Developing a new national MDMA policy: Results of a multi-decision multi-criterion decision analysis

A.L.W.M. Nabben, Jan van Amsterdam, Gjalt-Jorn Ygram Peters, Ed Pennings, Tom Blickman , Kaj Hollemans

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Abstract
Background: Ecstasy (3,4-methylenedioxymethamphetamine (MDMA)) has a relatively low harm and low dependence liability but is scheduled on List
I of the Dutch Opium Act (‘hard drugs’). Concerns surrounding increasing MDMA-related criminality coupled with the possibly inappropriate scheduling
of MDMA initiated a debate to revise the current Dutch ecstasy policy.
Methods: An interdisciplinary group of 18 experts on health, social harms and drug criminality and law enforcement reformulated the science-based
Dutch MDMA policy using multi-decision multi-criterion decision analysis (MD-MCDA). The experts collectively formulated policy instruments and rated
their effects on 25 outcome criteria, including health, criminality, law enforcement and financial issues, thematically grouped in six clusters.
Results: The experts scored the effect of 22 policy instruments, each with between two and seven different mutually exclusive options, on 25 outcome
criteria. The optimal policy model was defined by the set of 22 policy instrument options which gave the highest overall score on the 25 outcome
criteria. Implementation of the optimal policy model, including regulated MDMA sales, decreases health harms, MDMA-related organised crime and
environmental damage, as well as increases state revenues and quality of MDMA products and user information. This model was slightly modified to
increase its political feasibility. Sensitivity analyses showed that the outcomes of the current MD-MCDA are robust and independent of variability in
weight values.
Conclusion: The present results provide a feasible and realistic set of policy instrument options to revise the legislation towards a rational MDMA policy
that is likely to reduce both adverse (public) health risks and MDMA-related criminal burden
Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalDeveloping a new national MDMA policy: Results of a multi-decision multi-criterion decision analysis
Publication statusPublished - 2021

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