%0 Government Document %D 2024 %T The drug situation in Belgium in 2022. Annual report from the Belgian REITOX network %A Jérôme Antoine %A Margot Balcaen %A Maarten Degreef %A Kim Fernandez %A L. Gremeaux %A E Plettinckx %A L Van Baelen %I Sciensano %C Brussels %P 227 %8 12/01/2024 %G eng %M D/2024.14.440/1 %0 Journal Article %J Molecules %D 2024 %T Full Characterisation of Heroin Samples Using Infrared Spectroscopy and Multivariate Calibration %A Eric Deconinck %A Lievens, Sybrien %A Canfyn, Michael %A Peter van Campenhout %A Loïc Debehault %A L. Gremeaux %A Margot Balcaen %K adulterants; ATR-IR; chemometrics; diacetylmorphine; diluents; mobile detection approaches %X

The analysis of heroin samples, before use in the protected environment of user centra, could be a supplementary service in the context of harm reduction. Infrared spectroscopy hyphenated with multivariate calibration could be a valuable asset in this context, and therefore 125 heroin samples were collected directly from users and analysed with classical chromatographic techniques. Further, MidInfrared spectra were collected for all samples, to be used in Partial Least Squares (PLS) modelling, in order to obtain qualitative and quantitative models based on real live samples. The approach showed that it was possible to identify and quantify heroin in the samples based on the collected spectral data and PLS modelling. These models were able to identify heroin correctly for 96% of the samples of the external test set with precision, specificity and sensitivity values of 100.0, 75.0 and 95.5%, respectively. For regression, a root mean squared error of prediction (RMSEP) of 0.04 was obtained, pointing at good predictive properties. Furthermore, during mass spectrometric screening, 10 different adulterants and impurities were encountered. Using the spectral data to model the presence of each of these resulted in performant models for seven of them. All models showed promising correct-classification rates (between 92 and 96%) and good values for sensitivity, specificity and precision. For codeine and morphine, the models were not satisfactory, probably due to the low concentration of these impurities as a consequence of acetylation. For methacetin, the approach failed.

%B Molecules %V 29 %8 Jan-03-2024 %G eng %N 5 %R 10.3390/molecules29051116 %0 Journal Article %J Drug Test Anal %D 2023 %T Evaluation of an electrochemical sensor and comparison with spectroscopic approaches as used today in practice for harm reduction in a festival setting-A case study: Analysis of 3,4-methylenedioxymethamphetamine samples %A Eric Deconinck %A Marie Polet %A Michael Canfyn %A Céline Duchateau %A Kris De Braekeleer %A Robin Van Echelpoel %A Karolien De Wael %A L. Gremeaux %A Maarten Degreef %A Margot Balcaen %K ATR-(N)IR %K drug checking %K electrochemical detection %K MDMA %K Mobile detection approaches %X

More and more countries and organisations emphasise the value of harm reduction measures in the context of illicit drug use and abuse. One of these measures is drug checking, a preventive action that can represent a quick win by tailored consultation on the risks of substance use upon analytical screening of a submitted sample. Unlike drop-in centres that operate within a fixed setting, enabling drug checking in a harm reduction context at events requires portable, easy to use analytical approaches, operated by personnel with limited knowledge of analytical chemistry. In this case study, four different approaches were compared for the characterisation of 3,4-methylenedioxymethamphetamine samples and this in the way the approaches would be applied today in an event context. The four approaches are mid-infrared (MIR), near-infrared, and Raman spectroscopy, which are today used in drug checking context in Belgium, as well as an electrochemical sensor approach initially developed in the context of law enforcement at ports. The MIR and the electrochemical approach came out best, with the latter allowing for a direct straightforward analysis of the percentage 3,4-methylenedioxymethamphetamine (as base equivalent) in the samples. However, MIR has the advantage that, in a broader drug checking context, it allows to screen for several molecules and so is able to identify unexpected active components or at least the group to which such components belong. The latter is also an important advantage in the context of the growing emergence of new psychotropic substances.

%B Drug Test Anal %8 2023 Dec 12 %G eng %R 10.1002/dta.3625 %0 Report %D 2023 %T Gezondheid, welzijn en drugsgebruik onder personen in de gevangenis. Belgische resultaten van het PRS-20-project 2021-2023 %A E Plettinckx %A Nina Harth %A Stefaan De Smedt %A L. Gremeaux %A Nicky Dirkx %I Sciensano %C Brussel %P 29 %8 24/12/2023 %G eng %M D/2023.14.440/73 %0 Government Document %D 2023 %T Health, well-being and drug use among persons in prison. Belgian results of the PRS-20 project 2021-2023 %A E Plettinckx %E Nina Harth %Y Stefaan de Smet %? L. Gremeaux %? Nicky Dirkx %K Belgium %K Drug use %K prison %I Sciensano %C Brussels %P 29 %8 24/12/2023 %G eng %U https://hogent.be/projecten/prs20/ %M D/2023.14.440/75 %0 Generic %D 2023 %T A mixed methods study about health problems and drug use in Belgian prisons during 2021-2022 %A E Plettinckx %A Nina Harth %A Elena Damian %A Maarten Degreef %A Nicky Dirkx %A Stefaan de Smet %A L. Gremeaux %I European Journal of Public Health %C Dublin %V Volume 33, Issue Supplement_2 %8 October 2023 %G eng %R https://doi.org/10.1093/eurpub/ckad160.1122 %0 Journal Article %J Drug and Alcohol Dependence %D 2023 %T Patient Reported Outcome and Experience Measures (PROMs and PREMs) in substance use disorder treatment services: A scoping review %A Charlotte Migchels %A Amine Zerrouk %A Cleo L. Crunelle %A Frieda Matthys %A L. Gremeaux %A Kim Fernandez %A Jérôme Antoine %A Wim van den Brink %A Wouter Vanderplasschen %B Drug and Alcohol Dependence %V 253 %8 Jan-12-2023 %G eng %R 10.1016/j.drugalcdep.2023.111017 %0 Journal Article %J Drug and Alcohol Dependence %D 2023 %T Patient Reported Outcome and Experience Measures (PROMs and PREMs) in substance use disorder treatment services: A scoping review %A Charlotte Migchels %A Amine Zerrouk %A Cleo L. Crunelle %A Frieda Matthys %A L. Gremeaux %A Kim Fernandez %A Jérôme Antoine %A Wim van den Brink %A Wouter Vanderplasschen %B Drug and Alcohol Dependence %V 253 %8 Jan-12-2023 %G eng %R 10.1016/j.drugalcdep.2023.111017 %0 Report %D 2023 %T Santé, bien-être etconsommation de drogues chez les personnes incarcérées. Résultats belges du projet PRS-20 2021-2023 %A E Plettinckx %A Nina Harth %A Stefaan De Smedt %A L. Gremeaux %A Nicky Dirkx %I Sciensano %C Bruxelles %P 29 %8 24/12/2023 %G eng %M D/2023.14.440/74 %0 Generic %D 2022 %T Applying and implementing future-oriented methods on a national level; towards enhanced policy and service preparedness to threats in the drugs domain %A L. Gremeaux %A Laura Smit-Rigter %A John-Peter Kools %K Drug policy %K Foresight %K illicit drugs %X

Background

Developments in the area of drugs are evolving rapidly and new threats request countries to step up to address these challenges. Meanwhile, most drug policies and services are still grounded in response approaches that address issues of the past decades (e.g. problematic heroin and cocaine use). The current rise of prevalence and use of synthetic opioids (SO) in a number of countries in Europe stresses the need to become better prepared in order to prevent further harm. More innovation and future-oriented strategies are needed to address other current and future developments in the drug field.

