During the present legislature, the government will take several initiatives that center in a modern politics concerning the modern drug, based on the principles enumerated to the chapter 1. The projects have been grouped in five chapters:
¨ An integrated and global approach;
¨ Epidemiology, assessment and research;
¨ Prevention;
¨ Aid, reduction of the risks and reinsertion; and
¨ Repression.
4.1. A global and integrated approach
Ø Summary
Following the demand of the Room of the Representatives, the Flemish Parliament, the European union and the sector of the aid, the federal Government will tackle in priority the creation of a Cell Drugs loaded to support the led politics.
The aimed objective is the realization of a global and integrated politics. The Cell Drugs will be composed thus of representatives of all authorities concerned (federal State, Communities and Regions). The direction of the Cell Drugs will be assured by un(e) coordinat(eu)r(ice) concerning drugs, compétent(e) to coordinate the politics concerning drugs. The Cell Drugs will push the action and will give some opinions to the authorities concerned ainsique in the Political interdepartmental Conference concerning Drugs that can be convened by every participating authority and by a certain number of other interdepartmental Conferences.
The federal Government wrote to this effect an okay project of cooperation (federal State - Communities - Regions). The signatory parts commit to put their strategies in concordance by the dialogue, on basis of a certain number of explicit objectives. The autonomous expertises of the Communities and Regions are respected. Regional differences for what is the principles and the practice will persist therefore.
The objectives of the Cell Drug as proposed by the federal Government are:
1. the obtaining of a global summary of all aspects of the problematic of the drug;
2. the continuous prevention of the addiction and the limitation of the damages caused by this one;
3. the optimalisation of the offer of care and treatment proposed to the drug addicts;
4. the repression of the illegal production and the traffic of drugs;
5. the development of strategic plans devised in the perspective of a global and integrated politics concerning drugs.
The missions of the Cell Drug as proposed by the federal Government present themselves as follows:
1. to centralize, to complete and to put up-to-date an inventory retailed of the authorities and the competent public utilities concerning drugs, as well as of research there pertaining;
2. to centralize, to complete and to put up-to-date the inventory retailed of the accredited institutions and/or subsidized, of the organizations, organs, specialized centers, centers of research and universities whose action is centered on one or several aspects of the problematic of the drug;
3. to propose measures motivated in order to harmonize the actions of the competent public utilities and authorities signatory of the agreement;
4. to propose motivated measures likely to increase the efficiency of these actions;
5. to give out the counsel's opinions and recommendations about the harmonization of the politics concerning drugs, either of his/her/its own initiative, either to the demand of the Political interdepartmental Conference concerning Drugs;
6. with the support of the the Belgian observatory of the Drugs and Addictions (to see action not: Belgian observatory of the Drugs and Addictions), to value the quality of data and information provided to the Cell by every authority left to the agreement and by every public process in order to be able to accomplish the missions as described above;
7. to propose and to prepare agreements of cooperation in order to reach concrete and concerted objectives. These objectives will be valued by means of concrete indicators;
8. to write a report politicizes trisannuel (as it is the case in the neighboring countries) as well as a report of activities yearly (annual pension).
In the setting of the mentioned missions the Cell Drugs above, can start a dialogue with the services and competent administrations and ask them to provide him some information. The Cell Drugs can make call to the collaboration of experts and associations or institutions whose action is targeted on the problematic of the drug and confer with the representatives of the organizations of drug addicts.
The reports (the political report and the report of activities) some Cell Drugs are sent to all authority signatory of the agreement (that transmits them to his/her/its Parliament). In the setting of the Political Interdepartmental Conference concerning Drugs, the parts to will value the agreement of collaboration and the working of the Cell Drugs.
The federal Government proposes to organize the Cell Drugs to the federal level (it will be a matter for the expertise of the Minister of the Public health) and to distribute financing of it among the authorities signatory of the agreement.
Ø Responsible Minister
The Minister of the Public health to the federal level is responsible (to the federal level) of the execution of this point of action. She/it acts in dialogue with the Minister of the social Business, the Minister of the Justice, the Minister of the inside, the Minister of the foreign Business, the Minister of the social integration and the Minister charged of the Politics of the big cities. The federal government negotiates surely with the federate entities that wish to participate.
Ø Calendar
For the middle of 2001, the Ministers of Health (public) of the federal government and the federate entities will sign an agreement of cooperation in view of the creation of a Political Cell of Health Drugs. This Cell has like only objective and expertise to tackle the clarification of an integrated health politics with regard to the problematic of the drug. She/it is the first step on the way of the creation of the general Cell Drugs that will approach the different strategic aspects also (notably the justice, the social business, the teaching, the well-being,..). The so-called extended Cell will be created by the slant of a cooperation agreement that should be approved by the federal government and the federate entities as well as by the different parliaments. The realization of this initiative is planned for the end 2002.
Ø Valued budget
Political cell of Health Drugs: 7 millions BEF per year. This amount will be freed by the Ministers of Health (public) signatories of the agreement, according to a distribution key similar to the one used for the financing of the investigation on health.
Cell general Politics concerning Drugs: the budget there pertaining must be foreseen from 2002. The necessary means will be freed by the authorities signatory of the agreement according to a distribution key similar to the one used for the financing of the investigation on health.
In the event some authorities would not like to participate in the initiative, the amounts of the contracting parts will be reviewed.
4.1.2. Justice - Aid: of the clear agreements
Ø Summary
The recourse to the aid in the setting of the reaction of the judicial system to the problematic consumption of drugs is considered more and more like appropriate, so much by the judicial system that by the sector of the aid. The penal approach made place to elements targeted on the treatment. The contribution of the aid can consist of the following aspects: welcome of emergency, welcome of crisis (orientation by the police, put in liberty under conditions), preventive screening (orientation by the police, therapeutic opinion), treatment / accompaniment as condition (probation prétorienne, penal mediation, put in liberty under conditions, internment, probation, conditional liberation), the external aid (at the time of the detention), the social rehabilitation (after detention).
A certain number of secondary criterias is essential to this subject.
First of all, the aid must keep the right to refuse some customers even though the alternative is the jail. A communication and a collaboration minimal must remain guarantees.
Then, so much the judicial system (penal) that the aid requires that one agrees on clear and very definite arrangements.
It is more precisely about aspects as the professional secrecy, the respect of the processing programs (clean finality of the aid) and the helper's statute in the contracts of security and society, the contracts of prevention, the contracts drugs and the alternative judicial measures.
The federal government will create a containing task group of the representatives of the aid and the justice, that will assign to define the possibilities and the limits for the two sectors and that will formulate propositions of instructions in order to structure the collaboration between said sectors. Of the local agreements of collaboration concrete will be able to be concluded on the initiative of the local group of coordination Drugs. These agreements of collaboration will take account maximally of the local situation and the viewpoints of every Community. The agreements must leave from the principle of a constructive collaboration, in the respect of the finality and the specific features of the parts concerned (the aid is articulated around the customer whereas au breast of a judicial process, the interest of the early society). The task of the justice helpers is to control the judicial conditions.
The task group will grant a particular attention to the recognition and to the explicitation of the existing professional secrecy (the range of this notion is interpreted differently by the judges to the penal and the public Ministry, on the one hand, the representative organizations of the actors of the aid, on the other hand):
· Who is resulted from the professional secrecy and who is not?
· What are the information that raise the professional secrecy and what are those that he/it is not?
The task group will formulate a proposition of clear cutoff of the land then.
A problem here is the fact that the intervening parties often ignore the penal measures that watch the customers again. In the past, some therapies have been interrupted or have been stopped because the concerned person had to undergo a punishment involving personal restraint. The belated execution of the pains can lead to the customer's démotivation. He/it belongs, in the first place, to the customer to communicate as precisely as possible and already at the time of the preliminary interview, what are the penal measures taken to his/her/its consideration that must be executed again. An agreement with the justice on a minimal formal communication about the execution of these measures and the calendar there pertaining would improve the efficiency of the aid appreciably (and of the penalty). The task group will also bend on this problem.
In order to rationalize the relations between the justice and the aid, of places them managers concerning addiction (coordinators of the care) will be designated in every house of justice (to see also: the penal politics - detention and retail trade). These coordinators of care will be of the helpers of justice who dedicate themselves (in part) to the problematic of the drug. They will have received a sufficient formation (knowledge of the aid and the judicial system). They must be able to inform the magistrates of the public prosecutor's office and police's services on the different shapes of aid. The SSTC will raise the inventory of the global offer of aid concerning drugs. Place them judicial managers should be also in measure to give some opinions on the opportunity of incitement measures to the treatment. It is necessary that they arrange of sufficiently of human and material means to be able to answer the questions of the magistrates of the public prosecutor's office quickly. A permanence should be put in place in every house of justice, during the office hours. This places judicial managers will make part of the coordination groups local Drugs and will participate to the development of the local circuits of care. In the 3rd paragraph of the article 7 of the law of March 5, 1998 relative to the conditional liberation modifying the law of April 9, 1930, the words on consignment are suppressed. It to underline the central role of places them managers or coordinators of the judicial care.
