2. Exploratory considerations and recommendations of the parliamentary group Drug
June 5, 1997, the parliamentary group Drugs made report to the Room (Doc. Parl. Room, 1996-1997, 1062/1 to 1062/3). The parliamentary task group, composed of representatives of several commissions and benefitting from the accompaniment of experts, organized public audiences on the different aspects of the problematic of the drug and made some recommendations to the government.
The recommendations of the parliamentary group led to a motion of the Room (doc. Parl. Room, 1996-1997, 1062 (4) in which she/it asks to the government notably to create a Cell Drugs and to make report regularly on the implementation of his/her/its recommendations.
The findings and recommendations of the parliamentary group are summarized in the academic report "The Belgian politics concerning drug - year 2000: situation" of professors B. Of Ruyver (Rijksuniversiteit Race) and J. Casselman (Katholieke Universiteit Leuven). This chapter is based on the aimed academic report.
2.1. Exploratory considerations
The parliamentary task group opted for a politics of normalization and an integrated and global approach.
In such an integrated and global normalization politics, the highest priority must be the prevention, consistent by the aid and, if the case arises, by the repression.
The most important objective is the dissuasion and the reduction of the consumption of drugs, legal or illegal; it also consists in slowing down the number of new consumers by the slant of the prevention.
The second priority is the protection of the society and his/her/its members confronted to the phenomena of the drug. She/it also concerns the drug addicts to which the necessary aid must be given in order to allow them to lead an existence in conformity with the human dignity in spite of the drug (while encouraging the politics of reduction of the risks).
With regard to the control of the offer of drugs, a reinforced repressive politics must be developed with regard to the traffic of drug and the criminal organizations having some ties with this traffic.
The penal politics must be adapted with regard to the consumers of drugs. It is necessary to avoid that the users not having committed any offenses finish in jail.
A penitentiary politics permitting to avoid that people incarcerated for various reasons have resort to the drug must be led. Besides, it is about making so that the drug-addicted convicts have access to the treatments of substitution.
A regular assessment of the results of the applied measures is indispensable if one wants to adapt the politics of struggle against the drug to the social developments.
To master the phenomenon of the drug causes a question to two shutters. In the first place, it is important to fix the limits of that that a society and his/her/its components can support (on the social, economic, ethical plan) for what is the consumption of the substances in reason. In second place, it is necessary that the society organizes itself in order to assure the respect of these limits, on the basis of the objectives policies applied for.
2.2. Integrated and global approach
2.2.1. In general
The conductive thread of the report of the parliamentary task group was the necessity of a collaboration and a coordination between the different concerned actors, a collaboration of as much more necessary to the political level. The partition of expertises between the levels federal, communal, regional, provincial and local is not really favorable to an integrated politics. The parliamentary task group considered the harmonization of the politics to the different levels like the second premise to a politics of normalization. This harmonization must be concretized so much to the vertical level that to the horizontal level.
2.2.2. Vertical political harmonization
The vertical harmonization of the politics of prevention and aid as well as the social politics proves to be necessary. This harmonization must take place between the federal and communal level, between the communal and provincial level, between the federal and local level and between the provincial and local level.
2.2.3. Horizontal political harmonization
With regard to the horizontal harmonization of the different levels of powers, most forums of dialogue are already largely available. An interdepartmental dialogue, of the provincial and local platforms of dialogue concerning prevention and aid as well as a provincial and local pentagonal dialogue, exists thus.
The disparate financing of the projects to the different levels of the politics is a crucial problem.
2.3. Assessment / Epidemiology
In order to be able to make himself an exact idea of the nature and the size of the use of drugs, the following recommendations are formulated:
1. studies of population will be organized in a systematic manner and to regular intervals; they will be about comparable groups;
2. the studies will also be about other categories that the young schooled;
3. other specific at risk groups will be integrated in the research;
4. the studies will also be interested in general in the use of drugs in the population;
5. the quantitative approach will be completed by a more qualitative survey in order to put up-to-date better the use of the different substances.