The presentation will first describe how to identify and respond to known and currently ongoing threats. The second part will describe how foresight research can contribute to national drug information systems for better preparedness and how it can be developed and implemented at national levels.

Methods

A combination of more traditional multi-source qualitative research (literature research, Reitox workbook consultations, key stakeholder interviews and focus groups) is combined with more innovative future-oriented approaches (e.g. horizon scanning, scenario development and back-casting). Outcomes are used to actively support research agencies, policymakers and services. Multiple workshops and national dialogues will be facilitated in order to implement these methods on a national level.

Results

Conclusions and discussion

Multi-method research, using traditional and more innovative methods, is effective in supporting better monitoring and intervention activities. It proves useful in preparing for particular possible trends - like with SO - and it will be useful for other similar developments in substance prevalence, trade and consumption.

In order to supports enhanced preparedness and resilience of European countries’ drug information and intervention capacity to respond to emerging drug trends and threats, intensified research and applied implementation support is highly recommended. Targeted foresight research is a very useful instrument for national observatories, policy makers and civil society to get better insight and understanding in possible upcoming developments and respond accordingly.

In becoming better prepared for the future.

%B Annual ISSDP Conference - Drug market and Drug innovation in a changing world %I The International Society for the Study of Drug Policy %C EMCDDA building, Lisbon, Portugal %V 15 %8 2022-11-22 %G eng %U https://www.issdp.org/wp-content/uploads/2022/11/15th-Annual-ISSDP-Conference-final-program.pdf %0 Journal Article %J Reviews in Analytical Chemistry %D 2022 %T Chemometrics and infrared spectroscopy – A winning team for the analysis of illicit drug productsAbstract %A Eric Deconinck %A Céline Duchateau %A Margot Balcaen %A L. Gremeaux %A Patricia Courselle %K Chemometrics %K illicit drugs %K infrared spectroscopy %K Raman spectroscopy %X

Spectroscopic techniques such as infrared spectroscopy
and Raman spectroscopy are used for a long
time in the context of the analysis of illicit drugs, and
their use is increasing due to the development of more
performant portable devices and easy application in the
context of harm reduction through drug checking or
onsite forensic analysis. Although these instruments are
routinely used with a spectral library, the importance of
chemometric techniques to extract relevant information
and give a full characterisation of samples, especially in
the context of adulteration, is increasing. This review
gives an overview of the applications described in the
context of the analysis of illicit drug products exploiting
the advantages of the combination of spectroscopy with
chemometrics. Next to an overview of the literature, the
review also tries to emphasize the shortcomings of the
presented research papers and to give an incentive to
what is needed to include chemometrics as a part of the
daily routine of drug checking services and mobile forensic
applications.

%B Reviews in Analytical Chemistry %V 41 %8 Jan-01-2022 %G eng %N 1 %R 10.1515/revac-2022-0046 %0 Book %B Complexity and differentiation of the MDMA retail market: insights from the European Web Survey on Drugs %D 2022 %T Complexity and differentiation of the MDMA retail market: insights from the European Web Survey on Drugs %A L. Gremeaux %K Drug Monitoring %K illicit drugs %K MDMA %K Web Survey on Drugs %X

In recent years the European MDMA market has been characterised by the increasing availability of high-strength products, resulting in a number of deaths. Most studies documenting the patterns and trends in use of this stimulant have grouped tablet (‘ecstasy’) and powder/crystal forms together into a single category, which could lead to an underestimation of MDMA use. This study uses data from nine countries covered in the European Web Survey on Drugs (EWSD) to study intensity of use and patterns of buying behaviours among MDMA users, with specific attention given to comparing the use of MDMA in tablet form and in the form of powder/crystals. The results indicate significant price differences across the countries and that the number of tablets and quantity of powder/crystals consumed on a typical occasion was higher for regular users than occasional users. Through this analysis, this paper shows how using web surveys for drug data collection can be an effective way to develop a better understanding of the use of particular forms of drugs. This is especially of high importance in the case of rapidly evolving drug market changes, such as the volatile nature of MDMA purity in Europe

%B Complexity and differentiation of the MDMA retail market: insights from the European Web Survey on Drugs %I EMCDDA %C Luxembourg: Publications Office of the European Union %P 9 %8 2022-06-28 %@ 978-92-9497-803-5 %G eng %9 Monitoring Drug Use in the digital age: Studies in web surveys, EMCDDA Insights %) EMCDDA %R 10.2810/789306 %0 Report %D 2022 %T Reitox national reporting to EMCDDA on drugs and drug addiction, 2021 %A E Plettinckx %A Jérôme Antoine %A Kim Fernandez %A Elena Damian %A Maarten Degreef %A L. Gremeaux %K illicit drugs %X

One of the core tasks of the European Monitor Center for Drugs and Drug Addiction (EMCDDA) is to collect, analyse and disseminate information on drugs and drug addiction in Europe. In order to fulfil the above, the EMCDDA relies on the collaboration with the European information network (Reitox), consisting of all national drug observatories in the EU Member state plus Turkey, Norway and the European Commission. Each of these Reitox National Focal Points collects information and produces comparable and scientifically sound data on the national drug situation. 

Up to 2014, Reitox national reports were provided to the EMCDDA on an annual basis to feed the monitoring of the situation across Europe. Since 2015, the EMCDDA changed strategies concerning the transfer of the national drug-related information, which allows the Centre to better address the needs for information of European and National Stakeholders. IThe newly implemented reporting tool does no result in a standalone document that can be published for national objectives. Nevertheless, the annual reporting & related information is certainly at hand and anyone can receive tailored information upon request.

The annual reporting comprises of 10 Chapters:

Chapter 1: Drug Policy
Chapter 2: Legal Framework
Chapter 3: Drug use in (the) (sub)population(s)
Chapter 4: Preventino
Chapter 5: Treatment
Chapter 6: Best Practice
Chapter 7: Harms and harm reduction
Chapter 8: The drug market and crime
Chapter 9: Prison
Chapter 10: research

%I Sciensano %C Brussels %G eng %0 Generic %D 2022 %T Signals from the future: Exploring implications for drug policies %A L. Gremeaux %E John-Peter Kools %E Tuukka Tammi %E Elsa Lavado %E Vasco Calado %E Barbara Janikova %E Brian Galvin %K DRUG-PREP %K Foresight %K illicit drugs %K preparedness %X

Building futures literacy in the drug policy domain contributes to enhanced preparedness and will support more proactive drug policy responses. As part of the DRUG-PREP project, this workshop aims to introduce the participants to basic foresight approaches and mutual learning practices for exploring the dynamics of future uncertainties and change in the drugs field.

The overall aim of DRUG-PREP is to contribute to enhanced preparedness and resilience of EU countries’ drug surveillance systems and effective policy making. To this end, conference participants form an important component for this foresight project by bringing along the required international perspectives and experience from diverse domains in current drug policy, practice and science.

In a first step, participants will be introduced to key drivers, predetermined elements and critical uncertainties that form the basis for shaping the future drugs policy area, which will have been mapped by DRUG-PREP via horizon scanning prior to the workshop. A participatory consultation process will then be facilitated for in-depth exploration of subsequent implications for European drug policies. A distinction will be defined between drivers and trends with a certain and uncertain outcome. By mapping when and how emerging issues and themes are likely to impact on the policy area, a shared sense of purpose is built and the requirements for mitigating threats and seizing opportunities are marked.