The penal judicial system asks more for clarity on the possibilities of welcome of crisis of the drug addicts. The development of the circuits of regional care (to see also: organization of the offer of the care) will permit to put regional networks of welcome of crisis and emergency in place.
Ø Responsible Minister
The Minister of the Public health is responsible for the execution of this point of action. She/it acts in dialogue with the Minister of the inside, the Minister of the Justice and the Minister of the social integration.
The Minister of the Justice is responsible for the precise definition of the tasks and the designation of the judicial place-managers.
Ø Calendar
The task group must start its activities beginning 2001 and must present his/her/its report final end 2001. Place them judicial managers will be designated for the mid 2001.
The execution of this point of action must be finished in December 2001.
Ø Valued budget
The agreements between the justice and the aid for what is the professional secrecy, of the respect of the clean objectives and the statute of some helpers don't have, in principle, not of budgetary implication. Place them managers and the circuits of regional care will be landed farther in the present note.
4.1.3. The shutter drugs of the global plan (contracts with the townships)
Ø Summary
The federal government subsidizes 51 townships currently for a total amount of 320 millions FB per year for the welcome of the drug addicts (shutter drugs of the global plan). These funds are used for the financing of the MASS, of the centers of welcome, of the coordination of the drug, of the prevention, of the crisis centers, etc. On the 51 townships that benefit from subsidies, there are 22 cities that wrote down a shutter drugs in their contract of security and society, 20 townships have a contract aiming a plan drug in annex of the contract of prevention and 9 townships have a contract solely concerning the plan drug. The projects that are financed thus function in general rather well.
The setting in work of these projects continues however to pose specific problems.
In the first place, the educators of street, the workers of the sector of the prevention and the other intervening parties paid according to this formula continue to function in an ambiguous context. Their position towards their customers is sometimes problematic. Their task consists effectively in helping their customers to improve or to consolidate their situation and not to lend aid to police's services in their fight against criminality. The reality is not always as obvious because of financing integrated of the contracts (the contract drugs are often integrated in a contract of security). Henceforth, the educators of street, the workers of the sector of the prevention and other intervening parties will be endowed unequivocally with a mission and of a clear statute in the contract concluded with the township.
The fact that the intervening parties, the workers of prevention and the educators of street are hired by the slant of one year contracts puts problem. The federal government will study what manner these recruitments could make themselves as contracts to indeterminate length (or at least long-term).
A second problem is the imprecise cutoff of the prevention tasks between the services of police and the sector social médico-psycho. The international scientific organizations ask that a clear distinction is operated, in all interventions and in all situations, between the prevention of socio-sanitary problems and the prevention of crime. The sector social médico-psycho is responsible for the prevention of the abuse of legal and illegal drugs; police's services is responsible for the prevention of crime (possibly linked to the drug). Police's services has, obviously, also a repressive task. The services of police and the sector of the prevention should work in the setting of a permanent dialogue and clearly agreed arrangements in order to avoid the incompatibility of the applied strategy.
The SPPP manages the prevention of crime bound to the drug and is explicitly person responsible of the prevention and struggle against the social nuisances. The foreign examples learn us that an approach decentralized of the phenomenon of the social nuisances, assorted of a national support, provides very good results.
A realization of this new politics confided to the SPPP implies that it can develop the following actions:
¨ to raise the card of the problematic to the local level;
¨ to throw a survey of the struggle experiences against the abroad phenomenon;
¨ to organize a dialogue with the competent processes;
¨ to execute the points of action via a national country (supporter account of the local priorities);
¨ to develop the appraisal methods and the instruments of support.
Besides, the activities currently achieved by the SPPP should be maintained reinforced or even. It is about:
¨ of the assessment of the contracts (on the basis of regular visits to the projects and via the writing of appraisal reports)
¨ of the support to the projects (on the basis of formations, while taking into account the local demands, as well as of a reaction fast to the new tendencies).
Third, the coordination with other initiatives is often insufficient (initiatives of the the federal authorities, of the Communities and the Regions, the provinces or the townships). To palliate this lack of harmonization, the workers of health financed by the shutter drugs of the global plan will participate henceforth (by the slant of a privity in deed) to the politics of prevention and health of their Community and their Region or the federal state. In the event they would be detached by the township that concluded the contract, the detachment will only aim services of health and social existing. Then, the affectation of the available means in the setting of the plan drugs and intended to the aid will be confided to the Minister of the Public health, in dialogue with the Minister of the inside, as well as the Communities and the Regions. The Minister of the inside distributes the means destined to the prevention and the local coordination coming from the shutter drugs of the global plan, in dialogue with the Minister of the Public health, the Communities and the Regions. The National Commission of assessment and accompaniment is suppressed. The political Cell Drugs takes his/her/its missions that consist to:
¨ to value the projects of conventions proposed by the townships and to communicate a counsel's opinion on each of these projects to the Minister of the inside and to the Minister of the Public health;
¨ to look after the execution of the finished conventions;
¨ to look after what the program defined in the convention is perfectly integrated in the other programs already applied in similar domains.
The aforementioned measures must contribute to neutralize the secondary effects of the one year contracts, to give a better framing to the hard-working socio-sanitary and to simplify and to improve their formation and retraining (organized by the Communities).
Ø Responsible Minister
The Minister of the inside is responsible for the execution of this point of action. He/it negotiates with the Communities and confer with the Minister of the Public health, the Minister of the social Business and the Minister of The social integration.
Ø Calendar
The reform as described above must be finished end 2002.
Ø Valued budget
The cutoff of the tasks in the domain of the prevention of the addictions between police's services and the sector of the prevention has budgetary consequences for the federal authority and for the Communities. The Minister of the inside will negotiate with the Communities.
The new task of the SPPP (to push the local approach of the social nuisances bound to the drug) requires the investments that will be the subject of discussions in the setting of the budgetary control also.
4.1.4. International politics concerning drugs
Ø Summary
Belgium will continue to integrate in the European politics concerning drugs. Our country won't only participate as far as possible in the European programs (for example for the follow-up and other treatments after care) but will plead, besides, on every occasion that is offered to him, for the pursuit of the development of the European cooperation. The objective is to arrive to an innovative, realistic and integrated politics, that approaches the judicial, economic, social and sanitary aspects globally. In this context, the production of the legal substances must also be treated.
A politics coherent transfrontalière that harmonizes as much that to make can itself the legislations and practices interns as regards to the drug is desirable. Belgium will plead in favor of the creation of a system of European monitoring of the legislation and practices concerning drugs and addictions, put in place within the European observatory of the Drugs and Addictions.
The Cell Drugs will operate therefore, in an European context, as "national coordinator" (point 1.2.2 of the Action plan 2000-2004). The Cell Drugs will participate to the activities of the Pompidou group (Council of Europe) and of the different organizations of the United Nations. The Belgian observatory of the Drugs and Addictions will work in narrow contact with the European observatory of the Drugs and Addictions (point 1.2.3. of the action plan 2000-2004).
The present note politicizes enrolls in the extension of the Action plan of the European union concerning struggle against the drug (2000-2004) and of the recommendations of the Pompidou group of the Council of Europe. Belgium will continue to participate actively in the meetings of the Pompidou group. Belgium will adopt henceforth, as promised to the director of the PNUCID, a more active attitude within the organs of the United Nations whose activities are dedicated to the drugs and will present future the results of the experience that she will have acquired concerning "reduction of the demand" and "reduction of the risks."
Ø Responsible Minister
The Minister of the foreign Business is responsible for the execution of this point of action. Other Ministers who participate regularly in the international meetings treating this thematic are the Minister of the Justice, the Minister of the inside and the Minister of the Public health (that is responsible for the Political Cell of the Drugs).
4.2. Epidemiology / Assessment / Research
4.2.1. Belgian observatory of the Drugs and Addictions
Ø Summary
An uniform registration of the relative data to the clinical treatment is indispensable, for the same reason as the inventory of the existing epidemiological research and the collection of his/her/its results. The "dead angles" must be identified and new studies, more targeted, must have initiated. It is the reason for which the federal government wishes to make progressively of the national Focal Point a Belgian Observatory of the Drugs and Addictions, being a matter for the expertise of the Cell Drugs.
