The national focal point is located within the Epidemiology Unit of the Scientific Institute of Public Health (IPH). The IPH is a state (federal) scientific organisation and implements policies in response to the legal framework and priorities of the Federal Minister for Health and the President of the Federal Public Service for Health, Food Chain Security and the Environment. The IPH provides support for public health policy through scientific research, expert opinions and the work carried out by its departments. On the basis of scientific research, the IPH formulates recommendations and solutions in respect of priorities for a proactive health policy at the national, European and international level. The main tasks of the drugs programme of the IPH include the monitoring, collection, analysis and dissemination of drug-related information. It also maintains an early warning system on synthetic drugs.
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In 2013 the fifth National Health Interview Survey (NHIS) was carried out among the general population, with a sample size of 4 931 people aged 15–64. It included questions on cannabis, cocaine, amphetamines, ecstasy and opiate use. Lifetime prevalence of cannabis use was reported by 15.0 % of respondents aged 15–64, compared with 14.3% in 2008, 13.0 % in 2004 and 10.7 % in 2001. Last year prevalence of cannabis use was reported by 4.6 % of all respondents. Recent cannabis use is more prevalent among younger age groups, thus 12.2 % of those aged 15–24 had used cannabis at least once in the last year, and is more prevalent among males than females. The 2013 study observed a decline in the last year use of cocaine and amphetamines among all respondents, when compared to data from 2008.
The Health Behaviour in School-aged Children (HBSC) study was carried out in the Flemish and French communities in 2009–10 among a representative sample of students aged 12–18. In both communities cannabis was the drug most frequently reported by students aged 15–16, with 21 % in the Flemish community and 20 % in the French community reporting that they had used cannabis at least once in their lives. In both communities an increase in the lifetime prevalence of cannabis was noted by age: among respondents aged 18 some 39 % of the Flemish community and 44 % of the French community had used cannabis at least once. There were signs of a reduction in the lifetime prevalence of cannabis use among students in both communities compared to 2006 data. Results of the 2013–14 HBSC study in the French community indicated that 26 % of male students and 18% of female students aged 15–16 had used cannabis at least once in their lifetime.
In 2011 the European School Survey Project on Alcohol and Other Drugs (ESPAD) was repeated among students aged 15–16 in the Flemish community. Lifetime prevalence of cannabis use was 24 %, and was higher among males (28 %) than females (21 %). Regarding other drugs, lifetime prevalence was 7 % for inhalants, 5 % for amphetamines and 4 % for ecstasy and for cocaine. Last year prevalence of cannabis use was 20 % and last month prevalence was 11 %.
The most recent data on illicit substance use among school students aged 12–18 are available from the 2012–13 and 2013–14 VAD (association for alcohol and other drug problems) school survey study. The study confirms the prevailing use of cannabis among the population of school students and corroborates stable lifetime cannabis trends reported in other studies, while the 2013–14 study indicates an increase in last year prevalence, which should be examined in further studies.
Regular studies on psychoactive substance use in recreational and nightlife settings have been conducted in the Flemish and the French communities. Although both communities utilised different sampling methods, which makes the results of these studies neither comparable nor generalisable, the findings indicated that cannabis is by far the most popular illicit substance in nightlife settings in these communities.
The organisation, implementation and monitoring of prevention activities is the responsibility of Belgium’s communities and regional governments, and for this reason strategies for drug prevention differ significantly across the three language communities. For example, in the Flemish community substance use prevention is carried out following a Flemish tobacco, alcohol and drugs action plan for 2009–15 and is oriented towards actors in the education and health sectors, while in the French community the approach is one of global health promotion implemented through community plans, with a focus on social integration and access to decent housing and health services. In the German community the Association for Addiction Prevention and Life Management (ASL) provides all prevention activities. There are also commonalities in the implementation of drug prevention, such as a focus on strengthening the network of field workers available to young people, innovative programmes for children and families and robust efforts to implement environmental strategies in recreational settings.