The identified insights of high impact for the future EU drug policy area will serve as a precursor for the next research stage in the DRUG-PREP project, which involves strategic planning through further developing country-specific policy implications, visioning change and roadmapping towards an alternative future for drug policies in 2030+.

The strength of this interactive session is the twofold return by creating foresight capacity building with the workshop participants, as well as the active contribution that will be injected into the overall DRUG-PREP foresight exercise.

%B Lisbon Addiction. European Conference on Addictive Behaviours and Dependencies %I Lisbon Addictions %C Lisbon, Portugal %V 4 %8 2022-11-23 %G eng %0 Journal Article %J International Journal of Mental Health and Addiction %D 2022 %T Synthetic Cannabinoids and Cannabis: How the Patterns of Use Differ: Results from the European Web Survey on Drugs %A Hugo López-Pelayo %A Santiago Madero %A L. Gremeaux %A Sanna Rönkä %A João Matias %K cannabis %K new psychoactive substances %K Synthetic cannabinoids %K Web Survey on Drugs %X

The aim of the current study is to assess if the patterns of use, socio-demographic characteristics,
and use of other drugs differ among people who only use cannabis and those that
use synthetic cannabinoids. Data from the second wave of the European Web Survey on
Drugs, a web-based cross-sectional survey from 10 different European countries including
individuals aged 18 and over (n = 37,109). Participation was anonymous, self-selecting,
and voluntary. Cannabinoid exposure was taken as the dependent variable and categorized
into the four following variables: (1) neither last year use of cannabis nor of synthetic
cannabinoids (SC) independently of lifetime use, (2) cannabis use, (3) synthetic cannabinoids
use, and (4) use of both, in the last 12 months. Independent variables included
socio-demographic data, other drug use in the last month, and patterns of cannabis use.
The use of SC was associated with higher odd of polysubstance use in the last year (OR
2.17; 95%CI 1.27–3.72) and use of other drugs during the last month. Low income (OR
2.34; 95%CI 1.20–4.58) and unemployment (OR 3.02; 95%CI 1.34–6.83) were related to
SC use alone and cannabis plus SC use (OR 1.53; 95%CI 1.13–2.05) (OR 4.12; 95%CI
3.45–4.91). Social vulnerabilities were associated with the use of cannabis in the last year,
but more markedly with synthetic cannabinoids use. Those who used synthetic cannabinoids
reported using other drugs more often than those who used or did not use cannabis.
The findings highlight the importance of social vulnerabilities and poly-drug use when
assessing the use of new psychoactive substances such as SC and how these differ when
compared to cannabis.

%B International Journal of Mental Health and Addiction %8 Mar-10-2022 %G eng %R 10.1007/s11469-022-00919-6 %0 Journal Article %J Drugs, Habits and Social Policy %D 2022 %T Which drugs of choice are on the rise or in decline? A trend analysis of Belgium’s treatment settings (2015-2019) %A Jérôme Antoine %A Michaël Hogge %A Else De Donder %A Geert Verstuyf %A E Plettinckx %A L. Gremeaux %K addictive behaviour %K alcohol %K Belgium %K illicit drugs %K Substance abuse %K treatment %X

Purpose

The opioid epidemic in the USA, the new psychoactive substances emerging on the market and the recent increase in cocaine treatment demands in Western Europe, all emphasise the importance of monitoring the use and harms of drugs over time. To be informed about new consumption patterns, this study aims to study the trends among people entering treatment for substance use in Belgium.

Design/methodology/approach

Belgian data from the Treatment Demand Indicator collected between 2015 and 2019 were used. A reference group of treatment units was selected to allow for comparisons between the different years. Trend analysis was performed by using a joinpoint regression among different regions and groups of clients.

Findings

The drugs of choice that were most frequently mentioned among the 23,000 analysed treatment episodes were alcohol and cannabis. Both remained relatively stable over time. Heroin seemed to be decreasing significantly at the national level, but increased in Brussels. Benzodiazepines decreased significantly in Flanders and Brussels, but not in Wallonia. On the other hand, reports of crack cocaine increased significantly in the three regions with a more pronounced trend in Wallonia and Brussels. Substances such as fentanyl, methamphetamine, ketamine or volatile inhalants have been mentioned significantly more by people entering treatment in 2019, although their contribution to the total number is still limited.

Originality/value

To the best of the authors’ knowledge, this study is the first to evaluate trends for all drugs of choice at a national and regional level. These results might not only benefit national policymakers but also other countries with similar alcohol or drug use patterns.

%B Drugs, Habits and Social Policy %8 26/08/2022 %G eng %R 10.1108/DHS-10-2021-0055 %0 Journal Article %J J Affect Disord %D 2021 %T COVID-19 and people who use drugs: Impact of the pandemic on general anxiety and depressive disorders among adults in Belgium. %A L Van Baelen %A L. Gremeaux %A Jérôme Antoine %A Helena Bruggeman %A Lydia Gisle %A E Plettinckx %A Karin De Ridder %K Adult %K Anxiety %K Belgium %K COVID-19 %K cross-sectional studies %K dépression %K Depressive Disorder %K Humans %K Male %K Pandemics %K Pharmaceutical Preparations %K SARS-CoV-2 %X

BACKGROUND: During previous pandemics people who use drugs (PWUD) were categorized among the most vulnerable. In the current study, firstly, we wanted to evaluate the impact of the COVID-19 crisis on the prevalence of anxiety and depressive disorders among PWUD. Furthermore, we wanted to compare the prevalence of these disorders with that of members from the general population who did not use drugs.

METHODS: We used a matched cohort design based on two separate repeated cross-sectional online surveys (April and November 2020) among PWUD and the general population. Results of GAD-7 and PHQ-9 were used as outcome variables. We calculated absolute and relative risks for matched pairs for both affective disorders, and logistic regression to compare affective disorders over both waves for PWUD.

RESULTS: In April, the prevalence of affective disorders was similar for PWUD and the general population. In November, the risks for anxiety disorders increased with 64% for PWUD compared to non-PWUD (RR = 1.64, 95%CI 1.42-1.88), whereas the risks for depressive disorders more than doubled (RR = 2.29, 95%CI 1.97-2.67). Having a job and being male were protective factors for PWUD for both anxiety and depressive disorders.

LIMITATIONS: As this study used self-reported data, GAD-7 and PHQ-9 give an indication of the presence of anxiety and depression which might differ from a clinician's judgement.

CONCLUSIONS: PWUD might be disproportionally affected by COVID-19. Health care providers should be attentive to substance use as an indicator for increased risk of mental health problems.

%B J Affect Disord %V 295 %8 01/12/2021 %G eng %R 10.1016/j.jad.2021.08.069 %0 Journal Article %J Drug Testing and Analysis %D 2021 %T An infrared spectroscopic approach to characterise white powders, easily applicable in the context of drug checking, drug prevention and on-site analysis %A Eric Deconinck %A Camille Ait-Kaci %A Andries Raes %A Michael Canfyn %A Bothy, Jean-Luc %A Céline Duchateau %A Corenthin Mees %A Kris de Braeckeleer %A L. Gremeaux %A Peter Blanckaert %K ATR-(N)IR %K Chemometrics %K illicit drugs %K Mobile detection approaches %X

More and more events, such as the summer music festivals, are considering the

possibilities for implementing on-site testing of psychoactive drugs in the context of

prevention and harm reduction. Although the on-site identification is already

implemented by plenty of drug checking services, the required rapid quantitative

dosing of the composition of illicit substances is still a missing aspect for a successful

harm reduction strategy at events. In this paper, an approach is presented to identify

white powders as amphetamine, cocaine, ketamine or others and to estimate the

purity of the amphetamine, cocaine and ketamine samples using spectroscopic

techniques hyphenated with partial least squares (PLS) modelling. For identification

purposes, it was observed that mid-infrared spectroscopy hyphenated with

PLS-discriminant analysis allowed the distinction between amphetamine, cocaine,

ketamine and other samples and this with a correct classification rate of 93.1% for an

external test set. For quantitative estimation, near-infrared spectroscopy was more

performant and allowed the estimation of the dosage/purity of the amphetamine,

cocaine and ketamine samples with an error of more or less 10% w/w. An easily

applicable, practical and cost-effective approach for on-site characterisation of the

majority of the psychoactive samples encountered in Belgian nightlife settings based

on IR spectroscopy was proposed.