The Cell Drugs will assign the Belgian observatory of the Drugs and Addictions to study the effects of the different political decisions notably and will compare them between them. The Cell Drugs will propose adaptations of the politics led on the basis of these numbers.
In this manner, it is not only possible to put to level the epidemiology showing a deficit but our country can also fill his/her/its European obligations. The Belgian observatory of the Drugs and Addictions will be charged of the implementation of the indicators standardized European (of the European observatory of the Drugs and Addictions). For 2000, it is about the following aspects: the consumption of drugs of the population in general, the prévalence of the consumption of drugs problematic, the need of handling, mortality and the infectious morbidity. From 2001, the number of these indicators will be carried to 29. Even though a big number of data is recorded in the sector so much the prevention that of the aid, this registration doesn't make itself in an uniform manner and is done to different ends.
We don't yet arrange, in our country, of sufficiently of relative data to the clinical treatments. On present hour, the Communities put to the point of such systems of registration that should be applied on the whole of the sector of the care. During the three draining years, the Flemish Community dedicated more than 16 millions to the development of the VAD (Vlaamse Registratie Middelengebruik) that is responsible for the system.
The tasks of the Belgian observatory of the Drugs and Addictions are the following:
¨ the installation, the development and the maintenance of a communication network between the partners concerned by the problem of the addiction (to improve the fame and the visibility of the Belgian observatory);
¨ the collection, the analysis, the synthesis and the diffusion of the relative data to the drug and to the addiction, as well as the qualitative and quantitative improvement of these operations (of data encoded on the whole concerning the consumption of drugs of the population who will complete those gathered to the communal level);
¨ the collection, the diffusion and the valorization of the knowledge in all disciplines concerned by the problematic of the drug and the addiction (in collaboration with the responsible organizations to the communal level);
¨ the development of the appraisal and the promotion of the epidemiological research on this land (in dialogue with the existing organizations of coordination);
¨ the realization of the liabilities contracted by Belgium towards the European observatory of the Drugs and Addictions.
¨ The Belgian observatory of the Drugs and Addictions will harmonize the registration (on the basis of the variables and European definitions) so that the numbers can be used on the federal and European plan. An unique code will avoid the double jobs without compromising for as much anonymity. The unique code will be defined to the departure of a set of identity data but the inverse operation (to recover the identity to the departure of the code) won't be feasible.
These tasks can only be executed in narrow dialogue with the Communities. The present collaboration within the Belgian Information Reitox Network (BIRN) (between the focal point and the 4 points under focal, to know the VAD, CCAD, ASL and CTB-ODB) is maintained.
The federal government will integrate in his/her/its Investigation on the health of 2001 a module dedicated to the consumption of drugs and narcotics, in order to get a preview of the consumption of these substances on the whole of the population. The questions will be based on the protocol of the European observatory of the Drugs and Addictions.
An attention must be granted, on the plan so much the epidemiology that of the assessment, to the variables and specific differences between the sexes. This aspect has not been taken sufficiently before in consideration, what have truncated the picture of the problematic of the drug involuntarily. He/it seems, besides, that the women have, by comparison with the men, resort less often to the sector of the care. Of the relative studies to the reasons of this discordance (probably enlarging) makes defect.
Ø Responsible Minister
The Minister of the Public health is responsible for the execution of this point of action. She/it negotiates with the Communities and confer with the Minister of the social Business.
Ø Calendar
The Belgian observatory of the Drugs and Addictions will be created in dialogue with the Communities and the Regions, on opinion of the Commission Drugs (if it is already operational).
Ø Valued budget
With regard to the creation of the Belgian observatory of the Drugs and Addictions, a feasibility study is in progress at present. This feasibility study will give an evaluation of the expenses that the working of the observatory will entail in 34 millions FB for 2001, 32 millions FB for 2002 and 29.5 millions FB for 2003. 2 millions FB will be poured every year by the European observatory of the Drugs and Addictions. The federal government will conclude an agreement with the Communities on the financing of the remaining amount. At the moment, the Communities finance alone the national focal point.
The quoted amounts are based on the following evaluation:
BUDGET IN BEF (X 1 000)
Mission 2001 2002 2003
Coordination 2.216 2.216 2.216
Network and communication 2.998 2.548 2.548
Prévalence of the use of drugs in the population 1.333 1.446 0
Indicatory of the treatment demand 3.302 2.739 2.739
Local prevention of the problematic consumption 1.783 1.783 1.333
National Prévalence of the problematic consumption 3.358 1.671 1.671
Impact of the problematic consumption 1.108 1.108 1.108
Mortality 2.036 2.711 2.036
Infectious illnesses bound to the use of drugs 1.108 1.108 1.108
Analysis of the products in circulation 1.851 1.851 1.671
TOTAL 21.094 19.181 16.431
REITOX 12.431 12.319 12.319
4.2.2. Precocious alert system ("early warning")
Ø Summary
The clarification of a "precocious alert system" for the new synthetic drugs is in progress since December 1997. The national focal point, the points under focal and various laboratories collaborate in order to identify the new drugs and to establish the profile of their consumption. This information is distributed to the participating and transmitted to a certain number of partners.
The transformation of the national focal point in a Belgian Observatory of the Drugs and Addictions will permit to perfect this precocious alert system (more of laboratories and socio-cultural information). To the federal level, the system will essentially be limited to the European obligations. It is not therefore the federal government that will make develop the systems of analysis "one site" (where users could have synthetic drugs tested, be practiced like that at the festival of rock and dance in Dour).
The results of analyses of products done regularly (of the well stocked products so much by the justice that by the actors on the land) and the inventory of new tendencies in the consumption will be communicated to the European observatory of the Drugs and Addictions, to the sector of prevention, to the sector of the aid, to a certain number of services (supra)nationaux of justice and police and (as far as possible) to the consumers of drugs. Information will also be transmitted to the persons responsible of the different telephonic call numbers (telephonic information permanence, anti-poison center…).
The system allowed the discovery and the diffusion of the existence of a dangerous XTC variety very high dose lately of active principle. The 4-MTA has also been identified by the slant of this system.
Ø Responsible Minister
The Minister of the Public health is responsible for the execution of this point of action.
Ø Calendar
The calendar coincides with timing planned for the creation of the Belgian observatory of the Drugs and Addictions that will direct the precocious alert system.
Ø Valued budget
To see also: Belgian observatory of the Drugs and Addictions. The laboratories will be paid for the benefits provided in this context. The Minister of the Public health will elaborate a regulation concerning indemnification.
4.2.3. Assessment of the treatment methods, facilities and circuits of care
Ø Summary
Besides the epidemiological studies, the sector also asks for an uniform, permanent and scientific assessment of the methods of treatment and prevention. The Cell Drugs will play a role in this respect of innovatory and motor. Certainly, some research are done in Belgium, but they are dispersed too much and the feedback of the results on the practice is insufficient (even though such a feedback could improve the quality).
The care to the drug addicts, and in particular the care in institution, are very expensive (to see framed). It is important that the drug addicts who look for a help can receive an aid and an accompany as efficient as possible. The federal government will assign the SSTC to make achieve one or several studies of assessment on the efficiency (results) of the aid to the drug addicts. Such an assessment can only be achieved via a longitudinal survey. All facilities and applicable actors must be taken (hospitals, structures catégorielles, Centers of mental health, physicians,…).
Besides, the SSTC will make achieve a research on the organization of the care to the drug addicts (to see action following as not). The setting of the concepts of networks and circuits of care introduced in the context of the aid to the drug addicts (to see: organization of the offer of the care) can serve setting of reference.
Ø Responsible Minister
The Minister of the scientific Politics is responsible for the execution of this point of action. He/it confers with the Minister of the social Business and the Minister of the Public health.
Ø Calendar
Order of the survey: July 2001
Ø Valued budget
16,5 millions will be registered to the budget of the SSTC to finance research on the efficiency of the care concerning drug (including his/her/its organization).
Ø Summary
An assessment of the MASS and networks that they constituted is in progress since July 1st, 1999 under the aegis of the Federal Services of the Scientific, Technical and Cultural Business (SSTC). Research will continue until June 30, 2001. From now on, he/it is established that the MASS can offer a handling of quality to the consumers of drugs marginalized and problem. The tasks of the MASS are the following:
1. from a medical viewpoint: to improve the quality of life of the drug addict while bringing an answer to his/her/its needs concerning treatment and while reducing the damages caused to his/her/its health by the consumption of drugs;
2. from a social viewpoint: to assure the drug addict's social rehabilitation (management of the debts, management of the income, lodging, social cover, professional accompaniment);
3. of the viewpoint of the incentive: to motivate the drug addict in order to bring it to participate in the programs targeted on one life without drugs.