The differences between the communities are particularly accentuated in the case of universal school-based prevention programmes. The prevention activities in primary school settings focus on licit substances, but remain rare across the communities. The French community follows a model in which specialised associations or internal services provide awareness raising, training or counselling in schools, mostly targeting educators and teachers. Addiction Support Points, created in 2007, are interfaces between schools and other structures involved in prevention activities, such as police, municipal organisations and associations. In the Flemish community programme-based comprehensive interventions have been adopted within the secondary school setting. A range of manualised programmes is used, including Unplugged. The ASL drug prevention activities in the German community’s schools are implemented in the wider context of lectures on rights, duties and risks in society. In addition to school-based universal prevention interventions, the communities also develop and implement activities focusing on parenting skills, and the French and Flemish communities provide telephone and email helplines, and increasingly develop online early intervention services that are easily accessible.
In Belgium selective prevention activities are mainly oriented towards ethnic minorities, young people with special needs and a mild mental disability, marginalised people, drug-using parents and their children, and people in recreational settings.
Between September 2011 and February 2013 a pilot project was coordinated in the Flemish community that organised preventive actions towards young people from ethnic minorities, and in 2014 a new project oriented towards parents from ethnic minorities was initiated. In 2011 special guidance was issued on how to organise drug use prevention with mentally handicapped young people, while in Limburg province a programme for young people with special educational needs has been implemented. In the French community attention was given to peer prevention programmes targeting marginalised people (for example, people who are homeless).
In recreational settings selective prevention is mostly limited to the dissemination of information through information stands, peer prevention and websites targeted at partygoers, or through mobile teams whose aim is to intervene at locations (generally at large festivals) where there is significant (often synthetic) drug use. The Quality Nights Charter is a health promotion label in recreational settings, used in both the Flemish and the French communities, and is part of a European network of ‘safer party’ labels. It aims to improve the health and safety of people attending festivals, parties, etc. by certifying that the organisers and operators of events have complied with specific health and welfare standards. A simpler version of Quality Nights is being developed for implementation in smaller settings and events. A number of other projects also operate in recreational settings and events in these communities.
Indicated prevention activities are increasingly available in Belgium. Indicated prevention activities in the Flemish community include promoting screening and early interventions at the primary healthcare level using the ASSIST instrument, which was made available in the Dutch language in 2010. Another project, SBIRT, focuses on brief interventions and referrals to treatment for young people admitted to emergency departments with substance use problems. An early intervention in other settings for young people has also been developed, and a number of online self-care and self-help tools are available in the Flemish and French communities. Some early intervention and motivational interviewing programmes are available in the German community.
Up to 2012 the EMCDDA defined problem drug use as injecting drug use or long duration/regular use of opiates, cocaine and/or amphetamines. However, in 2012 a new definition of ‘high-risk drug use’ was adopted. The new definition includes ‘problem drug use’, but is broader (mainly in its inclusion of high-risk use of more substances). Details are available here.
No population-size estimate of high-risk opioid users is available for Belgium. A national estimate of the number of injecting drug users (ever injected) is derived annually using the human immunodeficiency virus (HIV) multiplier method. The 2014 study indicated no significant changes in the size of the ever-injected drug use population over the past 10 years, and estimated that there were between 17 638 and 35 699 people who had ever inject drugs in Belgium, with a prevalence rate of 3.5 per 1 000 residents aged 15–64 (sensitivity interval: 2.4–4.9).
Based on the 2013 national health interview survey, it is estimated that 0.5 % of 15- to 64-year-olds used cannabis daily or almost daily, which characterises a frequent use pattern.
The treatment demand indicator (TDI) registration was officially approved by the Inter-Ministerial Conference on Public Health in 2006. In 2008 the first treatment demand data were reported. In 2010 a new TDI registration protocol (based on TDI 2.0) was adopted and this was operational from 2011, while the new TDI 3.0 was adopted in 2013 and has been implemented from 2015 on.
