To the authors of the commentary [1], the negative outcome of the referendum seems rather disappointing. They look for answers along political and demographic lines (conservative-liberal, rural–urban, age). But recent experiences with referenda in the European Union (EU) show that the outcomes are hard to predict. A vote in Britain for its exit from the EU (‘Brexit’) was deemed unlikely, until the day after. In the Netherlands, the first popular (non-binding, advisory) referendum on the Ukraine–European Union Association Agreement was held in 2016. With a turn-out rate of only 32%, the outcome rejecting the agreement was deemed legal, yet hardly substantial, with 19% of all potential votes against and 12% in favour [2]. Few people were aware of the details of the agreement. Politically, the referendum was used by a coalition of conservatives who admitted they were not interested in the agreement or Ukraine as such, but generally were using it as a tool to object to EU influence in Dutch politics. They later founded a new and successful neo-conservative party (Forum voor Democratie). The Brexit referendum in the UK did not look much different, although the UK Independence Party and Brexit parties failed to build a political base after their singular goal was achieved. However, the vote did change the balance between major political parties in the UK. So, apart from their immediate direct effect, referenda may be potent political tools as game-changers.

Historically, drug issues have a high symbolic value. Think of prohibition in the USA, when a democratic majority of drinkers voted to ban alcohol from their society, or of other examples of what Joseph Gusfield called symbolic crusades [3]. A current example is the Mexican proposal for cannabis legalisation where a majority in parliament is not supported by a popular majority [4]. Looking back, we think that had the reforms in Dutch drug policy in the 1970s and 1990s been put to a popular vote, they probably would have failed. The 1976 Dutch policy reform made a distinction between cannabis as a soft drug and more damaging hard drugs. It was the outcome of tumultuous changes in society, with young people breaking the law on cannabis on a large scale. After a long period of absence, the Labour party (PvdA) was part of a coalition government, which made changes deemed ‘progressive’ possible. In the lead-up to the 1976 change, the son of the health minister read out price guidelines of hashish and marijuana on the national radio. But although the discourse on drugs had shifted, popular ideas on drugs were still quite negative. The change in 1976 laid the ground for what has become known as the Dutch approach. Increasingly based on harm reduction principles, a white paper on Dutch drug policy was published, formalising existing practices and unifying the rules for licenced sale of cannabis across the country [5]. The core of the policy is that municipal councils have the right to permit the sale of small quantities of cannabis in licenced establishments (so-called coffee shops). The cannabis policy was, and is, strictly regulated and intensively supervised. Publication of the white paper caused quite a stir internationally, particularly from the French government. In terms of Dutch popular discourse, the policy is now reasonably supported and not controversial politically. No political party would try to turn back the clock on this point. We think this could, however, change dramatically if a referendum would be organised around this or other drug issues, with an unpredictable outcome.

More recent changes in policy in the Netherlands have been the introduction of a heroin maintenance regime in treatment for opioid addiction (for the political turmoil it caused, see [6]), and initiation of an experiment on legalisation of production of cannabis in a number of selected municipalities, which were both passed in parliament [7]. In both cases, advocates and opponents used a highly symbolic rhetoric, with academics doing their best to produce a balanced factual base, emphasizing the medical aspect for heroin maintenance. For cannabis legalisation, utility in fighting organised crime was the argument, by creating a closed circuit of production, distribution, retail and use of cannabis. These were thus presented as small steps that do not stir nationwide emotions. Similarly, in 2003 a legal medical marijuana regime was set up without much opposition in parliament and hardly any media coverage, with all steps from production to distribution supervised by the Ministry of Health. If the Dutch people had been consulted in a referendum, these measures would not have passed as easily. Referendum results are often not based on rational, evidence-based information. Careful research and planning may be wiped out by a populist storm.