The inami repays the expenses exposed more or less by the MASS by patient. One applies here a ceiling (for example: 150 patients / week). A certain number of MASS has a number of patients superior however in the ceiling. The investigation of assessment will indicate if this system of financing must be reviewed.
It is essential that the MASS integrate in the local area network and take a very definite position in the regional network of care.
The need to have agreements of precise cooperation between the MASS and other ambulatory and residential structures makes itself feel.
The federal government will adapt, if the case arises, his/her/its politics on the basis of the assessment survey.
Ø Responsible Minister
The Minister of the social Business is responsible for the execution of this point of action. He/it negotiates with the Minister of the Public health and the Minister of the inside.
Ø Calendar
This point of action will be concretized from October 1st, 2001.
Ø Valued budget
The federal government waits for the results of the SSTC research to take a decision on an extension/réorientation possible of the means affected to the MASS.
The communities have an important expertise concerning prevention. A political note that pleads for an integrated and global approach doesn't conceive itself however without this chapter. The political note hires the federal government currently only. There will be some negotiations with the Communities. The federal government asks the Communities to pursue their efforts concerning prevention and recognizes their autonomous expertise in this domain.
Ø Summary
Although the demand of treatment comes more and more masculine drug addicts, it proves to be that the women are proportionally more numerous to tempt to find a solution to a dependence to the medicines. The specialized centers and the physicians general practitioners must become aware of this phenomenon. The dependence in relation to the medicines didn't receive a sufficient attention on behalf of the scientific research. This problem presents a sufficient quantitative and qualitative gravity. It is effectively about a serious dependence that, in Belgium, makes distinctly more victims than in other European countries. Besides the individual suffering, this shape of dependence would also cause economic damages because of the decrease of productivity and absenteeism that it provokes.
This point of action consists of strategic measures specifically targeted on the medicines psychoactifs.
The Minister of the Public health will reexamine the registration of the benzodiazépines and amphetamines in dialogue with the European partners, in light of the therapeutic increment of these substances. In dialogue with the European partners, some supplementary warnings will be mentioned on the packings and in the notes of the benzodiazépines (to see action not: to drive under the influence of some products). The Council Supérieur of hygiene will organize, in collaboration with the universities, physicians and pharmacists, a conference of consensus about the prescription of the benzodiazépines. A campaign of prevention will be launched also in order to attract the attention of the population on the dangers of the benzodiazépines (among which the risks in the circulation).
The behavior of the physicians for what is of the prescription of products generating a dependence, will be accompanied and follow-up by the Groups of medical assessment (GLEM) and the provincial medical Commissions, on the preventive and repressive plan. The provincial medical Commissions can, in exceptional circumstances, to withdraw a physician's visa or to send back it before the order of the Physicians and even before the justice.
The federal government will also examine the role that Pharmanet can play in this respect and more especially, if an extension of Pharmanet to the non repaid medicines is indicated. A confrontation with the numbers of Pharmanet (comparison with the behavior of colleagues physicians concerning prescription) is sufficient "to correct" the behavior of an individual physician.
The inspection of the Pharmacy will also play a role in this problematic (law of February 4, 2000).
The federal government will take some measures in order to reduce the influence of the pharmaceutical industry on the behavior prescriber of the physicians and will take concrete initiatives in order to limit the advertisement for the medicines to scientific and objective information. The visits to the physicians done by independent visitors and organized by the Belgian Center of Pharmacothérapeutique information, will be maintained. The files of promotion of the appraisal established by the Belgian Center of Pharmacothérapeutique information that can be used by the GLEM, will be completed and distributed on a bigger scale. The sampling distribution to the physicians will be reduced appreciably for the benzodiazépines. For what is the amphetamines and other narcotics, the sampling distribution to the physicians is forbidden for a long time.
The flights of notebooks of orders (virgins) (and of nominative seals) among the physicians are numerous, the goal being to get some narcotics. There is even a delivered traffic illegal of these notebooks and narcotics. The platform of dialogue federal "security of the physicians", presided by the SPPP, will develop the concept of the prescriptions in double copy and numbered. The federal government will put a national system of prescriptions in place in double copy and numbered for the narcotics on the basis of this dialogue.
The federal government will organize a dialogue above on the mentioned measures with the representative organizations of the physicians, the unions of pharmacists and the pharmaceutical industry. The cell Medicines, created by the Minister of the social Business and the Minister of the Public health, will be here responsible for the coordination of the mentioned measures before.
Ø Responsible Minister
The Minister of the Public health is responsible for the execution of this point of action. She/it confers with the Minister of the social Business, the Minister of the economy and the Minister of the inside.
Ø Calendar
This point of action is currently under development. The conference of consensus "benzodiazépines" will take place to the mid 2001. The follow-up of the behavior prescriber and the campaign of prevention will be finalized beginning 2001.
Ø Valued budget
20 millions of BEF will be registered to the budget of the Minister of the Public health.
4.3.2. To drive under the influence of the alcohol, drugs and medicines
Ø Summary
The dissuasion of the conduct under the influence of legal or illegal drugs will take the shape of tests of tracking of drugs on the drivers.
The conduct under the influence of illegal drugs and medicines has been made explicitly penal by the law of March 16, 1999 and by the AR of execution of June 4, 1999. The Minister of the Justice has, in the meantime and in collaboration with the Minister of the Mobility and Transportation, prepared of the circular and directive to the intention of the services of police and the public Ministry.
Le(s) Ministre(s) has (have) held account of the following principles:
1. a campaign of sensitization or information (organized by the Belgian institute for the road Security) informs the user of the road preventively on the existence of the law (and the reasons of his/her/its existence), as well as on the rights and duties there pertaining;
2. the enforcement of law of March 16, 1999 will be valued annually; in order to permit this assessment, a system of registration will be developed;
3. the law has for objective to increase the security of the circulation and no to tackle the consumption of drugs or to aim, or even to discriminate some groups (of age);
4. the withdrawals of urine or blood are only justified after observation of clear outside signs (by the slant of a battery of tests standardized); the policemen are driven to the recognition of these outside signs;
5. the objective will consist in fixing clear boundary values;
6. a large range of adequate alternative pains is put in place.
The federal Government will develop, if the case arises, in dialogue with the European partners, of the specific measures to fight against the conduct of vehicles under the influence of medicines. These specific measures understand:
1. the apposition of a warning on the packing of the medicines concerned (one thinks of a sticker representing a car, in the center of a red interdiction signal, glued on the packing by the pharmacist delivering the medicine that would give, at the same time, some explanations to the customer on the danger that the conduct represents under the influence of the aimed substances);
2. the adaptation of the note; and
3. the sensitization of the physicians prescribers
The formation of the policemen that does the breathalyzers will also attract the attention on the evoked problem.
Ø Responsible Minister
The Minister of the Justice is responsible for the realization of this point of action. Him it devises with the Minister of the Mobility and Transportation. The Minister of the Public health is put in charge of the part of the action that milked to the packing and the note of the medicines as well as the sensitization of the physicians. The Minister of the inside is responsible for the relative part to the formation of the policemen.
Ø Calendar
Stopped of execution: December 1st, 2000
Conducted under the influence of medicines: January 1st, 2002
Ø Valued budget
The relative credits to the measures concerning the medicines psychoactifs are registered to the budget of the Minister of the social Business (to see: medicines psychoactifs).
Ø Summary
The prevention of the tobacco addiction and the alcoholism imposes itself. The federal Government will look after what the Cell Drugs and the Political interdepartmental Conference concerning Drugs grants attention sufficiently to these products. This point of action only consists of the political measures for specific products, that means specifically oriented political measures toward a very determined product (tobacco or alcohol).
Tobacco
In order to be efficient, the legislation must control so much the offers (modes of sale, price, advertisement) that use (in public places, to the school, to work,…) of tobacco. Some legal initiatives must be completed by countries of sensitization. A certain number of measures aiming to reduce the consumption of tobacco is a matter for the expertise of the federal government.
The question of the advertisement for the products of tobacco and his/her/its derivatives are regulated by the Law Vanvelthoven, annulled in part by the Court of arbitration in his/her/its stop of September 30, 1999 (GP Formule 1 in Francorchamps).
The public transportation are, in a large measure, "nonsmokers". This matter is governed by the A.R. of September 15, 1976. He/it is prohibited from smoking in the trams, buses and planes. There are even some places planned for smokers in the trains and they always separated of the "nonsmokers." This matter is a matter for the expertise of the Minister of the Mobility and Transportation. Considering the numerous complaints, the possibility and the opportunity of a total interdiction to smoke are examined. It is sufficient to reduce the number of compartments for smokers in the trains maybe.