Treatment demand data for Belgium for 2014 was based on data received from 131 specialised outpatient and inpatient treatment centres and nine low-threshold agencies. General practitioners (GPs) and prisons are not part of the registration system, which may imply a lack of those treatment providers (particularly GPs). Nevertheless, there has been a steady increase in the number of reporting facilities in Belgium in the past years, which is also reflected in the number of clients entering treatment. In 2014 a total of 10 702 clients entered treatment, of which 3 773 were new clients entering treatment for the first time.
In 2014 the majority of treatment demands were related to cannabis (3 501 or 33 %), followed by opioids at 3 079 (29 %) and cocaine at 1 809 (17 %). Among new treatment clients more than half (53 %) reported cannabis (1 984 clients) as the primary substance of abuse, followed by cocaine at 628 (17 %), opioids at 434 (12 %) and stimulants at 423 (11 %). Since 2011 a steep increase in cannabis treatment demands and reduction in opiate treatment demands has been observed. The increase in cannabis treatment demands is partially attributed to the increased number of referrals from the judicial system. An increase in the number of clients entering treatment for primary use of stimulants other than cocaine has also been observed in the last years. In general, one in six of all and also new opioid treatment clients reported injecting drug use.
In 2014 the mean age of all clients entering treatment was 32 years, while new treatment clients were on average 29 years old. With regard to gender, 77.8 % of all treatment clients were male. A similar gender distribution was reported for new treatment clients.
In Belgium, cases of HIV and acquired immune deficiency syndrome (AIDS) are registered at the Scientific Institute of Public Health. In 2014 eleven people who were diagnosed with HIV reported injecting drug use as the probable mode of transmission, which is about 1.1 % of all newly registered HIV cases.
Data on the infection rates of HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) among people who inject drugs (PWID) are available in Belgium from various sources. In the Flemish community data are based on biological tests for a selected sample of people who had ever injected drugs who were in contact with a medical doctor, and these are made available through De Sleutel, an institution composed of several ambulatory and residential treatment centres. Another data source is the outpatient clinic Free Clinic, located in Antwerp, whose data are based on voluntary blood screening offered to patients on a regular basis. There were no positive testing results for HIV among PWID tested in De Sleutel, while 5.7 % of Free Clinic clients tested positive for HIV. HCV and HBV prevalence rates are also obtained from the same data sources, while in 2014 additional data on HCV from medical social care centres in the Flemish-Brabant region became available. HCV prevalence rates among PWID also fluctuate between testing sites, with 7.5 % of PWID testing positive in the Flemish-Brabant region, 27.5 % in De Sleutel and 75.2 % in the Free Clinic. The HBV infection rate among PWID, measured by positive aHBc, ranged from 4.2 % among De Sleutel clients to 49.0 % among Free Clinic clients. In terms of HIV prevalence rates and trends, there has been a decline in HIV infection rates reported by the French part of the country since 1994, and by the Flemish institution De Sleutel since 1998, while in the last nine years the prevalence rates have fluctuated and no clear trends are visible. In addition, the results of HCV and HBV testing do not reveal significant time trends in the last nine years.
In Belgium, drug-induced deaths are recorded in the General Mortality Register located at the National Institute of Statistics. Data extraction and reporting are in line with the EMCDDA definitions and recommendations.
Recent national data are missing as a result of delays at the level of the French and the Flemish communities. The latest available data at the national level are for 2012. In 2012 a total of 72 drug-induced death cases were registered, indicating a remarkable decrease compared to 2007–10 when, respectively, 118, 146, 155 and 106 drug-related deaths were reported annually. The latest figures are similar to the level of deaths reported in 2004. In 2012 a total of 53 drug-induced deaths were male and the average age was 42 years. All deaths were toxicologically confirmed. Less than half (21 cases) were related to mixed and unspecified substances, and 41 involved opiates.
The drug-induced mortality rate among adults aged 15–64 was nine deaths per million in 2012 (latest data available), which is below the most recent European average of 19.2 deaths per million.
