The Directorate General of the Penitentiary Institutions is responsible for the Belgian prison system. The Ministerial Circular Letter of 18 July 2006 regulates the principles of an integral and integrated prison drug policy as implied by the Federal Drug Policy Note of 2001. It also stresses the importance of the active detection of drug use and related health and psychiatric problems.
In 2009, data on drug use among prisoners were collected in two Belgian prisons and showed that approximately two thirds of inmates had used an illicit drug prior to imprisonment and 6 out of 10 had done so while in prison. One quarter of the inmates who used drugs at least once during imprisonment reported almost daily use inside prison. Cannabis was the most commonly used drug and a majority of those who used cannabis prior to imprisonment continued to do so while in detention.
Healthcare in prison is the responsibility of the Federal Public Service of Justice. Members of the medical staff are responsible for the provision of information about drugs, drug-related infectious diseases and treatment options to every person entering prison and for checking whether or not a prisoner had been treated prior to detention. The Central Service for Healthcare provides healthcare to inmates, while the Psychosocial Service provides medical and psychosocial advice as part of security measures in prisons and for those on probation.
Services for drug users in prison are provided by prison health teams and external caregivers. Information materials on drugs, harms and risk behaviour are available. The availability of drug-related health services, such as support from a psychologist, cognitive behavioural interventions, opioid substitution treatment (OST), therapeutic communities and drug-free programmes, varies among prisons. Drug treatment is often restricted to those with a medical prescription. OST can be either initiated or continued in prison; both methadone and buprenorphine are available.
With regard to the prevention of drug-related infections, voluntary testing for hepatitis B and hepatitis C viruses and human immunodeficiency virus (HIV) is available in some Belgian prisons. Treatment for infectious diseases is available in all prisons. Condom distribution takes place at health services and through small vending machines.
Referral to community services after release is available only in prisons in the Flemish Community.