To get a reliable evaluation of the problematic consumption of drugs, it is necessary that the authorities concerned coordinate their initiatives and arrive to an uniform and national registration of the different shapes of aid to the drug addicts and complete it by data gotten by the different levels of the administration of the penal justice (including police's services).
To the national level, the collection of the results of the epidemiological research achieved by different teams should be coordinated and encouraged.
The dissuasion is the attitude to adopt with regard to the consumption of illegal and legal drugs, with the exception of the substances prescribed to medically justified ends. To achieve this objective, it will be necessary to put in work of the preventive measures, of nature so much educational (the family, the school, the organizations of youngsters) that socioeconomic. The politics of prevention will be centered therefore, on the one hand, on a structural prevention (struggle against the precariousness, urbanization, development to the level of the districts, social urban politics) and, on the other hand, on a prevention aiming the person (promotion of health and sanitary education, stimulation of the social faculties, training of the management of the risks). The prevention must appear in the context of the life style of the groups to which it addresses. It is also necessary that the needs of the parents, the partners and the family are processed.
A society without drugs being an utopia, it is necessary to concentrate our efforts therefore on more realistic objectives as:
1. to warn the precocious addictions;
2. to fight against the conduct of vehicles under the influence of the aimed products;
3. to delay the consumption or to control it;
4. to reduce the abuse of the substances in reason.
In Belgium, the activities are always located especially to the level of the primary prevention. Besides the multiplication of the activities concerning secondary and tertiary prevention, the projects in the setting of the primary prevention must continue to benefit from an efficient support. A recent evolution - a slip of the attention toward the groups of younger ages - must be encouraged.
The secondary prevention must be centered on the following at risk groups: the young in the marginalized districts, the sector horeca and the penitentiary environment.
Since the actors of the prevention work to different levels, for different backers, a coordination of the dialogue supralocale and the harmonization of the different strategies of prevention prove to be necessary, and this two-level: to the level of the communities and to the level of the provinces.
In the same way to the coordination, the continuity of the work method and the promotion of the appraisal of the intervening parties of the preventive sector must be guaranteed. Besides, a fully-fledged statute for the concerned professional intervening parties must be finalized the point of emergency.
The medicines psychoactifs, the smart drugs and the influence of the legal and illegal drugs on the behavior to the wheel are points important of the prevention politics.
The school will be par excellence the site of the setting in work of the prevention. It is why the primary prevention in the teaching must be considered like essential and merit to be developed more.
The registration of some categories of medicines must be examined in light of their therapeutic increment. It is about medicines generating a dependence that is used currently massively for their pharmacological effects, outside of all objective medically justified.
The behavior prescriber of the physicians with regard to the medicines generating a dependence must be come with and follow-up on the plan so much preventive that reactive. The modification of the behavior of prescription of the physicians for what is substances psychotropics should be gotten, in particular within the groups of physicians that value the medical practice, while applying the technique said of the "peer review" (assessment by the equals). The medical provincial commissions have an important role to play in the prevention of this prescription behavior without discernment and in the correction of the possible individual dysfunctions. The pharmacists must actively participate in the politics of prevention.
The federal government must take emergency of the measures susceptible to act on the impact that the pharmaceutical industry has on the behavior prescriber of the physicians and to bring back the advertisement for the medicines to a scientific information objectifies.
It is important to avoid that the consumer is led in mistake for what is the nature, the composition and the effects of the proposed products.
2.4.5. Influence of the legal and illegal drugs on the behavior to the wheel
The consumption of legal and illegal drugs having a negative influence on the driver's behavior to the wheel must be advised against. The tests of tracking of the drug for the drivers must be generalized to this end. The legislation will be adapted to this effect and rates clear limits must be fixed. The infrastructure and the necessary formation must be put in place for people assigned to make respect the law.
The actions of sensitization and information on the influence of the drugs on the driver's behavior to the wheel must include all drugs, legal and illegal. It is necessary that the pharmaceutical and medical sector either more responsabilisé in this sense.