%B Drug Testing and Analysis %8 2021 %G eng %N 13 %& 679 %R https://analyticalsciencejournals.onlinelibrary.wiley.com/doi/10.1002/dta.2973 %0 Report %D 2021 %T La santé mentale des personnes consommant des drogues pendant la pandémie de COVID-19 en Belgique %A Helena Bruggeman %A L. Gremeaux %A Jérôme Antoine %A E Plettinckx %A L Van Baelen %K Illegal drugs %X

L'objectif de cette étude est d'examiner comment la santé mentale des usagers de drogues (UD) a évolué pendant la crise COVID-19 durant trois périodes différentes (avril 2020, novembre 2020 et mars 2021). En outre, nous regarderons si cette évolution était différente de celle dans la population générale. A cette fin, les résultats de l'enquête Drogues & COVID-19 (UD) et de l'enquête de santé COVID-19 (population générale), toutes deux réalisées par Sciensano, ont été utilisés.

Les échelles suivantes ont été choisies comme indicateurs de la santé mentale : GAD-7 (anxiété), PHQ-9 (dépression) et l'échelle de solitude de De Jong Gierveld.

Les résultats montrent que la crise du COVID-19 a un fort impact sur la santé mentale, tant au sein de la population générale que du groupe cible spécifique des UD. En outre, l'augmentation de l'anxiété et de la dépression au fil du temps semble plus forte chez les UD.

·        En avril 2020, au début de la crise du COVID-19, il n'y avait pas de différence significative dans la prévalence de l'anxiété et de la dépression entre la population générale et le groupe des UD.

·        Après 6 mois (octobre-novembre 2020), la probabilité de présenter des symptômes d'anxiété était 60% plus élevée pour le groupe des UD par rapport à la population générale. La probabilité de présenter des symptômes de dépression était deux fois plus élevée chez les UD que dans la population générale.

·        En mars 2021 également, la probabilité de présenter des symptômes d'anxiété et de dépression était significativement plus élevée (39% et 45% respectivement) dans le groupe des UD par rapport à la population générale.

Au sein des deux populations, les personnes les plus vulnérables aux troubles anxieux et dépressifs et qui nécessitent une attention particulière sont les femmes et les personnes qui n'ont pas d'emploi rémunéré. Les personnes peu qualifiées, les personnes vivant seules (dans la population générale et dans le groupe des usagers de cannabis uniquement) et les étudiants (dans la population générale et dans le groupe des usagers de stimulants) constituent également un groupe à risque. Enfin, les jeunes ont un risque accru de présenter à la fois des symptômes d'anxiété et de dépression dans la population générale, et un risque accru de présenter des symptômes de dépression chez les UD.

%I Sciensano %C Brussels %G eng %M D/2021/14.440/66 %0 Report %D 2021 %T Mentale gezondheid van personen die drugs gebruiken tijdens de COVID-19 pandemie in België %A Helena Bruggeman %A L. Gremeaux %A Jérôme Antoine %A E Plettinckx %A L Van Baelen %K Illegal drugs; COVID-19 %I Sciensano %C Brussel %G eng %M D/2021/14.440/66 %0 Report %D 2021 %T RAPPORT THÉMATIQUE : L’USAGE ET L’OFFRE DE DROGUES DURANT LA PANDÉMIE DE COVID-19 EN BELGIQUE %A Jérôme Antoine %A Helena Bruggeman %A L. Gremeaux %A E Plettinckx %A L Van Baelen %K drug use; Covid-19; pandemic; Belgium %G eng %M D/2021/14.440/20 %0 Report %D 2021 %T Reitox national reporting to EMCDDA on drugs and drug addiction, 2020 %A L Van Baelen %A Jérôme Antoine %A L. Gremeaux %A Peter Blanckaert %A E Plettinckx %X

Yearly contribution to the European Monitor Center for Drugs and Drug Addiction (EMCDDA) in collecting, analysing and disseminating information on drugs and drug addiction in Europe. In order to fulfil its mandate, the EMCDDA relies on the collaboration with the European information network (Reitox), consisting of all national drug observatories in the EU Member state plus Turkey, Norway and the European Commission. Each of these Reitox National Focal Points collects information and produces comparable and scientifically sound data on the national drug situation.

Up to 2014, Reitox national reports were provided to the EMCDDA on an annual basis to feed the monitoring of the situation across Europe. Since 2015, the EMCDDA changed strategies concerning the transfer of the national drug-related information, which allows the Centre to better address the needs for information of European and National Stakeholders. The newly implemented reporting tool does no result in a standalone document that can be published for national objectives. Nevertheless, the annual reporting & related information is certainly at hand and anyone can receive tailored information upon request to the Belgian national focal point at Sciensano.

The annual reporting comprises of 10 Chapters:

Chapter 1: Drug Policy
Chapter 2: Legal Framework
Chapter 3: Drug use in (the) (sub)population(s)
Chapter 4: Prevention
Chapter 5: Treatment
Chapter 6: Best Practice
Chapter 7: Harms and harm reduction
Chapter 8: The drug market and crime
Chapter 9: Prison
Chapter 10: research

%P +100 %8 10/2020 %G eng %0 Government Document %D 2021 %T THEMATISCH RAPPORT : HET GEBRUIK EN HET AANBOD VAN DRUGS TIJDENS DE COVID-19 PANDEMIE IN BELGIË %A Jérôme Antoine %A Helena Bruggeman %A L. Gremeaux %A E Plettinckx %A L Van Baelen %K drug use; Covid-19; pandemic; Belgium %I Sciensano %C Brussels %8 03/2021 %G eng %M D/2021/14.440/21 %0 Journal Article %J Archives of Public Health %D 2021 %T Use of health care services by people with substance use disorders in Belgium: a register-based cohort study %A L Van Baelen %A E Plettinckx %A Jérôme Antoine %A Karin De Ridder %A Brecht Devleesschauwer %A L. Gremeaux %X

The objective of the study was to describe the frequencies of health-care utilization by people with substance use disorder (SUD), including contacts with general practitioners (GP), psychiatrists, emergency departments (ED) and hospital admissions and to compare this frequency to the general population.

%B Archives of Public Health %V 79 %8 2021/06/23 %@ 2049-3258 %G eng %N 1 %0 Journal Article %J Nordisk Alkohol Nark %D 2021 %T Women's views on barriers and facilitators for seeking alcohol and drug treatment in Belgium. %A Julie Schamp %A Sarah Simonis %A Griet Roets %A Tina Van Havere %A L. Gremeaux %A Wouter Vanderplasschen %X

Aims: Although treatment barriers are different for men and women, research is dominated by males' and practitioners' perspectives rather than women's voices. The purpose of this study in Belgium was to identify and obtain a better understanding of the barriers and facilitators for seeking treatment as experienced by substance (ab)using women themselves.

