Belgium Country Drug Report 2018

Drug harms

Drug-related infectious diseases

In Belgium, cases of human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) are registered at Sciensano.

The proportion and number of new HIV cases linked to injecting drug use have fallen since the mid-1980s, and in 2016 only three new cases of HIV or AIDS were linked to injecting drug use. In terms of HIV trends among people who inject drugs (PWID), there has been a decline in HIV prevalence rates, reported by the French Community since 1994 and by the Flemish Community since 1998, although, in the last 10 years, the prevalence rates have fluctuated and no clear trends are visible. Hepatitis C and B virus (HCV and HBV) prevalence rates among PWID also varied between testing sites; however, many estimates are based on relatively small samples. In 2014, HIV prevalence was reported at 5.7 % among 370 PWID attending Free Clinic (an initiative in the Flemish Community), while almost half were HCV positive. Available data suggest that, of people who have ever injected drugs, half or fewer have been vaccinated against HBV.

Various data sources and additional studies indicate that some high-risk use patterns, such as sharing of needles or syringes, as well as ‘slamming’ (or injecting drugs in a sexual context) among men who have sex with men, have been observed among specific subgroups of people who use drugs in Belgium.

 

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Drug-related emergencies

Information on drug-related emergencies for Belgium is available from crisis intervention centres (CICs) and the Belgian Early Warning System on Drugs. The information from eight CICs suggests that there has been a decline in admissions — and hence in potential non-fatal intoxications — since 2011. In 2016, 692 people were admitted to CICs as a result of illicit drug use. The drugs most commonly linked to admissions were opioids (involved in one third of cases), followed by cocaine, other stimulants and cannabis.

The emergency rooms of the hospitals UZ Ghent and ZNA Stuivenberg in Antwerp participate in the European Drug Emergencies Network (Euro-DEN Plus) project, which was established in 2013 to monitor acute drug toxicity in sentinel centres across Europe.

 

Drug-induced deaths and mortality

Drug-induced deaths are deaths that can be attributed directly to the use of illicit drugs (i.e. poisonings and overdoses).

In Belgium, drug-induced deaths are recorded in the General Mortality Register located at the National Institute of Statistics and the latest available data at the national level are for 2014. Overall, the number of drug-induced deaths has been declining since 2009, with a stabilisation in numbers in 2012-14. Opioids (mainly heroin, but also fentanyl and derivatives) were involved in more than half of all toxicologically confirmed drug-induced deaths that were reported in 2014. The majority of the victims were male.

An additional source of information, the Early Warning System on Drugs, reported 60 drug-induced deaths in 2016, which were mainly caused by polydrug use, with opioids (typically heroin and methadone) being involved in more than half of those cases. New psychoactive substances, including synthetic fentanyl analogues, were implicated in at least five deaths.

The drug-induced mortality rate among adults aged 15-64 years was 8.19 per million in 2014 (latest data available), which is below the most recent European average of 21.8 per million.

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Methodological note: Analysis of trends is based only on those countries providing sufficient data to describe changes over the period specified. The reader should also be aware that monitoring patterns and trends in a hidden and stigmatised behaviour like drug use is both practically and methodologically challenging. For this reason, multiple sources of data are used for the purposes of analysis in this report. Caution is therefore required in interpretation, in particular when countries are compared on any single measure. Detailed information on methodology and caveats and comments on the limitations in the information set available can be found in the EMCDDA Statistical Bulletin.