2.5. Care, reduction of the risks and social rehabilitation
The problematic use of legal and illegal drugs cannot be avoided in our society. The problematic consumers must have access therefore to a large range of facilities, active of so-called initiatives down doorstep destinies to reduce the damages (as the exchange of syringes and the programs of substitution) to the therapeutic programs of abstinence told high doorstep. The aid must take the shape of "care to order", what verifies itself to fortiori for the young since their situation requires a more specific help. The facilities will be harmonized and will be coordinated thanks to the platforms of dialogue, to a system of registration well organized and to a formal control of the authorities. In the context of a multidisciplinary approach, the aid specialized to the drug addicts must be integrated in the network of the existing social and medical facilities.
The starting point is the will of the help claimant. It is necessary to avoid to force someone to follow a treatment. A treatment under a pressure, on the other hand, must be possible. From a legislative viewpoint, the possibilities exist, the problem is to use them more efficiently and to place at disposal the staff and the means required to this effect.
A collaboration between the justice and the aid must be supported by protocols of collaboration delimiting the land and based on the mutual recognition. The confidential relation between the customer and the intervening party and therefore the professional secrecy of this last must be processed.
It is necessary to elaborate a coherent system to the federal level describing all facilities granting a help to the drug addicts. The finality of every disposition must be determined and the norms to which the facilities must answer will be specified. It is on this basis that the aid balanced to the drug addicts to the different echelons must be developed.
To the regional level, the different institutions should develop a harmonized network and this thanks to a cutoff of the groups targets, to the involvement to the dialogue and to orientation toward a specialist as well as to the collaboration.
The development of the echelon zero and the first echelon must be pursued. This objective is fixed on the basis of the following consideration: an at risk behavior develops itself the most often at marginalized drug addicts with little or not of contact with the sector of the aid. This at risk behavior only is not located as regards to the public health, but also in the domain of the different shapes of criminality and linked nuisances to the drug. Besides, an aid down doorstep can represent an increment as link and catalyst in the setting of the setting up of a better regional network.
The initiatives of reduction of the risks must be stimulated. They have for objective to moderate the negative effects of an excessive use of drugs. The programs of substitution, the medical and psychological accompaniment, the programs of promotion of the social insertion by the use and an organization discriminating some leisures have all their interest here.
It is necessary to take account always because the consumption of drugs goes together with individual and social problems: to tackle a toxico-dependence cannot be efficient if the problematic underlying is not landed. In that sense, the multidisciplinary aspect is very important.
A flexible financing of this aid down doorstep must permit to reach the group really targets (often of the uninsured people).
The intervening parties of the first echelon (the physicians general practitioners, psychiatrists, pharmacists and centers of health) must be brought to participate in the treatment to the methadone, as far as the physicians general practitioners receive an adequate formation, that the specialized centers grant their support to these actions (for example to call on the physicians general practitioners in the regional antennas of the MASS) and that a system of registration to centralized management is put in place. Life deprived of the concerned people and the professional secrecy of the intervening parties must be protected at the time of the registration of the administration of the methadone (nor the judicial services, nor police's services won't have a legal access to the system). The registration has for objective, on the one hand, the collection of the epidemiological data capable to contribute to the development of a politics based on the present tendencies and, on the other hand, to avoid serious risks for health ("shopping" of methadone).
2.6. Repression
2.6.1. Production and traffic of drug
Ø The production of drugBelgium must enter maximally into the European politics concerning the drug.
To slow down the increasing production of the legal and illegal drugs asks for an international politics, integral of the political, economic, social and sanitary considerations.
In order to oppose the dependence economic of the production of drugs, a politics of structural economic development must be put in place in order to promote the cultures of substitution actively.
The international conventions governing the interdiction of the trade free of the precursors must be respected strictly.
As important producer of medicines psychotropics, Belgium must take the initiative while reducing the production of the legal drugs to the level justified of the viewpoint of the public health.