In Rychert and Wilkins' commentary [1], no mention is made of the UN Conventions on drugs. In 2013, the then Dutch justice minister Opstelten argued against the cannabis legalisation experiment, saying that any legalisation was impossible because of binding international treaties [8]. Researchers at Nijmegen University initially seemed to confirm this point [9]. However, the same authors later revoked their initial conclusion with an appeal based on human rights conventions [10]. This paved the way for a subsequent Dutch cabinet to propose the legalisation experiment currently underway. Among the five conditions mentioned by the Nijmegen researchers was that the policy should have a definite human rights interest and advantages, have sufficient popular support and that it be taken to a democratic vote. The latter two are interpreted as support by municipal councils, academia, police authorities, public health institutes, etc., rather than as a topic for a referendum. The basic rationale for legalisation of cannabis production and distribution was in terms of the large involvement of organised crime in production of cannabis, and the positive public health experiences with the regulated sales of cannabis in coffee shops. With such arguments, and the invocation of human rights conventions, Dutch politicians were persuaded to look past the UN drug conventions. Any effort towards legalisation of cannabis needs careful planning to counter potential arguments against the proposed change, such as was the case in Washington state and Colorado with a potential increase in driving casualties as a major concern. Here, and in other US states, and contrary to our argument above, a popular vote decided in favour of legalisation, with state legislatures being reluctant, perhaps for political reasons rather than public health. Other important issues after legalisation are expected pressures to expand the market commercially, with the need for provisions to limit availability and control promotion [11].

对于评论 [ 1 ] 的作者来说，公投的负面结果似乎相当令人失望。他们在政治和人口方面（保守派-自由派、农村-城市、年龄）寻找答案。但最近欧盟（EU）公投的经验表明，结果难以预测。英国投票退出欧盟（“Brexit”）被认为不太可能，直到第二天。在荷兰，2016 年举行了关于乌克兰-欧盟结盟协议的第一次全民公投（不具约束力、咨询性）。投票率仅为 32%，否决协议的结果被认为是合法的，但几乎没有实质性的，19% 的潜在投票反对和 12% 的赞成 [ 2]。很少有人知道协议的细节。在政治上，公投被一个保守派联盟使用，他们承认他们对协议或乌克兰本身不感兴趣，但通常将其用作反对欧盟在荷兰政治中影响力的工具。他们后来成立了一个新的成功的新保守党（Forum voor Democraticie）。英国的脱欧公投看起来并没有太大的不同，尽管英国独立党和脱欧政党在实现其单一目标后未能建立政治基础。然而，这次投票确实改变了英国主要政党之间的平衡。因此，除了直接的直接影响外，公投可能是改变游戏规则的有力政治工具。

从历史上看，毒品问题具有很高的象征价值。想想美国的禁酒令，当民主的大多数饮酒者投票禁止他们的社会饮酒时，或者约瑟夫·古斯菲尔德（Joseph Gusfield）所谓的象征性十字军东征的其他例子[ 3 ]。当前的一个例子是墨西哥的大麻合法化提案，其中议会中的多数未得到大众多数的支持 [ 4]。回顾过去，我们认为，如果 1970 年代和 1990 年代的荷兰毒品政策改革得到民众投票，他们可能会失败。1976 年的荷兰政策改革将大麻作为软毒品和更具破坏性的硬毒品区分开来。这是社会动荡变化的结果，年轻人大规模违反大麻法律。在长期缺席之后，工党 (PvdA) 成为联合政府的一部分，这使得被认为是“进步的”变革成为可能。在 1976 年变革之前，卫生部长的儿子在国家广播电台上宣读了大麻和大麻的价格指南。但是，尽管关于毒品的话语已经发生了变化，但流行的关于毒品的观点仍然相当消极。1976 年的变化为众所周知的荷兰方法奠定了基础。5 ]。该政策的核心是市议会有权允许在有执照的场所（所谓的咖啡店）销售少量大麻。大麻政策过去和现在都受到严格监管和集中监督。白皮书的发表在国际上引起了不小的轰动，尤其是法国政府。就荷兰的大众话语而言，该政策现在得到了合理的支持，在政治上没有争议。在这一点上，没有政党会试图让时光倒流。然而，我们认为，如果围绕这个或其他毒品问题组织公投，结果可能会发生巨大变化，结果不可预测。