In the sector horeca, the problem of the tobacco addiction carries, on the one hand, on the ventilation and on the other hand, on the cutoff of the zones smokers. Today, the sector respects the relative regulation much better to the systems of smoke aspiration and to the zones of interdiction to smoke that in 1999. The improvement of the results certainly results from the announcement of a sterner politics and the attention granted to the problem by the medias. Since it is necessary to improve the results constantly and that some complaints continue to rain, the actions of control of the inspection of the Food products must be repeated regularly. In the setting of an action of control integrated, the regulation on tobacco will be controled again in fall.
The federal government will negotiate with the Communities in order to arrive to an improvement of the behavior of the smokers in the schools. The legislation on the tobacco addiction in the school environment must be completed by an active politics of prevention. Every school network should develop a coercive politics against the tobacco addiction capable to be integrated in the general school regulation. The total interdiction to smoke offers a maximal protection against the passive tobacco addiction and would constitute a basis ideal for the promotion of a life style without tobacco. It is not necessary to stop underlining the importance of the function of example of the professors especially.
The additives that increase the dependence are added currently to the cigarettes. The possibility to bar such a practice must be examined.
The sale of the tobacco products returns, every year, to the government 68 FB billions of taxes. To it, it is necessary to oppose 50 deaths per day. The federal government will free, in dialogue with the federate entities, of the supplementary means to reinforce struggle against tobacco.
Anti-tobacco politics will be developed in a political note of the Minister of the Public health.
Alcohol
The federal government asks the Communities to plan place sufficiently in the school program to teach to the teenagers how to behave opposite the alcohol (to see also: development of the prevention) and to develop a prevention targeted on the families and the workplace.
The federal government will execute the recommendations of the Action plan European Alcohol 2000-2005, as far as these are on the subject compatible with the tradition, the culture and the public opinions.
The problem of the dependence to the alcohol will receive attention sufficiently at the time of the development of the circuits of regional care and the definition of the needs in regional care (to see also: organization of the offer of care).
The federal government will ask the Belgian producers of alcohol to take position on the document the Geneva Partnership one Alcohol: Towards has Global Charter" that has been elaborated by the international producers of alcohol, in collaboration with scientists and decision-makers.
The Minister of the Public health will verify in what measure the regulation of the advertisement for the alcohol must be adapted for the new mixed drinks (promues by the young, the "alcopops". She/it will take in consideration, in this respect, the misleading allegations, the obligation legal of a detached offer, the promotional stands at the time of feasts organized for the young, the specific advertising strategies and the recommendations of the European Parliament. She/it will confer with the Communities.
The competent services of inspection will grant importance more to the decree-law of relative November 1939 14 to the repression of the drunkenness and to the law of July 15, 1960 on the preservation moral of youth. They will especially become attached to the minimum age for the distribution of alcohol and to the distribution of alcohol to intoxicated people. The criminal law will be, here also, the ultimate remedy.
Ø Responsible Minister
The Minister of the Public health is responsible for the execution of this point of action. She/it will negotiate with the governments of the federate entities that have large assignments in this domain. She/it will confer with the Minister of the inside and the Minister of the economy.
Ø Calendar
The different measures will be set in motion during the present legislation.
Ø Valued budget
The Minister of the Public health will free some credits on his/her/its budget to take some measures in opposition to the advertisement for tobacco, in dialogue with the Communities.
4.3.4. Development of the prevention
Ø Summary
The viewpoints and actions of the Communities will be the starting point of all prevention politics.
The federal government will ask the Communities to integrate some initiations structurally to the prevention in the formation of the teachers and to free the necessary space in the school programs (for example via the program school "keys of life"). In the final terms of the Flemish teaching (mainly to interdisciplinary range), these themes have already been integrated in the school program. The federal government estimates desirable that the actions of prevention of the use of drugs start in the primary education and continue in the higher education. To this last level, the prevention of the use of alcohol and medicines seems indicated.
The development of the existing initiatives of prevention must be pursued to the different levels (it will be necessary to harmonize them as far as possible). The initiatives of prevention must also be sustained and estimated of scientific way in agreement with instructions and the criterias of assessment of the European observatory of the Drugs and Addictions in Lisboa.
In the same way to the primary prevention, oriented toward a large public or toward potential consumers, the secondary and tertiary prevention will also receive the requisite attention; these two preventive echelons are oriented respectively toward the fast detection of problems among the consumers and toward the limitation of the damages among the regular consumers. The prevention must, besides, to concern all drugs, legal and illegal. The prevention of proximity or to the local level (where exists a collaboration between the institutions of teaching, the care of health, the welfare, the justice, the organizations of leisures, the employers and the unions) merit to be encouraged. The federal government will stimulate the townships so that they elaborate a local politics.
The Minister of the Public health and the Minister of the inside will negotiate with the Communities and the Regions. They will conclude, when necessary, of the agreements-settings with these levels of power. The Cell Drugs (to see supra) will constitute, in this respect, an adequate forum for a politics drugs integrated and concerted. The Belgian observatory of the Drugs and Addictions will owe organiser/inventorier the scientific assessment of the prevention projects to the national level.
A politics coherent transfrontalière that harmonizes as much that to make can itself the legislations and practices interns as regards to the drug is desirable. Belgium will plead in favor of the creation of a system of European monitoring of the legislation and practices concerning drugs and addictions, put in place within the European observatory of the Drugs and Addictions.
The Cell Drugs will operate therefore, in an European context, as "national coordinator" (point 1.2.2 of the Action plan 2000-2004). The Cell Drugs will participate to the activities of the Pompidou group (Council of Europe) and of the different organizations of the United Nations. The Belgian observatory of the Drugs and Addictions will work in narrow contact with the European observatory of the Drugs and Addictions (point 1.2.3. of the action plan 2000-2004).
The present note politicizes enrolls in the extension of the Action plan of the European union concerning struggle against the drug (2000-2004) and of the recommendations of the Pompidou group of the Council of Europe. Belgium will continue to participate actively in the meetings of the Pompidou group. Belgium will adopt henceforth, as promised to the director of the PNUCID, a more active attitude within the organs of the United Nations whose activities are dedicated to the drugs and will present future the results of the experience that she will have acquired concerning "reduction of the demand" and "reduction of the risks."
Ø Responsible Minister
The Minister of the foreign Business is responsible for the execution of this point of action. Other Ministers who participate regularly in the international meetings treating this thematic are the Minister of the Justice, the Minister of the inside and the Minister of the Public health (that is responsible for the Political Cell of the Drugs).
Public health.
Ø Calendar
This point of action will be executed when the Cell Drugs will be operational.
Ø Valued budget
To the federal level, this point of action doesn't create any budgetary surcoûts temporarily.
4.4. Handling, reduction of the risks and (ré)insertion
The conventions and international treaties signed by Belgium are not really auspicious to an innovative politics of the aid in the domain of the drug. A realistic reaction to the use of cannabis and the initiatives of reduction of the risks (exchange of syringes, controlled distribution of heroine, possibility to test the drugs on the land, shooting rooms,…) are not foreseen in an explicit way in arrangements of the international texts aimed. In dialogue with other European countries defending a comparable approach, the federal government will plead for a renegotiation of the conventions of the NAKED. It is about here, in the first place, of the unique Convention of March 30, 1961, of the Convention of February 21, 1971 and the Convention of December 20, 1988.
4.4.1. Organization of the offer of care
Ø Summary
Where the prevention of the abuse of drugs or the toxicodépendance doesn't reach its goal, the aid must take the shape of a differential answer. As soon as the use of drugs becomes problematic for the health of the person concerned - in this sense that it doesn't control her/its behavior anymore - it is question of a mental health problem. As the dependence to the drug increases, the somatic factor plays a more and more important role. The most often, some challenging, aggravating or reactive elements are also in game. The addiction is a problem complex social bio-psycho that asks for an adapted multidisciplinary approach.
In the extension of the opinion of the task group permanent Psychiatry in view of the organization and the future development of the mental health care (national Council of the hospitable Establishments, 1997), a clean, global and integrated aid offer must be created for it group-target of the "drug-addicted consumers."
The Minister of the social Business and the Minister of the Public health will develop a better integrated setting, while taking into account the local needs clean to the aid. The institutions taken in INAMI conventions and the offer of care to the drug addicts of the mental hospitals (or psychiatric departments of hospitals) will be included in this new legal setting. This last must allow the organization of the care to the drug addicts by the slant of networks réionaux. These regional networks can develop themselves then in circuits of local care. The Centers of mental health will also be part of these circuits, as far as they wish it.
