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Different from previous waves, the BHIS used the computer-assisted personal interviewing CAPI method for the face-to-face part of the questionnaire, although drug use is still surveyed by the use of a self-completion part. The researchers maintained the same substance-related items of the survey, being the lifetime, last year and last month cannabis use; frequency of last month cannabis use; the age of first time cannabis use and the last year use of cocaine, amphetamines, ecstasy, LSD, heroin, methadone and buprenorphine. Results for the BHIS are expected by the end of Marginalized people homeless, prisoners, institutionalized persons are excluded from the sample because invitations to participate to this study are sent only to households after a prior phone contact. The self-completion questionnaire related to substance use is only filled out after having received the visit of the interviewer Van der Heyden et al. Plettinckx, E. Page In the whole school population, only the older students mentioned ever use of these substances: 4. The highest lifetime prevalence among the oldest school students y of the Flemish Community were reported for ecstasy 3. A lifetime prevalence of heroin use was found to be about only 0. Pages The study shows that about one fifth About one fifth Both the lifetime and the last year prevalence of the oldest students were about 10 times higher compared to those found in the youngest age group y: respectively 4. The prevalence of regular cannabis use was 2. Of the year old students, 3. A small but not trivial group of year old students 0. Higher prevalence of ever, last year and regular cannabis use were found in students following technical or vocational educational programmes compared to students of general programmes. Before , use and possession were often separately taken into account, which resulted in an overestimation of the total number of drug law offences. For this reason, numbers are only reported from on. In , a total of , criminal offences were registered, of which 47, concerned drug law offences possession and use , trade, trafficking, or production of drugs. The proportion of drug-related offences raised to 4. This was the first increase of prevalence in four years. Figure 9. In , the prevalence reached a record of Also the prevalence of production of drugs is increasing and reached 3. The proportion of drug law offences registered by police forces related to import and export is declining. The registered drug law offences related to trade are stable. They use this precaution as it is known that upon interference, when no evidence for dealing can be demonstrated, the police can only charge for possession of illegal drugs. However, the analysis of police charges and public prosecutor files revealed that dealers carry around more money in one's pockets than the average citizen. The presence of the money presumably refers to the illegal sale activities Decorte and D'Huyvetter, Where on the first of September the total number of prisoners is 10, Aebi and Delgrande , p. Belgium is not an exception and is confronted with the problem of prison overcrowding Aebi and Delgrande , p. Especially the category of sentenced prisoners and prisoners on remand is increasing Maes et al. Deprez, Nathalie, et al. This is a higher percentage compared to the latest data of the statistics of the Directorate-general showing that Consequently, this double counting also occurs with the latest data of the Directorate-general and cannot explain this higher percentage. Moreover, Space only includes sentenced prisoners, expecting not a higher, but lower percentage compared to the latest data of the Directorate-general, since the latter involves all categories of legal status. Compared to the self-reported data however, these figures show again a different result with Prisoners could give multiple answers. However, one would expect a result more in line with the A distinction has to be made, however, between a drug offender and a drug using or drug-addicted offender. It is found repeatedly in and , that the nature of the offence is not a predictable factor for drug use during imprisonment Van Malderen et. Both drug offenders and non-drug offenders take drugs while in prison and vice versa. During the past 4 years, more and more cannabis plantations were found in Belgium see also Table This could be a consequence of the more severe prosecution of cannabis-related organised crime in The Netherlands. Furthermore, Belgium is a trafficking country for cannabis resin. Belgium is also a meeting point for heroin traffickers rather than a heroin trafficking country. Seizures of more than 50 kg of heroin are rare in Belgium, but heroin traffickers meet in Belgium to stay out of the attention of the law enforcement in the countries were they are trafficking heroin. There is a strong link between the Dutch and Belgian synthetic drug production with the same persons being often involved in the synthetic drug market in both countries Dommicent, personal communication. These small-scale home growers are more and more working in a professional way. However, they are not necessarily profit-oriented. Reasons for this increase in small-scale growing of cannabis could be the dissatisfaction with the cannabis products sold in the Dutch coffee shops Decorte For all years, the majority of the drug seizures contained cannabis herbs, plants or resin. This percentage of cannabis related seizures gradually increased from This increasing trend stabilized in with This time trend is in line with the increasing number of cannabis related drug offences see Chapter 9, Section 2. While there has been a more or less steadily decrease in the percentage of cannabis resin seizures from The increase for cannabis plants 0. Another remarkable trend is the declining percentage of XTC-like substances in seizures. From to , the percentage seizures containing XTC, decreased from 5. For heroin, cocaine, amphetamines and LSD, no clear time trends were observed. The uncertainty in the incidence estimates was large. A sensitivity analysis was carried out, revealing that this uncertainty was primarily due to the uncertainty associated with the estimation of the HIV-prevalence rate among IDUs rather than with the uncertainty resulting from the stochastic mortality model. Time trends of the national prevalence rate of ever-IDUs are graphically presented in Figure 4. Partly as a result of the large uncertainty in estimates, no significant time trends were observed. Nevertheless, the results suggest a stabilizing trend in prevalence rate of