荷兰最近的政策变化是在阿片类药物成瘾治疗中引入海洛因维持制度（关于它引起的政治动荡，见 [ 6 ]），并在一些国家启动了大麻生产合法化的实验。选定的城市，这两个都在议会通过 [ 7]。在这两种情况下，拥护者和反对者都使用了具有高度象征意义的言辞，学者们尽最大努力创造一个平衡的事实基础，强调海洛因维持的医学方面。对于大麻合法化，通过建立大麻生产、分销、零售和使用的封闭循环，打击有组织犯罪的效用是争论的焦点。因此，这些被呈现为不会激起全国情绪的小步骤。同样，在 2003 年建立了一个合法的医用大麻制度，议会没有太多反对，也几乎没有媒体报道，从生产到分发的所有步骤都由卫生部监督。如果在全民投票中征求了荷兰人民的意见，这些措施就不会那么容易通过。公投结果通常不是基于理性的、基于证据的信息。

在 Rychert 和 Wilkins 的评论 [ 1 ] 中，没有提到联合国关于毒品的公约。2013 年，当时的荷兰司法部长 Opstelten 反对大麻合法化实验，称由于具有约束力的国际条约 [ 8 ]，任何合法化都是不可能的。奈梅亨大学的研究人员最初似乎证实了这一点 [ 9 ]。然而，同一作者后来根据人权公约提出上诉，撤销了他们最初的结论 [ 10]。这为随后的荷兰内阁提出目前正在进行的合法化实验铺平了道路。奈梅亨研究人员提到的五个条件之一是该政策应具有明确的人权利益和优势，有足够的民众支持，并进行民主投票。后两者被解释为市议会、学术界、警察当局、公共卫生机构等的支持，而不是公投的话题。大麻生产和分销合法化的基本理由是有组织犯罪大量参与大麻生产，以及在咖啡店管制大麻销售方面的积极公共卫生经验。有了这样的论点，并援引人权公约，荷兰政界人士被说服忽略联合国毒品公约。任何使大麻合法化的努力都需要仔细规划，以反驳反对拟议变更的潜在论据，例如华盛顿州和科罗拉多州的情况，驾驶人员伤亡可能会增加，这是一个主要问题。在这里，以及在美国其他州，与我们上面的论点相反，民众投票决定支持合法化，而州立法机构可能出于政治原因而不是公共卫生原因不愿意。合法化后的其他重要问题是预期的商业扩张市场的压力，需要规定限制可用性和控制推广[ 任何使大麻合法化的努力都需要仔细规划，以反驳反对拟议变更的潜在论据，例如华盛顿州和科罗拉多州的情况，驾驶人员伤亡可能会增加，这是一个主要问题。在这里，以及在美国其他州，与我们上面的论点相反，民众投票决定支持合法化，而州立法机构可能出于政治原因而不是公共卫生原因不愿意。合法化后的其他重要问题是预期的商业扩张市场的压力，需要规定限制可用性和控制推广[ 任何使大麻合法化的努力都需要仔细规划，以反驳反对拟议变更的潜在论据，例如华盛顿州和科罗拉多州的情况，驾驶人员伤亡可能会增加，这是一个主要问题。在这里，以及在美国其他州，与我们上面的论点相反，民众投票决定支持合法化，而州立法机构可能出于政治原因而不是公共卫生原因不愿意。合法化后的其他重要问题是预期的商业扩张市场的压力，需要规定限制可用性和控制推广[ 民众投票决定支持合法化，而州立法机构可能出于政治原因而不是出于公共卫生原因不愿意。合法化后的其他重要问题是预期的商业扩张市场的压力，需要规定限制可用性和控制推广[ 民众投票决定支持合法化，而州立法机构可能出于政治原因而不是出于公共卫生原因不愿意。合法化后的其他重要问题是预期的商业扩张市场的压力，需要规定限制可用性和控制推广[11 ]。