Methods: In-depth interviews were conducted with 60 female substance users who utilise(d) outpatient and/or residential treatment services. A content analysis was performed on women's personal accounts of previous treatment experiences as well as their experiences with services along the continuum of care, resulting in practical implications for the organisation of services.

Results: Female substance users experience various overlapping - and at times competing - barriers and facilitators when seeking treatment and utilising services. For most women, the threat of losing custody of their children is an essential barrier to treatment, whereas for a significant part of the participants it serves as a motivation to seek help. Also, women report social stigma in private as well as professional contexts as a barrier to treatment. Women further ask for a holistic approach to treatment, which stimulates the healing process of body, mind and spirit, and emphasise the importance of feeling safe in treatment. Participants suggested several changes that could encourage treatment utilisation.

Conclusion: Our findings demonstrate the need for a gender-sensitive approach within alcohol and drug services that meets the needs of female substance users, as well as gender-sensitivity within prevention and awareness-raising campaigns, reducing the stigma and facilitating knowledge and awareness among women and society.

%B Nordisk Alkohol Nark %V 38 %8 2021 Apr %G eng %N 2 %R 10.1177/1455072520964612 %0 Journal Article %J Harm Reduction Journal %D 2020 %T Awareness of users and motivational factors for using new psychoactive substances in Belgium %A Simons,K. %A Michael Canfyn %A Anton Van Dijck %A Tina Van Havere %A Eric Deconinck %A Peter Blanckaert %A L. Gremeaux %B Harm Reduction Journal %V 17 %8 Jan-12-2020 %G eng %N 1 %R 10.1186/s12954-020-00393-0 %0 Journal Article %J Harm Reduct J %D 2020 %T Awareness of users and motivational factors for using new psychoactive substances in Belgium. %A Sarah Simonis %A Michael Canfyn %A Anton Van Dijck %A Tina Van Havere %A Eric Deconinck %A Peter Blanckaert %A L. Gremeaux %K illicit drugs %K new psychoactive substances %K Substance use %X

BACKGROUND: Few data on motivations for using new psychoactive substances (NPS) are available. However, the cost, the legal status, and their accessibility through channels like internet contributed to the popularity of NPS. The objective of this article are first to gain a deeper understanding of the culture surrounding NPS in Belgium and second to define the awareness of the users concerning the content of the NPS they are consuming.

METHODS: Snowball sampling and partners in the drug demand reduction field were used as a gateway in order to reach a heterogeneous study population. In total, 45 users were recruited and in-depth interviews were conducted. The personal experiences of NPS users and their needs for support along the continuum of care were explored through an interview guideline, while subjects were given the opportunity to deposit a NPS sample for forensic analysis in a recognized laboratory.

RESULTS: A diversity of profiles was found among NPS users but also a wide diversity in the motives to consume NPS: personal reasons such as pleasure, mind exploration, being connected to others, or out of curiosity, but also external reasons such as price, accessibility or the specific effects procured by certain NPS. The results showed as well that a majority of NPS users seem to be aware of the substances they are using.

CONCLUSION: Understanding the motivations of use is of importance to determine which type of NPS targeted interventions are adapted to different profiles of users.

%B Harm Reduct J %V 17 %8 2020 07 25 %G eng %N 1 %R 10.1186/s12954-020-00393-0 %0 Report %D 2020 %T COVID-19 Online drugsonderzoek: Voorlopige resultaten over het gebruik en aanbod van illegale middelen tijdens de coronacrisis %A E Plettinckx %A Jérôme Antoine %A L. Gremeaux %A L Van Baelen %K corona %K coronacrisis %K COVID-19 %K drugs %K drugsonderzoek %K drugssurvey %K Enquête %K survey %I Sciensano %C Brussels %P 20 %8 05/2020 %G eng %U https://drugs.wiv-isp.be/docs/Documents/WebSurveyDrugs_W1_NL.pdf %0 Report %D 2020 %T De TDI-registratie in België, Jaarlijks rapport, Registratiejaar 2019. %A Jérôme Antoine %A E Plettinckx %A L Van Baelen %A L. Gremeaux %K illicit drugs %K Treatment Demand Indicator %X

In dit rapport presenteren we de gegevens voor 2019 inzake de vraag naar behandeling in verband met het gebruik van legale en illegale substanties in België. Deze gegevens worden reeds 9 jaar verzameld en de indicator vormt een zeer rijke bron van informatie om de evolutie van problematisch drugsgebruik in ons land te volgen via mensen die in behandeling gaan. In 2020 heeft de coronacrisis een grote impact gehad op de samenleving in het algemeen en in het bijzonder voor de meest kwetsbare mensen, zoals sommige drugsgebruikers. Het effect van de crisis op de vraag naar behandeling zal pas duidelijk worden bij het analyseren van de gegevens voor 2020 en een rapportering hierover wordt voorzien in 2021. De crisis heeft natuurlijk ook gevolgen gehad voor de organisatie van de gezondheidszorg maar dit zou slechts een beperkte invloed hebben gehad op de verzameling van TDI-gegevens voor 2019. De meeste gegevens werden verzameld in maart, net vooraleer de eerste COVID-maatregelen werden opgelegd. Slechts een klein aantal van de deelnemende -centra was niet in staat om ons hun jaarlijkse gegevens te verstrekken. Dit rapport is onderverdeeld in hoofdstukken volgens de voornaamste substanties waarvan patiënten aangeven dat deze aan de basis liggen voor de effectieve behandeling. Het rapport bevat tabellen met een structuur die relatief vergelijkbaar is met die van vorig jaar en maakt het daarom ook gemakkelijker om de rapporten van verschillende jaargangen te vergelijken. Bovendien kunnen trends van de afgelopen 5 jaar bestudeerd worden dankzij een selecte van groep centra die reeds sinds 2015 deelnemen aan de registratie. We willen met dit rapport gedetailleerde en betrouwbare informatie verschaffen om belangrijke vragen te beantwoorden van zowel professionals in het veld als van wetenschappers of beleidsmakers. Daarnaast wordt ook de waarde van de indicator benadrukt om een globaal beeld te verkrijgen van het drugsfenomeen in Europa: de Europese standaardisatie van de TDI maakt cross-country analyses mogelijk. Sciensano neemt actief deel in de samenwerking met andere landen en EMCDDA om de verzamelde Belgische TDI-gegevens optimaal te gebruiken in internationale vergelijkende analyses.

%I Sciensano %C Brussels, Belgium %P 56 %8 12/2020 %G eng %M D/2020/14.440/88 %) Gremeaux, Lies %0 Government Document %D 2020 %T Enquête en ligne sur l’usage et l’offre de substances illégales pendant la crise du coronavirus: premiers résultats %A Jérôme Antoine %A L. Gremeaux %A E Plettinckx %A L Van Baelen %K Covid-19 ; drug use %G eng %0 Journal Article %J Drug and Alcohol Dependence %D 2020 %T Estimates of people who injected drugs within the last 12 months in Belgium based on a capture-recapture and multiplier method %A E Plettinckx %A Forrest W. Crawford %A Jérôme Antoine %A L. Gremeaux %A L Van Baelen %K capture-recapture %K harm reduction %K hidden population %K multiplier method %K People who inject drugs %K treatment %X

Background

For Belgium, available estimates of the number of people who inject drugs (PWID) are based on data from more than fifteen years ago and apply only to those who report ever injecting drugs. As a result, no reliable baseline data exist to determine the scale of services for PWID.

