在本文中,作者对荷兰减少伤害领域的变化提供了看法。从1970年代到1990年代,荷兰成为减少伤害服务的领导者,在阿姆斯特丹和鹿特丹的Junkiebond等基层运动的推动下,如Medisch-socialeDienstHeroneGebruikers(MDHG)(Medisch-socialeDienstHeroneGebruikers(MDHG)翻译为英语医疗社会服务海洛因用户)。这些组织提倡以健康为中心的政策,启动针头交换计划,创造了安全的消费空间。他们的努力导致了重大的公共卫生改善和政策转向减少伤害,降低吸毒人群的艾滋病毒和肝炎发病率。到了1980年代,减少伤害在当地卫生和社会护理系统中变得制度化,导致与毒品有关的伤害和犯罪显着下降。然而,从2000年代开始,出现了向安全和预防犯罪的转变,受社会政治变化的影响。刑事司法措施的增加和减少伤害服务的预算削减使系统紧张,使其更难解决新兴的毒品趋势和使用毒品的人的复杂需求。尽管面临挑战,改革势头再起,特别是在地方一级,倡导对精神活性物质负责任的监管。阿姆斯特丹市长FemkeHalsema的2024年药物监管会议证明了这一转变,呼吁制定解决禁令失败和减少中心伤害的政策。联合国人权事务高级专员等国际机构支持这种做法,强调基于健康和权利的框架。随着荷兰驾驭这些不断发展的动态,迫切需要对减少伤害的基础设施进行再投资,确保它满足不同的社区需求,并重申其确认基本权利的原则。
In this article the authors offer their perspective on the changes in the Dutch harm reduction field. From the 1970s to the 1990s, the Netherlands emerged as a leader in harm reduction services, driven by grassroots movements like the Medisch-sociale Dienst Heroïne Gebruikers (MDHG) (Medisch-sociale Dienst Heroïne Gebruikers (MDHG) translates to Medical-Social Service Heroin Users in English) in Amsterdam and Junkiebond in Rotterdam. These organisations advocated for health-centred policies, initiated needle exchange programmes, and created safe consumption spaces. Their efforts led to significant public health improvements and policy shifts towards harm reduction, reducing HIV and hepatitis rates among people who use drugs. By the 1980s, harm reduction became institutionalised within local health and social care systems, leading to notable declines in drug-related harm and crime. However, from the 2000s, a shift towards security and crime prevention emerged, influenced by socio-political changes. Increased criminal justice measures and budget cuts for harm reduction services strained the system, making it harder to address emerging drug trends and the complex needs of people who use drugs. Despite challenges, there is renewed momentum for reform, particularly at the local level, advocating for the responsible regulation of psychoactive substances. Amsterdam Mayor Femke Halsema\'s 2024 conference on drug regulation exemplifies this shift, calling for policies that address prohibition failures and centre harm reduction. International bodies like the UN High Commissioner for Human Rights support this approach, emphasising a health and rights-based framework. As the Netherlands navigates these evolving dynamics, there is a pressing need to reinvest in harm reduction infrastructure, ensuring it meets diverse community needs and reaffirms its foundational rights-affirming principles.