The national drug strategy document, the Federal Drug Policy Note of 2001, specifies that the treatment offer should be based on a multidisciplinary approach adapted to the complex bio-psychosocial problem of addiction. This approach was further emphasised in the Communal Declaration of 2010 and elaborated in the Joint Statement of the Inter-Ministerial Conference on Drugs held in 2010. In Belgium competences concerning treatment are split between the federal and federate governments, but are coordinated nationally. A new State Reform is progressively applied in the country and will impact on the organisation of drug treatment organisations. A range of services for drug use treatment and/or healthcare is available in a large part of the country, except in the German community where there are no specialist treatment centres for drug users.
The primary care network encompasses general practitioners (GPs), general welfare centres, domiciliary help services, youth advice centres and public centres for social welfare, which provide outpatient treatment. Specialist outpatient care is provided by specialised consultation and day-care centres, medical and social care centres. In general, these centres provide low-threshold help or social reintegration services, including a wide range of psychosocial, psychological and healthcare services, and opioid substitution treatment (OST). Inpatient treatment consisting of detoxification, stabilisation and motivation, and social reintegration is offered at hospital-based residential drug treatment units and specialised crisis intervention centres, which provide the care based on case-management principles, at specialist hospital units or in long-term residential treatment services. Most aftercare and reintegration programmes are delivered in outpatient and inpatient structures. For example, there are halfway houses in therapeutic communities, day treatment in drug centres and employment rehabilitation programmes. Action has recently been taken to improve treatment for clients with a dual diagnosis or polydrug use and for children and young people, especially for cannabis use, while a pilot project exploring a community reinforcement approach combined with a voucher treatment method has shown promising results for the treatment of cocaine users. A new treatment programme for young cannabis users has also been piloted.
Consensus guidelines for OST have existed in Belgium since 1994. Nevertheless, treatment with substitution substances (such as methadone and buprenorphine) was still a crime until 2002. In 2002 the Law on the Legal Recognition of Substitution Treatment was adopted, and in 2004 a Royal Decree on OST that mentions methadone and buprenorphine as substitution substances was adopted. In the Flemish region most OST programmes (for which both methadone and buprenorphine are used) are provided by low-threshold, ambulatory and outpatient drug services. However, in smaller towns and rural areas methadone or buprenorphine may also be prescribed by GPs under the supervision of drug services. In the French community a broad range of agencies such as low-threshold facilities, GPs, outpatient specialised units and mental health facilities, and pharmacies offer access to both methadone and buprenorphine, though GPs still play the most important role in prescribing the treatment. According to the latest available estimates (2014) a total of 17 026 clients were on OST in Belgium, 15 213 of which were on methadone and 2 471 on buprenorphine (with a proportion of the patients receiving both substances). Between 2011 and 2013 an open-label randomised controlled trial was carried out comparing heroin-assisted treatment and methadone maintenance treatment. The study concluded that the use of heroin-assisted treatment should remain a second line treatment in patients who have resistance to methadone, and recommendations were provided for setting up a heroin-assisted treatment programme.
Needle and syringe programmes (NSPs) have existed in the French community since 1994. In 1998 a law was adopted allowing needle exchange in pharmacies. In 2000 the Flemish community made the necessary legislative adaptations, and from 2001 such programmes have also officially been implemented there. These programmes (stationary, mobile or in pharmacies) are now available across the country, except in the German community. In general, harm reduction projects are set up by non-governmental organisations, and some are managed by city authorities. In the French community these projects are funded by the Federal Public Service Home Affairs. In the Flemish community the projects are funded by the community itself. The harm reduction programmes offer sterile injecting material (syringes, filters, ascorbic acid, spoons, alcohol swabs, injectable sterile water), foil, bicarbonate and containers, and also collect used syringes and needles. In addition, these programmes facilitate the referral of PWID to other prevention and treatment services.