ever-IDUs from onwards. However, this comparison should be made with caution as a result of methodological differences age range, not accounting for non-AIDS mortality. From onwards, a revised and improved questionnaire is used. The age of the participants ranged from 18 to 63 years, with an average age of The vast majority of the participants reported non-concurrent poly drug use on average 4 products. As a result of reporting delay, no new AIDS diagnoses related to injecting drug use were reported for , so far. An overview of the hepatitis B and C prevalence rates for are given in Table 6. Regarding Hepatitis B, 2. The patient population of the Free Clinic is known to be a strongly marginalized population, explaining the high prevalence rates. Comparing the results for the prevalences with previous years, does not reveal significant time trends. The standardised European Standard Population drug-induced mortality rates per These differences although being not significant, except in are explained by differences in urbanisation degree, with the Brussels Capital Region being the more urbanized. For the Flemish region, a recent increasing trend was observed, which is significant when comparing with A similar rate is observed for the use of benzodiazepines without prescription and is classified as the third product most frequently used in prison over the years It seems that an important part can be categorised as regular users. Table 5. The unknown gender records were not indicated. A large majority of patients The main substances were opiates in The other substances were cocaine Figure 5. Patients in treatment for hypnotics are the oldest: On the opposite end of the spectrum, patients in treatment for cannabis are the youngest, with The percentage of new patients under the age of 30 who are being treated for a stimulant-, cocaine- or opiate-related disorder, is Patients entering treatment for the misuse of hypnotics are the group with the greatest percentage of women The percentages of women among patients in treatment for opiates, cocaine or cannabis are The objective of this registration is to avoid multiple prescriptions and allow warnings among concerned practitioners as requested by the Royal Decree of March 19th This database contains information from public pharmacies, hospitals pharmacies and specialized centres. Substitution treatments provided in prisons are not included in this database. There is also a lack of information regarding non-residents and people without health insurance. Of the 15, persons in treatment for methadone, More than one third The proportion of persons without school degree is considerably higher among persons between 45 and 54 years One in two treatment demands concern persons who are unemployed Cocaine abusers are most likely to be employed at treatment entry No gender differences in unemployment rates were observed among persons entering treatment. In particular opiate abusers Only small gender differences were observed, with In the Walloon region, , syringes were distributed through the 16 official fixed-site and mobile services and However, there is no information available on the number of syringes effectively sold through this network. Compared to previous years, the number of distributed needles slightly decreased Figure 7. The essence of this policy remains the recognition that the drug phenomenon primarily is an issue of public health. Therefore, repression, as a last resort ultimum remedium , is preceded by prevention and treatment. By evaluating the accomplishments of the Federal Drug Policy Note and by stipulating action points for future improvements, the Communal Declaration pursues the global and integrated approach. This document can be seen as a confirmation of the Federal Drug Policy Note, rather than as its replacement. The action plans of an both start with an overview of the preceding measures on drug policy. In a second part, the current statement of affairs is assessed, resulting in specific action points for the future. As the Federal Drug Policy Note thoroughly describes its action points, the Communal Declaration mainly assesses to what extent they have been realised. Consequently, the latter stipulates the efforts which should be made in order to further execute the action points of The Communal Declaration of on the other hand, draws a clear distinction between the prevention aiming at public health and the prevention of drug-related public nuisance. On this matter, a few objectives are described, mostly in regard to the local authorities. In order to reach a wider range of drug users, the declaration states that an increase in treatment capacity is needed. The support for the cooperation between the criminal justice system and the drug treatment services continues, with special attention for the necessary conditions. The projects that were implemented as part of the Federal Drug Policy Note continue to be supported. The Communal Declaration differs on the subject of risk-reduction. Although it remains an objective of the Belgian drug policy, its confirmation is rather implicit. The latter plans to enhance the repressive measures on the production and traffic of illegal drugs, as part of the control of the supply. In addition to the request for a cross-border approach for drug tourism in the policy note, an intensification of the cooperation and consultation with the neighbouring countries was promised in The penitentiary drug policy, as described in the policy note of , is not discussed as part of the action points of Rather than a tolerance policy, Belgium pursues a consequent dissuasion policy, in which the penalization of drugs shows the disapproval regarding the use of drugs. The underlying principle of this legislative reform is that the application of the criminal law as a response to illegal drug use should now constitute only a last resort. Cannabis use possession of a quantity of cannabis that can be used on a single occasion or at most within 24 hours — i. The law confirms that the possession and cultivation of cannabis remain offences, and provides for increased penalties for illicit production or trafficking. The law is based on the principle of deterrence from all drug use , including recreational use by adults. It is expressly stated that use by adults in the presence of minors will be treated more severely, with custodial penalties. Cannabis was differentiated from other illicit substances, and the two concepts of problem drug use and public nuisance were introduced. The new status of cannabis allowed the public prosecutor not to prosecute if there was no evidence of