By "circuit of care" it is necessary to hear the total offer of care that a network offers to a determined group-target (in casu the drug addicts). He/it is composed of modules that - all united - represent the set of the "courses of necessary care" for him group-target, also guaranteeing to order to the claimant of help of the care and a continuity of the care between the different phases of the handling. A module is an offer globalized of care and consist in a combination of one or several functions of proposed care in one or several fashions. A module is therefore a set of activities of care in a specific context, targeted on a very definite goal. A "course of care" is a set of modules and constitute a global component of the program of care that, as whole, constitute the answer to the demands of help globalized of a group-target"
The setting up of the circuits of care must permit optimaliser the care bound to the dependence. This care can be improved so much on the vertical plan (development and integration of the different categories of linked care to the dependence) that to the horizontal level (conclusion of agreements with the sectors borders). The circuit of care facilitates the care to order and the continuity in the administration of the care. The care to the drug addicts dons, otherwise, a more professional character thanks to an uniform registration, to the surveillance of the quality, to the adaptation of the offer to the demand, to uniform diagnoses and to the pose of indications as well as to techniques of scientifically founded treatment.
A certain number of elements is specific to the aid to the drug addicts:
1. a large attention must be granted to the incentive.
2. A low doorstep, flexibility, "the out-reaching" and the "places management" are important factors.
3. Good reports are necessary between the functions of oriented care toward the change (abstinence), the reduction of the risks and the social care proposed to the drug addicts (to offer a help to the survival of basis and to reduce the social nuisance).
4. The offer of care must be adapted permanently. The habits of consumption and the problems of dependence evolve extremely quickly.
5. It is necessary to plan courses of care for specific groups-targets (as the patients with a double diagnosis,…).
The different facilities and local actors will be united in "a Local Group of coordination Drugs" (GLD), that will look for, to his/her/its tour, to associate to the platforms of dialogue of the mental health. The provincial platforms of prevention in Flanders will be, to their tower, invited to participate actively in the local Group of coordination. Place them managers of the justice and the representatives of other organizations concerned (justice, social sector, associations of consumers, associations of parents,…) are invited also to be part of the local Group of coordination that fills a double mission:
1. to examine the regional needs concerning care;
2. to make the inventory of the prevention concerning drug and the aid to the drug addicts and to describe them in terms of programs of regional care and circuits of care, and this while leaving from a concept of mental health care;
3. to detect and to complete or even to the local level, by the slant of the dialogue, to suppress the incomplete functions and the overlaps concerning aid.
A course of care specifically adapted to the young is indispensable. He/it is, indeed, advisable to separate the offer of care for minor and major. It doesn't necessarily imply that facilities catégoriels for the young is required.
He/it is, besides, advisable to create a course of care specific for some patients presenting a double diagnosis.
The users allochtones of drugs is apparently underrepresented in some formulas of aid. They would also enter less often in consideration to benefit from the alternative penal measures and would meet thus more often in jail. Some studies have already been dedicated to this phenomenon. To the stranger, some measures have been taken with success to fight against this phenomenon. The cultural and linguistic differences play a role incontestably and the mediating interculturels can contribute to laméliorer the situation. He/it is as appropriate as the formation of the intervening parties grants a sufficient attention to the cultural differences with regard to the significance of the toxico-dependence. It is desirable to increase the number of helping allochtones. It is necessary to tempt to find the shapes of aid that offer the more of social rehabilitation guarantees. The facilities must provide supplementary efforts to touch the users of drugs allochtones.
The local group of coordination Drugs, as motor organism for what is the constitution of local area networks, acting in dialogue with the Cell Drugs, will develop, as quickly as possible, a network of welcome of emergency and crisis. The federal government grants a lot of importance to this initiative (to see action 4.4.3 not.) and will stay up to what an active involvement is kept like obligatory criteria in the conditions of financing of the facilities financed by the federal state. One will also attract on the subject the attention of the non specific centers of intervention and crisis on their responsibilities.
Ø Responsible Minister
The Minister of the Public health and the Minister of the social Business share the responsibility of the execution of this point of action. They negotiate with the Regions and the Communities (and via the Communities with the provinces).
Ø Calendar
The local Groups of coordination Drugs will be installed during the year 2001.
Ø Valued budget
The local Groups of coordination Drugs will be created within the platforms of Dialogue of the mental Health and don't generate any cost plus therefore.
Ø Summary
A big part of the operation centers is financed to the departure of conventions finished INAMI currently to individual title. Another part is financed on the basis of the legislation on the hospitals. The shutter "Drugs" the global plan completes these financings. The federate entities, the provinces and the townships also invest in the aid to the drug addicts.
A specifications will be established on the basis of the local needs and will retake the functions of care and the modules of care from to foresee. An integrated and global offer is aimed here. The long-term objective is a global financing of every circuit of care local.
The Minister of the social Business will value the wage costs of the ambulatory centers and day as soon as possible (financed via the INAMI conventions). The teams of these centers would undergo a chronic work overcharge. This assessment requires a registration of quality and a measuring instrument of the wage costs well evidently. It is necessary, surely, to take account of the measures of promotion of the employment of the federal government that has, in fact, alleviated the wage costs of some centers.
In the extension of the relative instructions the penitentiary politics has concerning drugs, the minister of the social Business looks for a solution to the problem of the consumers of drugs without funds by the health insurance on which weighs a measure of execution of the pain (liberty conditonelle, semi-liberty,...) and that are tidy in a MASS or another institution having a convention with the INAMI.
Ø Responsible Minister
The Minister of the social Business is responsible for the execution of this point of action. He/it will confer with the Minister of the Public health.
Ø Calendar
Assessment of her (sur)charge of work of the day centers and ambulatory: December 2001.
Financing by circuit of care: longer term.
Ø Valued budget
The costs depend on the assessment of the wage costs of the day centers and ambulatory.
4.4.3. Aid to the drug addicts by slot management
Ø Summary
He/it is evident from investigations, of realized experiences in Belgium and the abroad united appraisal that the introduction of the methodology of the places management proves to be desirable in the sector of the aid to the drug addicts. The Places management is a shape of accompaniment of the course. Of the consumers of greatly dependent drugs, who already followed several treatments, relapsed and present problems of reinsertion, will be followed in an individual manner. It is often about customers presenting a problematic complex and multiple (to see also: consumers of drugs presenting the headache psychiatric, double diagnosis). They are presumably at the origin of a considerable part of the social nuisance.
The objectives of the places management are located so much to the customer's level that of the institutions.
To the customer's level, the methodology aims the following points:
¨ to limit the recidivisms and, so necessary, to organize a new hospitalization that will only be temporary in due time;
¨ to guarantee some care to order and a continuity in the care;
¨ to promote the customer's social working.
To the level of the institutions, the methodology aims to:
¨ better to coordinate and to harmonize the care to the drug addicts;
¨ to improve the communication between the institutions (with the patient's agreement).
The methodology is characterized by five functions of basis: assessment, planning, direct and indirect interventions (notably orientation, out-reaching, coordination) monitoring and assessment.
The federal government will free funds on the budget of the minister of the Public health in order to finance projects interesting of slot management in the Local Groups of coordination Drugs. These last will determine themselves the affectation of the coordinators of care (slot managers) that will arrange a sufficient experience in the concerned domain and will be familiarized also with all applicable related domains.
Ø Responsible Minister
The Minister of the Public health is responsible for the execution of this point of action. She/it confers with the minister of the social Business and negotiate with the Communities and the Regions. She/it is inspired in progress by the survey project in oriental Flanders.
Ø Calendar
This point of action will be executed after the constitution of the circuits of regional care (or at least of the local Groups of coordination Drugs).
Ø Valued budget
30 millions BEF will be registered to the budget of the minister of the Public health in order to subsidize interesting local projects.
4.4.4. Consumers of drugs presenting psychiatric problems (doubles diagnosis)
Ø Summary
The sector of health and, in particular, the one of the mental health, is confronted in an increasing manner to the addiction. So much in the residential institutions that in the institutions of day and ambulatory, some more and more numerous patients present themselves that has to cope not only to their psychiatric problems, but also to a problem of dependence. Vice versa, many customers of the aid to the drug addicts also struggle with a psychiatric trouble. The consumption of drugs and the psychiatric affections influence themselves mutually in a negative manner. For a big part of the group says" to double diagnosis ", the offer of care present is insufficient. They feel some difficulties to find a follow-up in the programs of offered care to the drug addicts (since they present psychic unrests) and in the institutions of the psychiatric sector (since they are toxicodépendants). They are sent of an institution to the other and the percentage of treatment abandonments is raised.
