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Belgian National Report on Drugs 2014

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Belgian National Report on Drugs 2014 SERVICE SURVEYS, LIFESTYLE AND CHRONIC DISEASES BELGIAN NATIONAL REPORT ON DRUGS 2014 New DevelopmeNt aND treNDs Belgian national report on drugs 2014 (data 2013) new development and trends Scientific Institute Public Health (WIV-ISP) Operational Directorate Public Health and Surveillance Service Surveys, Lifestyle and Chronic Diseases Programme Drugs Julliette Wytsmanstreet 14 | 1050 Brussels | Belgium Public Health & Surveillance | November 2014 | Brussels, Belgium editors Lies Gremeaux Els Plettinckx authors Belgian monitoring Center for drugs and drugs addiction (BmCDDA) – programme drugs Jérôme Antoine Peter Blanckaert Karin De Ridder Lies Gremeaux Els Plettinckx external experts Lucia Casero EUROTOX asbl (socio-epidemiological observatory for alcohol and drugs in the Federation wallonia-Brussels) Fred Laudens VAD (association for alcohol and other drug problems) Freya Vander Laenen department of penal law and Criminology, institute for international research on Criminal policy (irCp), ghent university Contact e-mail: [email protected] Website: drugs.wiv-isp.be This document is available on the website of the Programme Drugs (drugs.wiv-isp.be) and the website of the Scientific Institute Public Health (www.wiv-isp.be). Please use the following citation: Plettinckx, E., Antoine, J., Blanckaert, P., De Ridder, K., Vander Laenen, F., Laudens, F., Casero, L. & Gremeaux, L. (2014). Belgian National Report on drugs 2014, New Developments and Trends. WIV- ISP, Brussels. Lay-out Nathalie da Costa Maya, CDCS ngo © WIV-ISP, Brussels 2015 Responsible publisher: Dr. Johan Peeters Depotnumber: D/2014/2505/66 www.wiv-isp.be EMCDDA Management Board Mr. Servais VERHERSTRAETEN, State Secretary Mr. Claude GILLARD, Legal adviser, Head of the for State Reform, Facility Management, in Department of criminal law, general Direction charge of Official Affairs. of law of the Federal Public Service of Justice. Mrs. Maggie DE BLOCK, State Secretary for Mr. Vladimir MARTENS, Deputy Director Asylum, Migration, Social Integration and General f.f., Administration of the French Poverty Reduction. Community. Mr. Hendrik BOGAERT, State secretary for Official Affairs, Modernization of the Public EMCDDA SCIENTIFIC Committee Services. Prof. Dr. Brice DE RUYVER, Full Professor, Mr. John COMBREZ, State Secretary for the Institute for International Research on Criminal fight against social and fiscal fraud. Policy (IRCP), University of Ghent. For the Walloon Region: Ministers involved IN THE global Mr. Paul FURLAN, Minister of Local Authorities, AND integrated DRUG POLICy IN Towns and Tourism. BELGIUM 2013-2014 Mrs. Eliane TILLIEUX, Minister of Health, Social For the Federal Government: Action and Equal Opportunities. Mr. Elio DI RUPO, Prime Minister. Mrs. Laurette ONKELINX, Vice Prime Minister For the Federation Walloon-Brussels: and Minister of Public Health and Social Affairs, Mrs. Fadila LAANAN, Minister for Culture, in charge of Beleris and the Federal Cultural the Audiovisual Sector, Health and Equal Institutions. Opportunities. Mrs. Joëlle MILQUET, Vice-Prime Minister and Minister of the Interior and Equal Opportunities. For the Flemish Community and Flemish Mr. Didier REYNDERS, Vice-Prime Minister and Region: Minister of Foreign Affairs, International Trade Mr. Jo VANDEURZEN, Flemish Minister for and European Affairs. Welfare, Public Health and Family. Mr. Steven VANACKERE, Vice-Prime Minister, and Minister of Finance and Sustainable For the French Community: Development, in charge of official affairs. Mrs. Eliane Tillieux, Minister of Health, Social Mr. Vincent VAN QUICKENBORNE, Vice-Prime Action and Equal Opportunities. Minister and Minister of Pensions. Mr. Johan VANDE LANOTTE, Vice-Prime For the German-speaking Community: Minister and Minister of Economy, Consumers Mr. Harald MOLLERS, Minister of Family, Public and North Sea. Health and Social Affairs. Mrs. Sabine LARUELLE, Minister of Small and Medium-sized Enterprises, Self-employed For the Communal Community persons and Agriculture. Commission: Mr. Pieter DE CREM, Minister of Defence. Mrs. Céline Fremault, Member of the Joint Mr. Paul MAGNETTE, Minister of Public Board of the Common Community Commission Enterprise, Science Policy and Development (COCOM), responsible for Health and Civil Cooperation, in charge of Big Cities. Service Policy. Mrs. Annemie TURTELBOOM, Minister of Mr. Guy Vanhengel, Member of the Combined Justice. College of the Common Community Mr. Olivier CHASTEL, Minister for Budget and Commission (COCOM), responsible for Health Simplification. Policy, Finance, Budget and Foreign Relations. Mrs. Monica DE CONINCK, Minister of Work. Mr. Philippe COURARD, State Secretary for For the French Community Commission: Social Affairs, Family, Persons with Disabilities, Mrs. Céline Fremault, Member of the board of in charge of employment risks. the French Community Commission (COCOF), Mr. Melchior WATHELET, State Secretary responsible for Civil