Methods

We obtained pseudo-anonymized identifier information from treatment and harm reduction service providers and a fieldwork study between February and April 2019 in Brussels. We estimated the number of PWID, defined as people who injected within the last 12 months, in Brussels using capture-recapture (CRC) methodology. To obtain national estimates, we scaled the proportion of PWID in Brussels to the total number of this population in Belgium based on two existing drug treatment registers, which were then multiplied with the result of the CRC.

Results

The total population of PWID is estimated to be 703 (95%CI 538 – 935) for Brussels and between 6,620 (95%CI 4,711 – 8,576) and 7,018 (95%CI 4,794 – 9,527) for Belgium.

Conclusions

These estimates provide crucial information to ensure that services to PWID are adequately maintained. They clearly indicate the need to maximize efforts to achieve the targets set by WHO for 2030 on the provision of 300 sterile needles and syringes per PWID per year, a 90% reduction of new HCV infections, and a 65% reduction of liver-related mortality.

%B Drug and Alcohol Dependence %G eng %R 10.1016/j.drugalcdep.2020.108436 %0 Report %D 2020 %T Het gebruik en het aanbod van drugs tijdens de COVID-19 pandemie en de percepties gelinkt aan de COVID-19 omstandigheden %A E Plettinckx %A Jérôme Antoine %A L. Gremeaux %A L Van Baelen %K COVID-19 %K Drogues %K drugs %I Sciensano %C Brussels %P 34 %8 2020 %G eng %U https://drugs.wiv-isp.be/docs/Documents/COVID-19_online_drugsonderzoek_2020.pdf %M D/2020/14.440/89 %R D/2020/14.440/89 %0 Report %D 2020 %T La consommation et l'offre de drogue en période de pandémie du COVID-19 et les perceptions liées aux circonstances du COVID-19 %A E Plettinckx %A Jérôme Antoine %A L. Gremeaux %A L Van Baelen %K COVID-19 Drogues drugs %G eng %M D/2020/14.440/90 %0 Journal Article %J Harm Reduction Journal %D 2020 %T Prevalence of HCV among people who inject drugs in Brussels—a respondent-driven sampling survey %A L Van Baelen %A E Plettinckx %A Jérôme Antoine %A L. Gremeaux %B Harm Reduction Journal %V 17 %8 Jan-12-2020 %G eng %N 1 %R 10.1186/s12954-020-00358-3 %0 Report %D 2020 %T Reitox national reporting to EMCDDA on drugs and drug addiction, 2019 %A E Plettinckx %A L Van Baelen %A Jérôme Antoine %A Peter Blanckaert %A L. Gremeaux %? Lucia Caséro %? Fred Laudens %K Illegal drugs %X

One of the core tasks of the European Monitor Center for Drugs and Drug Addiction (EMCDDA) is to collect, analyse and disseminate information on drugs and drug addiction in Europe. In order to fulfil the above, the EMCDDA relies on the collaboration with the European information network (Reitox), consisting of all national drug observatories in the EU Member state plus Turkey, Norway and the European Commission. Each of these Reitox National Focal Points collects information and produces comparable and scientifically sound data on the national drug situation. 

Up to 2014, Reitox national reports were provided to the EMCDDA on an annual basis to feed the monitoring of the situation across Europe. Since 2015, the EMCDDA changed strategies concerning the transfer of the national drug-related information, which allows the Centre to better address the needs for information of European and National Stakeholders. IThe newly implemented reporting tool does no result in a standalone document that can be published for national objectives. Nevertheless, the annual reporting & related information is certainly at hand and anyone can receive tailored information upon request.

The annual reporting comprises of 10 Chapters:

Chapter 1: Drug Policy
Chapter 2: Legal Framework
Chapter 3: Drug use in (the) (sub)population(s)
Chapter 4: Preventino
Chapter 5: Treatment
Chapter 6: Best Practice
Chapter 7: Harms and harm reduction
Chapter 8: The drug market and crime
Chapter 9: Prison
Chapter 10: research

%I Sciensano %C Brussels, Belgium %8 30/10/2020 %G eng %9 Reitox National Reporting to EMCDDA on drugs and drugs addiction %) Gremeaux Lies %0 Report %D 2020 %T Résultats préliminaires sur l’usage et l’offre de substances illégales pendant la crise du coronavirus %A E Plettinckx %A Jérôme Antoine %A L. Gremeaux %A L Van Baelen %K corona %K coronacrisis %K COVID-19 %K drugs %K drugsonderzoek %K drugssurvey %K Enquête survey %G eng %0 Report %D 2020 %T Understanding New Psychoactive Substance (NPS) use in Belgium from a health perspective (NPS-Care) %A Sarah Simonis %A Freya Vander Laenen %A Charlotte Colman %A L. Gremeaux %A Peter Blanckaert %A Anton Van Dijck %A Tina Van Havere %K illicit drugs %K new psychoactive substances %X

NPS provoke new patterns of use and pose unprecedented challenges to (drug) prevention-, careand harm reduction efforts. Similarly, research into drug use needs to reinvigorate and review its practices as well, to address this new situation. At present, data on the epidemiology of NPS are scarcely- and often partially available. Specific knowledge about the use of new substances and the possible health and social impact on users and society, is minimal. Besides the issuing of alerts that involve the use of NPS in the context of European and national Early Warning Systems (EWS), many questions remain. Who uses NPS? How and to which degree? Why? Which substances are popular? What are long-term effects on the health of users? Which specific interventions can we think of? These and other health related issues are tackled by the largely qualitative research endeavour called ‘Understanding New Psychoactive Substance use in Belgium from a health perspective’; in short, the ‘NPS-care’ project. Its findings will contribute to formulate ‘recommendations regarding the organisation and provision of interventions targeting NPS along the continuum of care; from prevention over harm reduction to treatment’ (BELSPO, contract DR/02/79). Data collection covers a two-year period between March 2017 and June 2019. Commissioned and funded by Belgian Federal Science Policy, NPS care was coordinated by the University College of Ghent, joined by Sciensano as co-coordinating partner.

%I Belgian Science Policy Office (BELSPO) %C Brussels, Belgium %P 163 %8 2020 %G eng %) Belgian Science Policy Office (BELSPO) %0 Journal Article %J European Journal of Public Health %D 2020 %T Use of general health care by people with substance use disorders in Belgium (2008-2017) %A L Van Baelen %A Brecht Devleesschauwer %A Karin De Ridder %A E Plettinckx %A L. Gremeaux %B European Journal of Public Health %V 30 %8 Jun-09-2022 %G eng %N Supplement_5 %R 10.1093/eurpub/ckaa165.689 %0 Report %D 2020 %T Websurvey over het gebruik en aanbod van illegale middelen tijdens de coronacrisis: eerste resultaten %A L Van Baelen %A L. Gremeaux %A E Plettinckx %A Jérôme Antoine %K COVID-19 %K drugsonderzoek %I Sciensano %C Brussel %P 29 %8 07/2020 %G eng %M D/2020/14.440/64 %0 Journal Article %J Journal of Substance Use %D 2019 %T All-cause mortality rate of people in treatment for substance use disorders in Belgium: A register-based cohort study %A L Van Baelen %A Jérôme Antoine %A Karin De Ridder %A E Plettinckx %A L. Gremeaux %K all-cause %K Belgium %K mortality %K substance use disorder %K Treatment Demand Indicator %B Journal of Substance Use %V 24 %8 Mar-09-2019 %G eng %N 5 %R https://doi.org/10.1080/14659891.2019.1604841 %0 Journal Article %J talanta %D 2019 %T Combining Attenuated Total Reflectance- Infrared Spectroscopy and chemometrics for the identification and the dosage estimation of MDMA tablets %A Eric Deconinck %A Raf Van Campenhout %A Cherazade Aoudi %A Michael Canfyn %A Bothy, Jean-Luc %A Peter Blanckaert %A L. Gremeaux %A Patricia Courselle %K ATR-(N)IR %K Chemometrics %K illicit drugs %K Mobile detection approaches %B talanta %V 195 %8 04/2019 %G eng %& 142 %R ://doi.org/10.1016/j.talanta.2018.11.027 %0 Journal Article %J Acta Gastroenterol Belg %D 2019 %T Diagnostic hepatitis C testing of people in treatment for substance use disorders in Belgium between 2011 and 2014 : a cross-sectional study. %A L Van Baelen %A Jérôme Antoine %A Karin De Ridder %A Gaetan Muyldermans %A L. Gremeaux %K Belgium %K cross-sectional studies %K Hepacivirus %K Hepatitis C %K Humans %K Mass Screening %K Substance Abuse, Intravenous %X

