Risks related to drugs

Drug-related mortality are key harms associated with substance use and have a significant contribution to premature mortality among adults. 

• Monitoring nation-wide, population-based statistics on deaths directly attributable to the use of drugs is possible through the general mortality register hosted by Statbel. 
• Mortality can also be partly monitored through the registrations of specific post-mortem drug analyses within the Belgian Early Warning System on Drugs (BEWSD) project. 

A unique insight into acute health harms can be provided by hospital emergency services, which widen the scope of monitoring health consequences of drug use. For the moment, the Unit Illicit drugs can rely on the Euro-DEN Plus expert network set up at the European level, which reports drug-related hospital emergencies from a network of sentinel hospitals across Europe. 

Driving under the influence is the offense of driving, operating or being in control of a vehicle while impaired by alcohol or drugs (both recreational drugs and those prescribed by physicians). Lab results from blood or oral fluid tests are shared with the Unit Illicit drugs.

Sharing of drug use equipment (e.g. to inject or to inhale) increases the risk of transmitting and acquiring blood-borne infections, such as HIV, hepatitis B or C viruses (HBV and HCV), and invasive bacterial infections. These drug-related infectious diseases constitute a high morbidity and mortality burden among people who inject drugs and people who inhale drugs. Drug use before and during sex is also linked to an increased risk to get infected by viruses such as HIV, HCV and bacterial sexually transmitted infections.

To monitor these drug-related infectious diseases, the Unit Illicit drugs:

• analyses the HIV register managed by Sciensano, TBC register and the registrations of the medical social care centres in Belgium. 
• actively undertakes specific studies (e.g. Push, PRS20).

This indicator collects data on the prevalence and incidence of recurrent drug use that is causing actual harms (negative consequences) to a person (including dependence, but also other health, psychological or social problems), or is placing that person at a high risk of suffering. Two well known drug use patterns considered as high-risk drug use are injecting drug use and opioid use. These types of drug use can be monitored mainly through the treatment demand indicator (TDI) or through specific projects that include self-reported questionnaires (e.g. Push or Drug Vibes).

Mental health problems are common among people with a substance use disorder. These patients exhibit more severe clinical and psychosocial problems than those patients without additional mental health problems.

Self-reported questionnaires can assess the presence of mental health comorbidities. These tools can be included in surveys such as Drug Vibes and the Health Interview Survey.

Sciensano also monitors the pilot-project ‘dual diagnose’ of the ministry of Public Health, which created 2 specific units in hospitals for the treatment of patients with a diagnosis of both mental health and addiction.

The Belgian national burden of disease study quantifies the health impact of 37 key diseases, including drug and alcohol use disorders, in terms of Disability-Adjusted Life Years (healthy life years lost due to morbidity and mortality).