Approximately 926 000 syringes were distributed through 51 specialised agencies and 14 sites serviced by outreach workers, coordinated by the Free Clinic in the Flemish community and by Modus Vivendi in the French community in 2014; however, this number may be underestimated as some NSPs do not report on distributed sterile injecting equipment. In addition to syringe provision by specialised agencies, pharmacies in the French and Flemish communities distribute a substantial number of syringes. In the French community syringes are distributed mainly as part of the subsidised ‘Sterifix’ kit (5 230 kits dispatched in 2014). Annual evaluations of the needle and syringe programmes in the Flemish region indicate that pharmacies can play an important role in the provision of injecting material, as almost two-thirds of NSP clients report purchasing injecting material from pharmacies. It is important to note that not every province has a good geographical spread of NSPs. Moreover, in Belgium there are no programmes providing sterile injecting equipment to prisoners. In the prevention and control of infectious diseases among PWID, special emphasis has been given to HCV counselling and testing in the recent years.
Belgium has an important position with regard to the production of cannabis and synthetic drugs (mostly MDMA, amphetamines and also, recently, new psychoactive substances), with remarkably strong connections with drug production in the neighbouring Netherlands. Growing operations or drug laboratories are most often concentrated in the border region, sometimes with common production chains. Drugs produced in Belgium are mainly exported to other European countries. In 2014 thirty illicit synthetic facilities were dismantled in Belgium. Belgium is also a transit zone for new psychoactive substances (NPS), which frequently originate in China and are destined for neighbouring countries or other European Union (EU) countries. Eighty-one NPS were reported in Belgium in 2014. The port of Antwerp is one of the largest container ports in the world, and is pivotal in international drug trafficking, as are Brussels airport and Liège airport.
A steady increase in the number of cannabis plants seized annually in Belgium was registered from 2006 till 2013, when the record number of 396 758 cannabis plants were seized from 1 212 plantations. In 2014 a total of 356 388 cannabis plants were seized from more than 1 250 plantations. In 2013 a record amount of 14 882.32 kg of herbal cannabis was reported, while in 2014 the amount seized was slightly lower at 10 744 kg. It is notable that some of the cannabis products cultivated in Belgium are intended for export to the Netherlands. However, Belgium also remains a transit country for cannabis products trafficking from African countries, Thailand, Mexico and Jamaica, predominantly for markets in the Netherlands and Ireland. Cannabis resin of Moroccan origin is mainly trafficked into the country by road. In 2013 there was an exceptionally large seizure of cannabis resin, which originated from Pakistan, and this led to an increase in the reported amount of cannabis resin seized to 4 274.64 kg, while in 2014 the amount seized was the lowest in the past decade at 841 kg. Cocaine is the second most frequently seized substance. It is smuggled into Belgium predominantly via air or sea from South and Central America, and also, in recent years, via express mail companies. Most of the cocaine arriving in Belgium is destined for the Netherlands or other EU countries. In 2014 a total of 9 293 kg of cocaine was seized, which is the second largest amount reported since 2004. Heroin seized in Belgium often comes from Turkey, but African countries and Pakistan are also mentioned. The trend in the number of heroin seizures continued to reduce compared to previous years, and 149 kg of the substance was seized in 2014, which is almost nine times less than in 2013. Following a reduction in the quantities of ecstasy and amphetamines seized in 2012, in 2013–14 the amounts seized increased, indicating further recovery in the ecstasy market. In 2014 a total of 44 422 tablets containing MDMA were seized. Furthermore, the available data indicate that ecstasy tablets in the market are of increased purity, while the prices have generally fallen as a response to the greater availability of new precursors. In 2013 almost 38 kg of methamphetamine was seized, while in 2014 the amount seized was four times smaller at 9 kg.
Data from the federal police indicates 48 727 drug-law offences in Belgium in 2014. Two-thirds of all drug-law offences were use-related, and cannabis remains the drug most commonly involved, at 29 825 of all drug-law offences.
The use of controlled substances is not mentioned as an offence in Belgian drug laws; however, a user may be punished on the basis of prior possession. In 2003 personal possession of cannabis was differentiated from the possession of other controlled substances. The concepts of problem drug use and public nuisance were also introduced. The new status of cannabis allowed the public prosecutor not to prosecute possession 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 2005 called for full prosecution for possession in cases where the ‘user amount’ (3 grams or one plant) is exceeded, public order is disturbed or aggravating circumstances are identified. This includes possession of cannabis in or near places where schoolchildren might gather and also ‘blatant’ possession in a public place or building. Such cases are punishable by three months to one year in prison and/or a fine of EUR 1 000–100 000. In cases that lack such circumstances, personal possession of cannabis is punishable by a fine, which should be higher for any offence within one year of a previous conviction.