BACKGROUND: Hepatitis C prevalence figures for people who use drugs in Belgium are scarce, and particularly for people who inject drugs. The current study refines the existing HCV estimates by focussing on diagnostic HCV testing practices for this population at risk.

METHODS: The analysis is the result of a descriptive crosssectional study, based on data extracted from the linkage between a database of people in treatment for substance use disorders in Belgium and a database of the Belgian health insurance companies. By using national nomenclature codes for HCV tests, the number of people in treatment for substance use disorders who were tested on HCV, were estimated.

RESULTS: 18,880 out of 30,905 patients (61.1%) in treatment for substance use disorders between 2011 and 2014 have been screened at least once for HCV between 2008 and 2015. 58.0% of those who had never injected and 59.1% of those with an unknown injecting status were tested for HCV, compared to 86.5% of the patients who had recently injected and 84.5% of those who had ever injected. 36.8% of the people who had recently injected were tested for HCV RNA.

CONCLUSIONS: This study supports the need of a continued effort of health care providers to identify people infected with HCV. For a population at risk such as people who use drugs, regular screening is needed to reach the goal set by WHO of near viral elimination of HCV by 2030.

%B Acta Gastroenterol Belg %V 82 %8 2019 Jan-Mar %G eng %N 1 %0 Generic %D 2019 %T The European Web Survey on Drugs: patterns of use of new psychoactive substances in Belgium %A L. Gremeaux %X

Background: While new psychoactive substances (NPS) have become a global phenomenon, epidemiological and qualitative knowledge remains very limited in Belgium. Such rapidly emerging trends cannot be easily monitored by means of the national Health Interview Survey in the general population because it is only held every five years. In addition, the questionnaire on substance use is limited and the number of people in the sample who have used substances other than cannabis is too low to permit further analyses. To provide in additional information on the patterns of use, EMCDDA’s European Web Survey on Drugs was conducted in Belgium by the Reitox national focal point at Sciensano between mid-November 2017 and the beginning of January 2018.

Methodology: The survey ran in Dutch, French, German and English. The applied self-selection sampling strategies included targeted advertising on social networking sites and sharing the web link through a variety of media from national network partners. Selection criteria were a minimum age of 18, living in Belgium and having used one or more of the drugs covered by the survey. Participation was anonymous and respondents could opt out at any stage in the questionnaire. Next to cannabis, cocaine, MDMA, amphetamine and methamphetamine, a specific module was available covering questions on the pattern and motivation of NPS use as well as the conditions of purchase.

Conclusions: NPS are prevalent on the regular drug market in Belgium and experimental use is established in recreational settings. Questioning of NPS use remains methodologically challenging due to the diversified groups of available NPS and therefore different related user profiles, as well as the limited common terminology among users.

%B Lisbon Addictions 2019 %I SICAD %C Lisbon, Portugal %G eng %N SICAD, EMCDDA, Addiction journal, SSA, ISAJE %0 Report %D 2019 %T Reitox national reporting to EMCDDA on drugs and drug addiction, 2018 %A E Plettinckx %A L Van Baelen %A Jérôme Antoine %A Peter Blanckaert %A L. Gremeaux %K illicit drugs %X

One of the core tasks of the European Monitor Center for Drugs and Drug Addiction (EMCDDA) is to collect, analyse and disseminate information on drugs and drug addiction in Europe. In order to fulfil the above, the EMCDDA relies on the collaboration with the European information network (Reitox), consisting of all national drug observatories in the EU Member state plus Turkey, Norway and the European Commission. Each of these Reitox National Focal Points collects information and produces comparable and scientifically sound data on the national drug situation. 

Up to 2014, Reitox national reports were provided to the EMCDDA on an annual basis to feed the monitoring of the situation across Europe. Since 2015, the EMCDDA changed strategies concerning the transfer of the national drug-related information, which allows the Centre to better address the needs for information of European and National Stakeholders. IThe newly implemented reporting tool does no result in a standalone document that can be published for national objectives. Nevertheless, the annual reporting & related information is certainly at hand and anyone can receive tailored information upon request.

The annual reporting comprises of 10 Chapters:

Chapter 1: Drug Policy
Chapter 2: Legal Framework
Chapter 3: Drug use in (the) (sub)population(s)
Chapter 4: Preventino
Chapter 5: Treatment
Chapter 6: Best Practice
Chapter 7: Harms and harm reduction
Chapter 8: The drug market and crime
Chapter 9: Prison
Chapter 10: research

%I Sciensano %C Brussels %G eng %0 Journal Article %J International Journal of Law and Psychiatry %D 2018 %T Alternatives to prison for drug offenders in Belgium during the past decade %A E Plettinckx %A Jérôme Antoine %A L. Gremeaux %A Herman Van Oyen %B International Journal of Law and Psychiatry %V 61 %8 Jan-11-2018 %G eng %R 10.1016/j.ijlp.2018.09.003 %0 Journal Article %J Arch Public Health %D 2018 %T Longitudinal pharmacoepidemiological and health services research for substance users in treatment: protocol of the Belgian TDI-IMA linkage. %A L Van Baelen %A Karin De Ridder %A Jérôme Antoine %A L. Gremeaux %X

Background: Not much is known about the health seeking behavior of people with substance use disorders before they enter specialized treatment and afterwards. This paper explains in detail the protocol that has been followed to establish the Belgian TDI-IMA-database, which is linking two separate databases: the Treatment Demand Indicator (TDI) and the database of the Intermutualistic Agency (IMA). The Treatment Demand Indicator is measuring incidence of people with substance use disorders entering drug treatment. The IMA-database covers data, collected in the framework of the compulsory Belgian health care and benefits insurance program, on reimbursed medication and the use of reimbursed health services. The linkage results in pharmacoepidemiological and health service data for people who were in treatment for substance use disorders and for a group of comparators.

Methods: The TDI-database was linked to the IMA-database for the period between 01/01/2008 and 31/12/2017, based on the national identification number of patients who have been in alcohol or drug treatment between 01/01/2011 and 31/12/2014. Through this linkage, pharmacoepidemiological and health service data became available for at least 3 years before the first registered episode in the TDI-database till at least 3 years after the first episode. For each person in TDI four comparators, who were not in specialized treatment, were matched on age, sex and place of residence.

Discussion: The TDI-IMA-database allows for an analysis of health seeking behavior and health care pathways of people before and after they entered specialized alcohol and drug treatment. The presented protocol could be used in other European countries to establish a linkage between existing health databases. This will allow for a better understanding of the health care needs of patients with substance use disorders.