The group to double diagnosis is responsible for important social nuisances and is characterized by elevated costs of treatment. It coincides with the features of this group, to know,:
1. a problematic complex, multi-dimensional and a difficult diagnosis;
2. of the cognitive capacities and a resistance limited;
3. a reduced incentive, of the frequent abandonments of treatment and an elevated recidivism rate (with regard to so much the consumption of substances that the psychiatric symptomatology);
4. a behavior at elevated risk and a lot of violence (towards oneself and the other);
5. of the legal and penal problems;
6. it is often about homeless person.
The objectives of the aid offer that go to the group to double diagnosis are the improvement of the general level of the working, the reduction of the consumption of drugs and problems there pertaining, the stabilization of the psychiatric unrests, the reduction of the risks and the resocialisation (dwelling, work and daily occupation). This group constitutes the group-target par excellence of the place-management.
Some institutions grant, since numerous years an attention sustained to the patients to double diagnosis. In the meantime, a certain appraisal has been acquired. The federal government will value the experiences on the double diagnosis and will sustain them. He/it will throw the pilot projects taking the shape of distinct units of intensive treatment of patients presenting a double diagnosis in the general hospitals. Some new beds won't be created to this effect but the framing and the staff's formation will be improved in the existing sharp sections. The federal government will also look after what the double diagnosis gets attention sufficiently in the perspective of the development of the circuits of regional care and the definition of the functions of care. If he/it proved to be that the programming of the circuits of care presents some hiatuses, the federal government would commit to take the necessary initiatives. The "cross-countries-trained teams" (of the teams who master the methods of treatment so much for the drug addicts that those of the psychiatric care) seem in any case necessary.
Ø Responsible Minister
The Minister of the Public health is responsible for the execution of this point of action.
Ø Calendar
The assessment and the support to the existing experiences concerning double diagnosis can make themselves short-term. The pilot projects will be thrown toward the midyear next.
Ø Valued budget
The necessary investments will be the subject of discussions in the setting of the budgetary control.
4.4.5. The network of welcome of emergency and crisis
Ø Summary
All actors of the sector of the mental health are held to foresee, in the cases of urgent help demands, of the modes permitting to enter in dialogue with the patients and their family, for example to give some advice by telephone; to be able to find the means to organize a non foreseen urgent consultation; to adjust an admission of emergency in hospitable psychiatric services. It is why all services must organize their working in order to guarantee a sufficient availability.
Since 1992, three pilot projects of crisis psychiatry are led in the general hospitals (Stuivenberg in Antwerp, Van Gogh in Charleroi and Brugmann in Brussels). In Brussels, he/it exists besides a welcome of emergency and distinct crisis for the drug addicts. A few other general hospitals created, with their own means, a service of crisis psychiatry (p.ex. EPSI in Bruges). The official pilot projects are organized each according to a clean model. The differences milked notably to the nature of the collaboration with the service of the emergencies and to the maximum number of hospitalization days in the unit of crisis. These three projects are the subject of an assessment currently in view of the definition of an uniform model for the psychiatry of crisis. Our experience allows us to pull the following findings:
· The abuse and the dependence of drugs constitute, together, the main motive of admission in the unit of emergency.
· For a group of treated patients to the service of the emergencies, an intensive hospitalization said of crisis is required, implying a brief therapeutic intervention that permits to avoid a classic hospitalization. After 1,5 to 5 days maximally it is possible to warn a long hospitalization in 80% of the cases.
· This device type requires a more elevated financing than the present financing of the A. beds This surcoût is compensated extensively by the realized economy because 80% of the patients of the crisis unit must not be hospitalized.
The actors on the land signal us a need urgent of capacity of crisis admissions, especially for the drug addicts. The studies learn us that, in the hospitals, of the units for to the minimum 4 patients and maximally 8 are desirable. Essential condition of the good working of such an unit of crisis: the integration in a circuit of care.
The needs estimated of the crisis welcome consists in an unit of 4 in 8 beds for 300.000 to 500.000 inhabitants according to the density of the population and the geographical distribution, what implies about 120 beds for Belgium. With regard to specifically the drug addicts, the needs are estimated to 60 beds.
In dialogue with his/her/its colleague of the social Business, the Minister of the Public health will define a containing specific legal setting the norms, financing and the pleasure of the psychiatric units of crisis in the general hospitals.
Ø Responsible Minister
The Minister of the Public health is responsible for the execution of this point of action. She/it confers with the Minister of the Social Business.
Ø Calendar
Starting of the introduction in several phases: toward the middle of 2001 for 20 beds, in the beginning of 2002 for 40 beds.
Ø Valued budget
The necessary investments will be the subject of discussions in the setting of the budgetary control.
Ø Summary
The federal government only has very restricted expertises with regard to the miners of age. It is necessary to grant them a particular attention however. It is effectively simpler to interrupt a process of dependence starting that to put a term to a dependence of long length. It is necessary to underline also that the tendency to the experimentation at the young is a normal evolution in adolescence. Some disproportionate reactions can have counterproductive effects.
The Services of help to Youth must be able to play their role towards the miners of age consumers of drugs. The welfare department of the help committee to youth can grant himself the requisite aid or orient people concerned toward an external aid service. The measures of diversion of the justice also offer quite a lot of possibilities to the judges of youth and to the office of the Prosecutor. The danger of the "clean widening" (extension of the network) cannot be lost not however of view.
He/it is recommended that the two parents, even though they separated, are brought to take part in the program of aid put in work, even though the parents separated.
The federal government finally underlines the importance of the role of the parents. Some parents of miners, consumers of problematic drugs, have big need of information, formation and a therapeutic offer clarifies. The government will examine what manner of the means can be unblocked to this effect. One thinks in the first place of new modules in the conventions specific INAMI.
Ø Responsible Minister
This point is a matter for the expertise of the Communities. The federal government will follow up in this respect on the wishes of the Communities and is arranged to push all initiatives susceptible to support the action of the Communities. He/it is a matter for the expertise of the minister of the social Business to foresee new modules in the INAMI conventions.
Ø Calendar
Judicial measures: end 2001
Ø Valued budget
The Minister of the Justice will value the budgetary consequences of this measure.
4.4.7. Consistent or treatment after-care
Ø Summary
The consumers (delinquent or no) must be able henceforth to call on a better organized follow-up. The aid plays a particular role in the social integration (and therefore in the prevention of the recidivisms). The federal government will ask that one grants attention more (and will free the credits necessary to this effect) to the follow-up in the institutions that it finances. The federal government will also verify if funds can be freed in the setting of the contracts drug and contracts concluded with the cities.
The initiatives aiming to orient them (ex)toxicomanes toward the job market must be harmonized better. These initiatives will be, of preference, valued by the Communities that are effectively competent for the vocational training, the mediation in the domain of the employment and the social help. One will ask these sectors to elaborate, in collaboration with the CPAS and the sector of the aid to the consumers of drugs for example, an action plan concerning the stake to the work of them (ex)toxicomanes. Contacts can be taken, in this context, with the houses of justice and the judicial social work. A course of formation targeted on the job market that is perfectly harmonized with the action of the aid facilities gives, indeed, the best guarantee of a lasting social rehabilitation.
It will be necessary to look after that that the execution of them (old) pains least possible mortgage a possible process of reinsertion. The recent guideline of the Minister of the Justice concerning the execution of the relatively short prison sentences for drug-addicted delinquents already answers this objective.
Ø Responsible Minister
The Minister of the social integration is responsible for the execution of this point of action. He/it negotiates with the Communities and the Regions. He/it will confer with the Minister of the social Business, the Minister of the employment and Work, the Minister of the Justice, the Minister of the Public health, the Minister of the inside and the Minister of the Politics of the big cities.
Ø Calendar
End 2001
Ø Valued budget
The Minister of the social integration will plan the means for the plan appropriate to work. The minister of the social Business will assign the INAMI to contribute to the organization of the follow-up. The federal government will also examine what are the possibilities in the setting of the plan drugs and of the contracts with the cities.
4.4.8. Treatments of substitution
Ø Summary
The treatments of substitution framed proved to be useful. The positive effects follow have been observed:
¨ a reduction of the use of other opiates;
¨ a growth of the social productivity;
¨ a decrease of the behavior to risks;
¨ a better contact with the aid;
¨ an improvement of the physical and psychic health and a decrease of mortality.
The federal government will translate the findings (adapted by the Council Supérieur of hygiene) of the Conference of consensus (Ghent, October 8, 1994) in a coercive legislation. In order to set in motion a politics based on the scientific research and to avoid some double jobs in the distribution, an uniform registration (centralized and anonymous) will be elaborated. One will invest in the formation (obligatory) and the continuing education of the physicians. The physicians will be part of a psycho-social network of framing so that the patients can benefit from a multidisciplinary accompaniment. It is necessary to avoid effectively that the physicians who don't prescribe a treatment of substitution to individual title turn into "ticket windows of methadone." Some transregional agreements will be concluded in the Eurégionses that, associated to the aforementioned measures, should permit to counter the tourism of the methadone.