For drugs other than cannabis, Belgian law punishes possession, production, import, export or sale without aggravating circumstances with between three months and five years of imprisonment and an additional fine of EUR 1 000–100 000. There is no separate offence of ‘trafficking’, but the term of imprisonment may be increased to 15 or even 20 years in the event of various specified aggravating circumstances. In situations like this, the fine is optional.
In 2014 the law was adapted to allow controlled substances to be listed according to generic group definitions. This generic legislation comes into effect in 2016. To curb the plethora of novel substances appearing in Belgium, the list of controlled substances has been updated in November 2015 to include over 100 NPS.
The federal drug policy of Belgium is expressed in two key policy documents, the Federal Drug Policy Note of 2001 and the Communal Declaration of 2010.
Although it did not have a defined timeframe, the Federal Drug Policy Note was adopted as a long-term document designed to provide a comprehensive approach through its focus on illicit and licit substances, including alcohol, tobacco and medicines. The Federal Drug Policy Note’s main goal is the prevention and limitation of risks for drug users, their environment and society as a whole. Three pillars are used to articulate the comprehensive approach taken, covering the areas of: (i) prevention of drug consumption; (ii) harm reduction, assistance and re-integration; and (iii) enforcement. In addition, provision was made for the establishment of a system of coordination units at the federal level, integrating representatives of the federal state, the regions and the communities. The five main principles of Belgian drug policy are stated in the Federal Drug Policy Note: (i) a global and integrated approach; (ii) evaluation, epidemiology and scientific research; (iii) prevention for non-users and risk reduction for problematic drug use; (iv) treatment, risk reduction and reintegration for problematic users; and (v) repression of producers and traffickers.
The Communal Declaration of 2010 provided a further statement and confirmation of the approach set out in the Federal Drug Policy Note. As a result, the Communal Declaration can be considered a more up-to-date elaboration of Belgian policy, rather than a replacement of the earlier document. In this sense, the action points stated in the Federal Drug Policy Note were assessed in terms of the extent to which they had been achieved, with additional steps to be taken, in the Communal Declaration. There are three overarching measures in the Communal Declaration: (i) a global and integrated approach; (ii) scientific research; and (iii) international coherence. Three pillars are used to structure action: (i) prevention, early detection and early intervention; (ii) treatment and harm reduction; (iii) repression (as a last resort). Priorities are focused on different groups within the three pillars, with prevention targeting non-(problematic) users; treatment, risk-reduction and reintegration aimed at problematic users; and repressive measures directed at producers and traffickers. Overall, the Communal Declaration interprets the drugs problem as a public health issue.
Following the sixth state reform a number of competencies related to drug policy were transferred from the federal to the federate levels. Each of the different regions in Belgium has its own drug strategy/action plan.
The General Drugs Policy Cell is responsible for both policy development and overall coordination in Belgium. As such, it operates at the inter-ministerial level as well as the day-to-day operational level. Following the ratification of a cooperation agreement between the State and the different federal levels in September 2002, the General Drugs Policy Cell has been fully operational since 2009. As well as being responsible for the coordination of a global and integrated drug policy in Belgium, the General Drugs Policy Cell is tasked with supporting and advising the different Belgian governments. It is coordinated by the national drug coordinator and supported by the Federal Public Service of Health, Food Chain Safety and Environment. The General Drugs Policy Cell includes 17 federal government representatives and 18 regional government representatives; it is composed of members from all relevant authorities. Three different cells support the work of the General Drugs Policy Cell: (i) the Drugs Health Policy Cell, established in 2001; (ii) the Research and Scientific Information Cell, operational since 2011; and (iii) the Control Cell, located at the Federal Public Service of Health, Food Chain Safety and Environment.
