drug-free detention treatment program was evaluated as well.
12 Treatment and services research (11)
As before, a substantial body of research on services, treatment processes and outcomes has been carried out. Many have been conducted from a descriptive-clinical perspective. The national alcohol and drugs information system gathers treatment data on an on-going basis. Clinical trials to be mentioned are: dialectical behavior therapy for borderline personality disorders (AIAR), the use of Palfium for heroine addicts (GGD Amsterdam); cue exposure in opiods (Addiction circuit Bloemendaal), Interpersonal Therapy (Network for Addiction Treatment Services, St. Oedenrode), and minimal psychosocial intervention in combination with acamprosate (UNRAB/AIAR). Field studies to be mentioned are concerned with matching (UNRAB); relapse prevention for drug abusers (University of Maastricht), and drop out (Department of Health Science and Epidemiology, University of Utrecht).
13 Clinical epidemiology (7)
One of the two divisions of the AIAR is dedicated to clinical-epidemiological research. Two projects on co-morbidity are mentioned, among them the development of the EuropASI. The Rotterdam Institute of Addiction Research (IVO), using among other methods an ethnographic approach, studies drug users in and outside institutional settings.
14 Prevention (2)
Only two research projects in the area of prevention can be mentioned, both on the National Campaigns on alcohol education (Netherlands Institute for health promotion and disease prevention, NIGZ).
15 Drug related nuisance (5)
Since the government has prioritized the lowering of drug related nuisance, a series of monitoring and evaluation research projects have been initiated, of which 2 are from Intraval in Groningen.
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