Dutch organisation denies glamorising addiction
Roll out the clichés and puns, it's open season again on Dutch drug policy. “Pot shots” have been fired at “junkies' magazine,” there has been “outrage over drug chic women's glossy,” and anti-drugs campaigners are “infuriated.” The British media report that a “new magazine,” Sister Mainline, produced by Amsterdam's Mainline Foundation, is considered a classic example of “drug chic” publishing, a “transparent validation” of drug use, which “stinks.”
Mainline, which provides health information to hard drug users, stands guilty of presenting a relatively positive self-image of women users, struggling with their addiction, but able to take practical steps to improve their health and take pride in their appearance. Even worse, say critics, Mainline has done this within the format of a “glossy” women's magazine.
Far from just saying “no,” Sister Mainline offers advice on staying healthy while addicted. However, although the articles may cover fashion and beauty tips, they hardly glamorise the harsh reality of addiction.
Part-funded since 1990 by the Ministry of Health, Mainline publishes a magazine every four months with a print run of 11 000. Once a year a product is aimed specifically at women. Last year it was Mainline Lady (BMJ 323:184), which carried articles on jail, HIV, prostitution, and the difficulties of maintaining long term friendships or raising children in the drug scene. This year it will be Sister Mainline, not a magazine but a diary, shortly to be printed. It will be packaged as a present, with articles on cooking, beauty tips, and quizzes.
Mainline's Jasperine Schupp said: “We believe the ‘glossy’ style is the best way of getting health information across to women hard drug users. Field workers asked these women what they wanted. It was a glossy ‘Cosmo-style’ magazine, but then for drug users.” Distributing Mainline Lady in Amsterdam's notorious Zeedijk red light district appeared to prove the point. After the magazine had been hyped in the Dutch press, three street prostitutes rushed up to Ms Schupp pulling on her bag, before sitting down on the pavement to read it.
“It was the dream of anyone in health information,” she said. “They identified with the articles whether on motherhood or HIV testing. Their response was: ‘If I have this information I don’t feel dirty, I feel better.'
“It is also very important to improve these women's self-esteem in order to stimulate them to take care of themselves. You don't do that by confirming a cliché junkie image, but by offering them something they can positively identify with.”
Ms Schupp denied glamorising drug use. “Just read the contents—we do not promote drugs. It is all about self control, taking responsibility for your health, taking your medication on time.”
Mainline can do this because the Netherlands has allowed the room, within a range of policies, for harm reduction. The statistics suggest that it works. The European Monitoring Centre for Drugs and Drug Addiction puts the Netherlands around the bottom of a European Union league table of drug related deaths. It estimates that there are 2.6 “problematic hard drug users” for every 1000 people, compared with 6.7 in the United Kingdom. Meanwhile, 70% of an estimated 25 000 hard drug users are in regular contact with health services and the average age is rapidly increasing. In Amsterdam it is now 41.
Dr Hans Tieken, deputy director of Amsterdam's addiction care services, Jellinek, said: “Harm reduction does not lead to higher drug use in the general population. Targeting a specific group with a specific measure that is effective does not harm society.” He explained that the target group determined whether to use harm reduction or prevention. Harm reduction is aimed at long term users, who are chronically addicted, who have been offered treatment that has not worked.
Dr Janhuib Blans, Jellinek's head of prevention work, said: “Credibility of information is the name of the game. For Mainline's target group a message like ‘Just Say No’ would not work.”
Figure.
After its success with the magazine, Mainline is now publishing a “glossy” diary