Functioning as an inter-governmental coordination and decision-making body, the Inter-Ministerial Conference on Drugs became operational in 2008 as a result of the 2002 cooperation agreement. The Conference’s members include all relevant ministers. While the General Drugs Policy Cell undertakes policy and coordination work, the Conference executes the proposals that are put forward by the Cell. The main activities of the Conference include:
The Inter-Ministerial Conference on Public Health is a key forum in the coordination of drug policy between the Federal and Federate levels. It holds thematic meetings to which relevant ministers are invited and works alongside the General Drugs Policy Cell to coordinate Belgium’s federal drug policy.
The Belgian drug policy note of 2001 had no associated comprehensive budgets (1). Prior to 2012 authorities had funded three successive studies of drug-related public expenditure for 2001, 2004 and 2008. Estimates were based on a well-defined methodology. In 2012 authorities decided to start estimating drug-related public expenditure on an annual basis.
The most recent study, concerning 2012, estimated that the total drug-related public expenditure (2) at the national level represented 0.16 % of gross domestic product (GDP). The total expenditure was divided into five areas (Table 1): law enforcement (68.8 %), treatment (29.9 %), prevention (0.9 %), harm reduction (0.3 %) and others (0.1 %). Trend analysis shows that from 2004 to 2008 drug-related public expenditure remained stable at 0.11 % of GDP and increased to 0.16 % in 2012.
Table 1: Total drug-related public expenditure, 2012
Drug policy area
% of total
% of GDP
Source: Vander Laenen et al. (2015).
(1) Some of the regions have budgets accompanying their policy notes.
(2) Some of the funds allocated by governments for expenditure on tasks related to drugs are identified as such in the budget (‘labelled’). Often, however, the bulk of drug-related expenditure is not identified (‘unlabelled’) and must be estimated by modelling approaches. The total budget is the sum of labelled and unlabelled drug-related expenditures.
The federal drug strategy provides a budget for scientific research in the drug field, which is managed by the Federal Science Policy Office through a research programme to support federal policy. Most studies funded through this programme are executed by networks of researchers, and the emphasis is mainly placed on drug treatment and on drug-related crime and nuisance. The national focal point collects information on ongoing and completed studies through its network of partners, and disseminates information on drug-related research findings to audiences through a variety of channels. Recent studies have mainly focused on aspects related to public expenditures, prevalence, the patterns and consequences of drug use, new psychoactive substances, prevention, harm reduction, guidelines, treatment and the mechanisms of drug use and effects.
|Problem opioid use (rate/1 000)||:||:||0.2||10.7|
|All clients entering treatment (%)||2014||28.8%||4%||90%|
|New clients entering treatment (%)||2014||11.5%||2%||89%|
|Purity — heroin brown (%)||2014||1||22.2%||7%||52%|
|Price per gram — heroin brown (EUR)||2014||EUR 25||EUR 23||EUR 140|
|Prevalence of drug use — schools (%)||2011||4.0%||1%||5%|
|Prevalence of drug use — young adults (%)||2013||0.9%||0%||4%|
|Prevalence of drug use — all adults (%)||2013||0.5%||0%||2%|
|All clients entering treatment (%)||2014||16.9%||0%||38%|
|New clients entering treatment (%)||2014||16.6%||0%||40%|
|Price per gram (EUR)||2014||2||EUR 57.00 - EUR 49.54||EUR 47||EUR 107|
|Prevalence of drug use — schools (%)||2011||5.0%||1%||7%|
|Prevalence of drug use — young adults (%)||2013||0.5%||0%||3%|
|Prevalence of drug use — all adults (%)||2013||0.2%||0%||1%|
|All clients entering treatment (%)||2014||9.8%||0%||70%|
|New clients entering treatment (%)||2014||9.4%||0%||75%|