problematic drug use or of public nuisance. After the Constitutional Court found that these concepts were insufficiently defined, a new directive issued in February called for full prosecution only in cases involving disturbance of public order or other aggravating circumstances. The main lines of the laws of 4 April and 3 May , in force from 2 June , are thus: 'Belgium is moving towards a policy of normalisation. This in no way means a policy of tolerance or legalisation of certain substances. It is based upon the following key points: 'Sanctions for illicit production or trafficking are strengthened; 'Possession or cultivation of cannabis remains an offence. In cases of personal use ie possession of a quantity of cannabis which can be consumed in one time only, or at maximum in 24 hours, namely 3 grammes , a simplified police report place, date and time of facts, type and use will be made. In case of problematic use, the prosecutor will be notified and may recommend treatment. A case of public nuisance will be passed to the prosecutor. Problematic use would mean a degree of dependence which prevents the user from controlling his consumption, shown either by physical or psychological symptoms. Public nuisance would mean possession of cannabis in prison, in an educational establishment or in the building of a social service, as well as in their immediate surroundings or in other places frequented by minors that may be of an educational, sporting, or social nature. Indeed, even recreational use by adults in the presence of minors will be prosecuted in the most severe manner. In , the Belgian government agreed to stop prosecution for use of cannabis and cultivation of cannabis for personal use, on the grounds that it did not constitute a nuisance and was not problematic Decorte, However, it was not until that guidelines outlining what was permitted were implemented. Under the new guidelines, cultivation of cannabis for personal use one female plant and possession of up to 3 grams are no longer grounds for prosecution Decorte, The action to be taken in cases of larger amounts is left to the discretion of the prosecutor, leaving the boundaries of cultivation limits unclear. This test replaces the former procedure of urinalysis, which was considered to be too complex and too time-consuming for the police authorities see also Chapter 9. Besides these objections, questions were raised whether the urinalysis and the ensuing blood sample analysis were reliable. The former detected the presence of THC even when the subject was no longer in a state of modified consciousness. The first Royal Decree regulates the checklist that precedes the oral fluid test to assess the indications of recent drug use; the second Decree regulates the ensuing blood analysis to determine the amount of drugs used. It replaces the previous circulars on this matter and comes into force on October 1st , at the same time as the oral fluid drug testing. The circular also elucidates the former mentioned Royal Decrees. In , the organisation of the needle exchange programme was reorganised, resulting in a lack of data for that year. On top, more than 10 other services distribute injection equipment. However, the number of syringes distributed within the later services is unknown. Home Belgium. Prevalence of Drugs Other Than Cannabis Among Young People in Belgium 'Results of the VAD school survey show that the use of illicit psychoactive substances other than cannabis was rather limited in the population of school students Melis, Drug Law Offenses in Belgium, by Type 'Drug use and possession are reported together as one offence since , as individual drug use implies the possession of drugs. Prison Population 'The Belgian prison population increased with Trafficking and Transshipment 'Information about the trafficking patterns for drugs in Belgium is also provided by the Belgian federal police. Home Cannabis Cultivation 'A recent overview of the research and police data on cannabis cultivation in Belgium and The Netherlands Decorte , pointed to the fact that the small-scale home growers constitute an important segment of the Belgian cannabis market. Prevalence of Injection Drug Use 'In , the prevalence rate per inhabitants, aged years of ever-IDUs was estimated to be 1. Injection Drug Users in Contact with Syringe Exchange in the Flemish Region 'Data on injecting drug users frequenting the syringe exchange programmes located in Flanders are collected using a structured, voluntary, anonymous questionnaire since Windelinckx Drug-Related Mortality 'In , 78 drug-induced deaths were observed in the Flemish region, which is the highest number observed since Five Main Principles of Belgian Drug Policy 'The Federal Drug Policy Note of was based on the conclusions and recommendations of the Parliamentary workgroup Drugs of and stated the five main principles of the Belgian drug policy: i a global and integrated approach; ii evaluation, epidemiology and scientific research; iii prevention for non- problematic users; iv treatment, risk-reduction and reintegration for problematic users and v repression for producers and traffickers. Clarifying Cannabis Policy 'Following the ambiguity regarding the legal status of cannabis use Gelders and Vander Laenen , the Communal Declaration chose to emphasise the actual intention of the Belgian drug policy. Penalties for Offenses 'In Belgium, the legislative reform concerning the use of drugs and their possession for use took effect in June following the adoption of four new texts Cannabis Laws 'In Belgium, a change in the law and a new prosecution directive were enacted in the first half of Cannabis Laws 'In January , the Belgian Government adopted a Policy Note in which it expressed the intention to modify the main drug law in order to reduce the penalty in the case of non-problematic use of cannabis. Legal Definition of Personal Use and Allowable Amounts of Cultivated Cannabis 'Policy changes in Belgium in relation to cannabis use, possession and cultivation may also have had some impact on the shift in production from the Netherlands to Belgium. Drugged Driving and Oral Fluid Testing 'The Act of July 31th which introduces the oral fluid drug testing in traffic, became operational the first of October Needle and Syringe Exchange Policies 'To reduce the spread of infectious diseases and other health risks among injecting drug users, as well as to reduce the risk to the general population by recuperation of used needles, syringe exchange programmes distribute injecting material and additional prevention material cf.

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