%B Arch Public Health %V 76 %8 2018 %G eng %R https://doi.org/10.1186/s13690-017-0249-x %0 Report %D 2018 %T Reitox national reporting to EMCDDA on drugs and drug addiction, 2017 %A E Plettinckx %A Jérôme Antoine %A L Van Baelen %A Peter Blanckaert %A L. Gremeaux %K illicit drugs %X

One of the core tasks of the European Monitor Center for Drugs and Drug Addiction (EMCDDA) is to collect, analyse and disseminate information on drugs and drug addiction in Europe. In order to fulfil the above, the EMCDDA relies on the collaboration with the European information network (Reitox), consisting of all national drug observatories in the EU Member state plus Turkey, Norway and the European Commission. Each of these Reitox National Focal Points collects information and produces comparable and scientifically sound data on the national drug situation. 

Up to 2014, Reitox national reports were provided to the EMCDDA on an annual basis to feed the monitoring of the situation across Europe. Since 2015, the EMCDDA changed strategies concerning the transfer of the national drug-related information, which allows the Centre to better address the needs for information of European and National Stakeholders. IThe newly implemented reporting tool does no result in a standalone document that can be published for national objectives. Nevertheless, the annual reporting & related information is certainly at hand and anyone can receive tailored information upon request.

The annual reporting comprises of 10 Chapters:

Chapter 1: Drug Policy
Chapter 2: Legal Framework
Chapter 3: Drug use in (the) (sub)population(s)
Chapter 4: Preventino
Chapter 5: Treatment
Chapter 6: Best Practice
Chapter 7: Harms and harm reduction
Chapter 8: The drug market and crime
Chapter 9: Prison
Chapter 10: research

%I Sciensano %C Brussels %8 30/10/2018 %G eng %0 Journal Article %J Arch Public Health %D 2018 %T Utilization of gabapentin by people in treatment for substance use disorders in Belgium (2011-2014): a cross-sectional study. %A L Van Baelen %A Karin De Ridder %A Jérôme Antoine %A L. Gremeaux %X

Background: Although gabapentin has been licensed in the European Union only for neuropathic pain and epilepsy for patients who have partial seizures, it has also been prescribed in treatment for substance use disorders. Many studies report the potential risk of abuse of gabapentin by people with substance use disorders. The objective of this paper is to determine if people who have been in treatment for substance use disorders bought gabapentin in a time span that could indicate consumption at a dose that exceeded the maximum approved dose of 3600 mg/day.

Methods: This analysis is the result of an observational cross-sectional descriptive study with matching. Two datasets were used and linked at individual level. Subjects were selected based on their first registration in the database of the Treatment Demand Indicator (TDI) between 2011 and 2014, without any exclusion criteria concerning nationality or age. Through linkage with the database of the InterMutualistic Agency (IMA) information on health service use and medication use was determined. In addition, each subject was matched on age, sex and place of residence to four comparators from the general population who were not in specialized treatment. The prevalence of gabapentin purchases in the period between 2008 and 2014 for both populations were compared. Quantification of the amount of gabapentin between two consecutive purchases was used as a proxy for potential abuse.

Results: Out of 30,905 patients in treatment for substance use disorders 2.7% had bought at least once gabapentin in a public pharmacy or received it from a hospital pharmacy, compared to 0.7% in the comparison group ( = 122,142). In both populations, more than half of the patients bought only once or twice gabapentin and about 10.0% bought at least once gabapentin in a time span that could indicate potential abuse. A limitation of the study is that it is only based on reimbursed medication without clinical information.

Conclusion: Through the linkage of the TDI-database and the database of the Belgian health insurance companies, no evidence was found for regular abuse of prescribed gabapentin in Belgium by people in treatment for substance use disorders.

%B Arch Public Health %V 76 %8 2018 %G eng %R https://doi.org/10.1186/s13690-018-0254-8 %0 Report %D 2016 %T Developments and trends on drugs 2015. Synthesis report by the Belgian Reitox National Focal Point %A E Plettinckx %E Jérôme Antoine %Y Karin De Ridder %? Peter Blanckaert %K demand %K harm reduction %K illicit substances %K prevention %K supply %K treatment %K use %I WIV-ISP %C Brussels %P 20 %8 jan 2016 %G eng %M D/2016/2505/05 %0 Journal Article %J Arch Public Health %D 2016 %T Treatment for substance use disorders: the Belgian Treatment Demand Indicator registration protocol. %A Jérôme Antoine %A Karin De Ridder %A E Plettinckx %A Peter Blanckaert %A L. Gremeaux %X

BACKGROUND: Registration of patients with substance use disorders is of key importance to get insights and to study trends in patients characteristics and substance use patterns. The Treatment Demand Indicator (TDI) is gathering this information at European level since 2000. In Belgium, this registration started at national level in 2011 and an increasing number of facilities of different types are participating in this data collection since then.

METHODS/DESIGN: This surveillance register collects information on every treatment episode started by patients for their substance use disorder. Information is collected on socio-demographic characteristics of the patient, treatment history and substance use patterns. Patients are identified uniquely using their national identification number in order identify multiple episodes followed by a same person. A large range of treatment facilities have the possibility to participate in this registration to allow a wide coverage of the population.

DISCUSSION: The objective of the paper is to facilitate the use of data by authorities or researchers by correctly describing all aspects of the indicator. The case definition, the variables collected and the way data should be reported are of key importance to use and interpret the data correctly. An overview of the data registered in 2014 gives also an idea of the content of the database. The article also pictures the strengths and limitations of the register and foresees some future improvements.

%B Arch Public Health %V 74 %8 2016 %G eng %R 10.1186/s13690-016-0139-7 %0 Report %D 2015 %T Belgian national report on drugs 2014. New Development, Trends and in-depth information on selected issues., %A E Plettinckx %E Jérôme Antoine %Y Peter Blanckaert %? Karin De Ridder %? F. Vander Laenen %? F. Laudens %? L. Casero %K demand %K harm reduction %K illicit substances %K prveention %K supply %K treatment %K use %I wiv-isp %C Brussels %P 198 %8 jan 2015 %G eng %M D/2014/2505/66 %0 Generic %D 2015 %T Comparison between non-general practice patients and general practice patients treated for substance use problems %A Jérôme Antoine %A Nicole Boffin %A Karin De Ridder %A L. Gremeaux %A Viviane Van Casteren %K addiction %K Belgium %K Comparison %K conference %K drug addiction %K general %K General practice %K General-practice %K Patient %K patients %K Practice %K problems %K Substance use %K use %B Addictions Conference %C Lisbon %8 0/0/2015 %G eng %N ? %1 37604 %2 01/07/2015 %0 Generic %D 2015 %T Health care trajectories and medication consumption of substance users in treatment: linking TDI and IMA databases (Belgium) %A Karin De Ridder %A Jérôme Antoine %A L. Gremeaux %A E Plettinckx %A Peter Blanckaert %A Jean Tafforeau %K Belgium %K care %K conference %K CONSUMPTION %K Database %K Databases %K drug addiction %K epidemiology %K health %K health care %K HEALTH-CARE %K medical drugs %K method %K methods %K TDI %K treatment %K Users %B Methods in Epidemiology Conference %C Leuven %8 0/0/2015 %G eng %N ? %1 37974 %2 2015 %0 Report %D 0 %T Reitox national reporting to EMCDDA on drugs and drug addiction, 2016 %A E Plettinckx %A Jérôme Antoine %A L Van Baelen %A Peter Blanckaert %A L. Gremeaux %G eng