|Price per gram (EUR)||2014||2||EUR 9.50 - EUR 12.00||EUR 3||EUR 63|
|Prevalence of drug use — schools (%)||2011||4.0%||1%||4%|
|Prevalence of drug use — young adults (%)||2013||0.8%||0%||6%|
|Prevalence of drug use — all adults (%)||2013||0.3%||0%||2%|
|All clients entering treatment (%)||2014||0.6%||0%||2%|
|New clients entering treatment (%)||2014||0.9%||0%||2%|
|Purity (mg of MDMA base per unit)||2014||125 mg||27 mg||131 mg|
|Price per tablet (EUR)||2014||2||EUR 4.90 - EUR 5.81||EUR 4||EUR 16|
|Prevalence of drug use — schools (%)||2011||24.0%||5%||42%|
|Prevalence of drug use — young adults (%)||2013||10.1%||0%||24%|
|Prevalence of drug use — all adults (%)||2013||4.6%||0%||11%|
|All clients entering treatment (%)||2014||32.7%||3%||63%|
|New clients entering treatment (%)||2014||52.6%||7%||77%|
|Potency — herbal (%)||2014||13.0%||3%||15%|
|Potency — resin (%)||2014||19.2%||3%||29%|
|Price per gram — herbal (EUR)||2014||2||EUR 8.70 - EUR 9.68||EUR 3||EUR 23|
|Price per gram — resin (EUR)||2014||2||EUR 9.10 - EUR 9.61||EUR 3||EUR 22|
|Prevalence of problem drug use|
|Problem drug use (rate/1 000)||:||:||2.7||10.0|
|Injecting drug use (rate/1 000)||2014||3.5||0.2||9.2|
|Drug-related infectious diseases/deaths|
|HIV infections newly diagnosed (cases / million)||2014||1.0||0.0||50.9|
|HIV prevalence (%)||:||:||0%||31%|
|HCV prevalence (%)||:||:||15%||84%|
|Drug-related deaths (rate/million)||2014||9.0||2.4||113.2|
|Health and social responses|
|Syringes distributed||2014||926 391||382||7 199 660|
|Clients in substitution treatment||2014||17 026||178||161 388|
|All clients||2014||10 702||271||100 456|
|New clients||2014||3 773||28||35 007|
|All clients with known primary drug||2014||10 702||271||97 068|
|New clients with known primary drug||2014||3 773||28||34 088|
|Drug law offences|
|Number of reports of offences||2014||48 727||537||282 177|
|Offences for use/possession||2014||35 320||13||398 422|
b Break in time series.
p Eurostat provisional value.
: Not available.
1 Gross domestic product (GDP) is a measure of economic activity. It is defined as the value of all goods and services produced less the value of any goods or services used in their creation. The volume index of GDP per capita in Purchasing Power Standards (PPS) is expressed in relation to the European Union (EU-27) average set to equal 100. If the index of a country is higher than 100, this country's level of GDP per head is higher than the EU average and vice versa.
2 Expenditure on social protection contains: benefits, which consist of transfers in cash or in kind to households and individuals to relieve them of the burden of a defined set of risks or needs.
3 Unemployment rates represent unemployed persons as a percentage of the labour force. Unemployed persons comprise persons aged 15 to 74 who were: (a) without work during the reference week; (b) currently available for work; (c) actively seeking work.
4 Situation of penal institutions on 1 September, 2014.
5 Share of persons aged 0+ with an equivalent disposable income below the at-risk-of-poverty threshold, which is set at 60 % of the national median equivalised disposable income (after social transfers).
|Year||Belgium||EU (28 countries)||Source|
|Population||2014||11 203 992||506 944 075 bep||Eurostat|
|Population by age classes||15–24||2014||11.9 %||11.3 % bep||Eurostat|
|25–49||33.6 %||34.7 % bep|
|50–64||19.7 %||19.9 % bep|
|GDP per capita in PPS (Purchasing Power Standards) 1||2014||119||100||Eurostat|
|Total expenditure on social protection (% of GDP) 2||2013||30.2%||:||Eurostat|
|Unemployment rate 3||2015||8.5 %||9.4 %||Eurostat|
|Unemployment rate of population aged under 25 years||2015||
|Prison population rate (per 100 000 of national population) 4||2014||117.9||:||Council of Europe, SPACE I-2014.1|
|At risk of poverty rate 5||2014||15.5 %||17.2 %||SILC|
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