Ø The traffic of drugBelgium has all interest to what develops himself an effective international collaboration, in particular to the level of the European union. Europol offers interesting perspectives in this respect. To the national level, a maneuver of correction must be foreseen concerning ratification of the relative treaties to the legal aid. In the same way the arsenal of instruments in the domain of the legal aid should be automated and the national magistrate should have a better framing. The maintenance of the criminal law must be optimalisé by a certain number of legislative initiatives and by the adaptation of the arsenal of the pains.
To the level of the narcotourisme, one pleads in favor of an approach integrated transfrontalière, notably by the slant of a triangular dialogue.
For what is local nuisances caused by the drug, the need of a local, containing integrated politics all sectors (social, aid, police, justice, administrative authorities) makes itself feel. The houses of justice can play a role in this context. It is desirable to spread the burgomaster's expertises in the domain of the administrative sanctions.
Ø Research and pursuitsThe penal intervention opposite the consumer of drugs rest the ultimate recourse. The setting in work of the repressive device is only judged appropriate when the consumer of drugs committed the offenses disrupting the social order. The nature of this intervention is determined by the gravity of the facts and the person's individual state concerned. The drug addicts (problematic) that have business to the police or to the justice must be oriented, in the first place, toward the aid. Set to part the specific at risk situations as the association of the use of drugs and the conduct of vehicles, the consumption of drugs must not lead as such to a penal intervention.
The possession of the illegal drugs remains penal.
It is necessary to make the distinction between the retail trade inspired by the only decoy of the gain and the retail trade that the consumers of drugs exercise to finance their personal consumption. In the first case, it is necessary to consider the retail trade like an essential link of the chain of the drug traffic. The approach must be identical to the one bet in work with regard to the wholesale trade. In the second case (to sell the drug to cover his/her/its own needs), it is preferable to have recourse off-shore range of possibilities of which arranges the repressive device (enters other the possibilities of orientation). Here makes itself to feel the need of a politics integrated in which the range of aid formulas proposed must harmonize with the needs of the administration of the penal justice and that puts some footbridges in place to the different phases of the aforesaid administration of the penal justice permitting such a harmonization.
Another distinction imposes itself, notably the one between the detention to ends of personal consumption of by-products of cannabises and other illegal drugs. The possession of cannabis for personal consumption must be accompanied with the weakest penal priority. In the case of the possession for personal consumption of other illegal drugs that the cannabis, he/it is indicated to start some pursuits if he/it is question of social nuisances or if the risk of apparition of such problems is real or if the concerned person is a problematic consumer.
A toxico-dependent person having committed offenses bound to the drug must, in the whole measure of the possible, to be punished (handling) by the slant of the alternative procedures foreseen by the penal legislation.
Ø Fixing of the painIt is necessary to avoid that the consumers of drugs not having committed any offenses succeed in jail. The jail is not besides the place indicated for the treatment of the drug addicts. The first objective of a jail is indeed to assure the security of the society.
From there that the consumers of drugs (dependent) must be able to benefit, in the whole measure of the possible, of the probation measures in the cases where the legal proceedings prove to be necessary.
In a general manner, it would be necessary to elaborate a penitentiary politics concerning drugs whose goal is to avoid that the incarcerated people begin to consume some drugs. The drug-addicted convicts, as for them, should have access to the treatments of substitution.
The function of the jail is targeted on the security of the society. The jail can only play a very reduced role in the handling of toxico-dependent people.
The number important of convicts presenting problems bound to the use of drugs mortgage all politics of execution of the pain within the penitentiaries. Considering the framing reduces and the considerable wage costs of the competent accompanists in the aimed establishments, he/it is right to resort to the external aid offer for the treatment of the drug addicts. A legislative regulation clarifies must, among others, to determine the responsibilities concerning the médico-therapeutic treatment.
A therapeutic relation that is developed itself during the detention can be pursued thereafter, notably thanks to the use of the various modes of the execution of the pain and the interruption of the aforesaid execution. The capacity of the section without drugs must be increased considerably.