The primary drug mentioned by people entering treatment for illicit substance use is a key piece of information in order to correctly treat and support the needs of these patients. Following up on trends in primary drug over time can help fieldworkers and policy makers to better adapt their offer of services. This study analyses trends in primary drug mentioned for treatment in Belgium between 2012 and 2018 globally as well as in different subgroups of patients.
The Belgian Treatment Demand Indicator database (TDI) collects self-reported data on people in treatment for substance use disorder since 2011 in a diversified and increasing group of treatment facilities across the country. A subset of facilities that have been reporting in a regular way between 2012 and 2018 has been selected for trend analysis in order to avoid bias due to the increase in coverage. Analysis has been performed for subgroups according to gender (male/female), age (three categories), geographical location (three regions of the country) and treatment history (naive patients and previously treaded). Joinpoint regression has been used to study the trends.
The subset of data used in this analysis is representative of the whole TDI dataset and for all covariates separately.
There is a significant increase in cocaine entrants (+11%/year) between 2012 and 2018. Moreover, this increase is significant in every subgroup (gender, age groups, treatment history, region). The decrease in opiates treatment entrants (-5%/year) is also significant over the period but the decrease is more important among the younger age group and in Flanders. Among all treatment entrants regardless of the substance, there is a significant increase in the total number of treatment entrants among the older age groups (30-44 and 45+). At regional level there is a significant increase in treatment demands in Wallonia but no significant trend in Flanders and in Brussels.
This analysis underlines the increase in treatment demands for cocaine as observed in several Western European countries since the last 6 years. The decrease in opiates treatment entrants is also a well-known long-term tendency in Europe but this analysis nuances this trend in different subgroups. For several primary drugs we clearly demonstrate a significant increase in the older age categories which stresses the need for services adapted to an ageing population.