Service, Health policy and for environment, Energy, Mobility and State Vocational Training for the Self-Employed. Reform. TABle oF Content Summary 9 Chapter 1. Drug poliCy: legiSlation, StrategieS anD eConomiC analySiS 13 1. Introduction 13 2. Legal framework 15 2.1. Adaptation of the Belgian Drug law of 1921 15 3. National action plan, strategy, evaluation and coordination 16 3.1. National action plan and/or strategy 16 3.2. Evaluation of the federal drug policy 18 3.3. Coordination arrangements 22 4. Challenges and opportunities 26 Chapter 2. Drug uSe in the general population anD SpeCifiC targeteD groupS 29 1. Introduction 29 2. Drug use in the general population 30 3. Drug use in the school and youth population 30 3.1. Drug use among Belgian secondary school students 30 3.2. Drug use among Flemish university and university college students 33 3.3. European study on young people and drugs 36 4. Drug use among targeted groups/settings at national and local level 38 4.1. Drug use in recreational settings in Belgium 38 5. Conclusions 40 Chapter 3. prevention 43 1. Introduction 43 2. Universal prevention 46 2.1. School 46 2.2. Family 49 2.3. Community 50 3. Selective prevention in at-risk groups and settings 54 3.1. At-risk groups 54 3.2. At-risk families 56 Content F 3.3. Recreational settings 58 4. Indicated prevention 61 le o B 4.1. Screening and brief intervention 61 a t 4.2. Early intervention 61 4.3. Self-care and self-help 62 6 5. National and local media campaigns 63 6. Conclusions 65 Chapter 4. high riSk Drug uSerS 67 1. Introduction 67 2. Prevalence of and trends in high risk drug users 68 2.1. Estimation of high risk drug use prevalence 68 2.2. Observed trends 72 3. Characteristics of high risk drug users 73 3.1. Injecting drug users in contact with needles exchange programmes in the Flemish Community 73 3.2. Drug users recruited at the street in the French Community 74 4. Conclusions 75 Chapter 5. Drug-relateD treatment: treatment DemanD anD treatment availability 77 1. Introduction 77 2. Drug-related treatment in Belgium 78 2.1. Policies and coordination 78 2.2. Organization and availability of drug treatment 78 2.3. Treatment demand data 82 2.4. Treatment modalities 84 2.5. Quality assurance of drug treatment services 85 3. Trends 86 4. New developments 88 4.1. Cannabis use disorder in troubled youth – The INCANT project 88 4.2. Heroin-assisted treatment – The TADAM project 88 4.3. Analysis and optimization of substitution treatment – The SUBANOP project 89 5. Conclusions 90 Chapter 6. health CorrelateS anD ConSequenCeS 91 1. Introduction 91 2. Drug-related infectious diseases 91 2.1. HIV/AIDS and viral hepatitis 91 2.2. Syphilis and tuberculosis 95 2.3. Behavioural data 95 3. Other drug-related health correlates and consequences 98 3.1. Non-fatal overdoses and drug-related emergencies 98 3.2. Other topics of interest 99 4. Drug-related deaths and mortality of drug users 101 4.1. Drug-related deaths in the general population 101 4.2. Drug-related deaths registered by the Belgian Early Warning System on Drugs 102 5. Conclusions 103 Chapter 7. reSponSeS to health CorrelateS anD ConSequenCeS 105 1. Introduction 105 2. Prevention of drug-related emergencies and reduction of drug-related deaths 105 Content 2.1. Prevention of drug-related emergencies through crisis care services 105 F 2.2. Prevention and reduction of non-fatal overdoses and drug-related deaths 107 3. Prevention and treatment of drug-related infectious diseases 110 le o B 3.1. Needle exchange programmes 110 a 3.2. Hepatitis C Virus treatment among injecting drug users 113 t 3.3. Prevention and treatment of drug-related infectious diseases in prison 114 4. Conclusions 115 7 Chapter 8. SoCial CorrelateS anD SoCial reintegration 117 1. Introduction 117 2. Social exclusion and drug use 118 2.1. Social exclusion among drug users 118 2.2. Drug use in socially excluded groups 120 3. Social reintegration 121 3.1. Housing 122 3.2. Education & training 124 3.3. Employment 124 3.4. Leisure activities 125 4. Conclusions 126 Chapter 9. Drug-relateD Crime, prevention of Drug-relateD Crime anD priSon 127 1. Introduction 127 2. Drug-related crime 128 2.1. Drug law offences 128 2.2. Other drug-related crime 131 3. Prevention of drug-related crime 133 4. Interventions in the criminal justice system 134 4.1. Alternatives to prison 134 4.2. Other interventions in the criminal justice system 137 5. Responses to drug-related health issues in prisons 140 5.1. Drug treatment 140 5.2. Prevention and reduction of drug-related harm 142 5.3. Prevention, treatment and care of infectious diseases 143 5.4. Prevention of overdose-risk 143 6. Reintegration of drug users after release from prison 144 6.1. Social services for drug users in prison 144 6.2. Central intake units 144 7. Conclusions 145 Chapter 10. Drug marketS 147 1. Introduction 147 2. Supply to and within the country 148 2.1. Drugs origin: national production versus imported 148 2.2. Trafficking patterns, national and international flows, routes, modi operandi and organization of domestic drug markets 148 3.
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