The new guideline grants a sufficient attention to the penitentiary treatments of substitution.
Ø Responsible Minister
The Minister of the Public health is responsible for the execution of this point of action. She/it negotiates with the Regions and the Communities.
Ø Calendar
Beginning 2001: modification of the law; end 2001: Royal decree for registration.
Beginning-of-record January 1st, 2002.
Ø Valued budget
The credits are registered to the budget of the Minister of the Public health.
Ø Summary
The royal decree of June 5, 2000 on the exchange of syringes (law of November 17, 1998) has been published July 7, 2000 to the Belgian Monitor. The decree of execution stipulates that the exchange of syringes must go together with the communication of information on the use correct of the material, the existence and the indications of the serological tests and on the offer of a psychological, social, medical and legal aid. The exchange of syringes cannot cause any nuisances in the district. The federate entities are responsible for the execution and the financing of the exchange of syringes.
Ø Responsible Minister
The Minister of the Public health signed this royal Decree.
Ø Calendar
The point of action has been executed.
Ø Valued budget
The financing of the exchange of syringes is incumbent upon the federate entities.
4.4.10. Controlled distribution of heroine
Ø Summary
The scientific experiences carrying on the distribution controled of heroine are or have been achieved abroad (notably to Netherlands, and in Switzerland). The federal government will conduct the assessment of the results of these experiences. He/it seems, among others, there to have a favorable effect on the number of new cases of contagion by the HIV and the virus of hepatitis.
The federal government won't throw and won't finance any experiences concerning controlled delivery of heroine.
The Cell Drugs can put in contact the active task groups in this domain in the different parts of the country.
Ø Responsible Minister
The Minister of the Public health is responsible for the execution of this point of action.
Ø Calendar
The calendar depends on the abroad experiences.
Ø Valued budget
This point of action doesn't generate any budgetary surcoûts.
Struggle against the drug traffic (offer) constitutes the priority first of all penal politics aiming to restrict the consumption of drugs and the delinquency that ensue some.
This struggle against the traffic passes nevertheless by a politics of struggle against the demand of narcotics and therefore, by a politics that aims to restrict the individual consumption maximally.
The consumption of drugs also generates well too often either a derivative criminality, either of the social nuisances. These aspects also deserve a particular attention, not only of the public Ministry, but also of all other public processes.
It is necessary to note that the repressive action has its limits with regard to numerous toxico-dependent consumers. These limits are directly function of those of the social and sanitary facilities.
In this context, the repression of the simple consumption and to a certain extent, of the consumption bound to criminal facts or in relation with social nuisances, must constitute the ultimate stage of the action of the public prosecutor's office and justifies itself only as remedy to an individual problem relapsing.
It is from then on essential to consider fashions of cooperation between the judicial environment and the socio-medical environment, as well as with the educational environment, in order to answer the different needs and to define with precision a setting permitting a social and sanitary approach of the phenomenon of the toxico-dependence and an appropriate repression at a time, reasoned and uniform in order to look after the imperatives of public security and to re-establish the social order.
Finally, when a consumer of drugs is in spite of incarcerated quite, it is necessary to stay up (in the setting of a coherent penitentiary politics) to guarantee him a place of life that will allow him to come out of his/her/its possible dependence. It supposes an eradication of the drug in the prison environment, but also the drug addict's access to the services of help and therapy appropriated and the continuity of this care after his/her/its liberation.
4.5.1. The federal Plan of security
We return to the federal Plan of security and Detention in the first place.
The federal programs dedicated to the organized criminality and to criminality in white collar don a particular importance in struggle against the traffic of drug organized. Without wanting to take in extenso their summary, we make reference to the projects 27 (to establish a profile of criminality organized), 28 (scientific research concerning the organized criminality), 29 (international cooperation), 31(technique of particular research), 32 (monitorings, take knowledge and registration of communications and private telecommunications), 33 (seizure of heritages of criminal origin), 34 (institution of a régime of repentant, protection of the witnesses and the anonymous witness), 35 (judicial chief constable quality), 39 (permanent platform of dialogue concerning financial and economic delinquency), 40 (deprivation of the advantages), 41 (research centered on the loot) and 42 (international cooperation).
4.5.2. Penal politics - traffic of drug
Ø Summary
After dialogue with the College of the attorneys general, the Minister of the Justice will establish a guideline about the methods permitting to tackle the traffic of drug. This guideline will fix, among others, of the priorities. Struggle against the unfit manufacture and the trade of the precursors and against the production of synthetic drugs will be intensified. Besides, the import of cocaine and heroine's traffic are troubling. For what is the narcotourisme, the preventive dimension and the one of the aid must be developed (as for example in the G-Screw project). The possibilities of seizure and confiscation will be optimalisées via a guideline of the Minister of the Justice and the legislative initiatives... All research dedicated to the traffic of drug of a certain span will be accompanied by a financial analysis to the level of the services of police and public prosecutor's office.
The program "drugs" the state police will be integrated within the federal police. He/it will be put in charge of centralizing the relative information to the operations of police bound to the drug. To term, his/her/its working will be spread until the level of a service of information. All it will go together with the specialization and a formation and a retraining pushed of the judiciary and police's services.
Ø Responsible Minister
The Minister of the Justice and the Minister of the inside are responsible for this point of action.
Ø Calendar
The guideline will be sent in June 2001.
Ø Valued budget
This point doesn't generate any additional expenses.
4.5.3. Penal reaction to the use of drugs
Ø Contained
First question: What is the margin of maneuver for a politics in light of the international treaties (UNO, Schengen) and of the European politics concerning drugs?
1. The international treaties
The United Nations themselves and the set of the international experts concerning legislation and relative treaties to the drugs agree on the following findings:
being about the possession of cannabis for an use personal, only the Treaty of the United Nations relative to the traffic of drugs of 1988 (art. 3, 2, 4 (c) and (d)) and the agreement of Schengen execution (1990) (art.76) are applicable;
the analysis of these arrangements allows us to pull the following findings:
We have the choice between the penal way or the administrative recourse to legal proceedings:
in the penal way the recourse allows the principle of opportunity, that that, for some shapes of possession, de facto duct to the decriminalization (not of criminal sanction since there are not any pursuits). We can differentiate strongly and can individualize the penal answer. The possibilities are very numerous;
to the administrative recourse to legal proceedings offers a large range of administrative sanctions that can also be individualized to a certain extent also.
He/it is right to pin however that the official channel intervenes in a more marked manner than the stereotyped penal treatment and that it doesn't know principle of opportunity.
The police is obliged to establish the administrative infringement (doesn't have unit of research and pursuit as it is the case in the penal circuit) and the administrative process must decide.
The practice in a set of states of the European union (to see farther) reveals us besides that one often resorts in a stereotyped manner to the administrative fines. This sanction is generally advised against in relation to the consumers of drug.
The art. 76 of the convention of execution of Schengen impose the neighborliness:
The member states of Schengen that wish to lead concerning drugs a more tolerant politics than the adjacent member states must look after what the adjacent member states don't undergo the prejudicial effects of it (among others the tourism of the drug and the consecutive nuisances).
SOURCES
¨ OF RUYVER, B., 'Medisch in recreatief gebruik sieve cannabis, het juridisch kader in europees in V.N. perspectief.', Vlaams Parliament, september 2000, Brussel, 15p.
¨ OF RUYVER, B., 'Drugsbeleid in of Europese Unie', Gedr. St Kamer, 1997, nr. 1062/3, p 107.122.
¨ MINISTERIE SIEVE JUSTITIE NEDERLAND, Notitie gedoogbeleid cannabis., 2000, p. 8.
¨ OF NAUW, A., 'Drugs', A.P.R., 1998, p. 4.
¨ SILVIS, J., 'Of international juridische speelruimte voor Nederlands drugbeleid.' BLOM in, T.; OF DOELDER, H. in HESSING, D.J. (eds.), Naar een consists drugbeleid. Een congresverslag. Deventer, 1996, p. 221-223.
¨ ARNAO, G., 'the Single Convention and drug policy reform.' the International Newspaper of Drug Policy, Flight. 10, No. 3, 1999, p. 173.
¨ KRAJEWSKI, K., 'How supple are the United Nations drug conventions? ', the International Newspaper of Drug Policy, Flight. 10, No. 4, 1999, p. 332.
¨ UNITED NATIONS, Commentary one the United Nations Convention against illicit traffic in narcotic drugs and psychotropic substances 1988, United Nations, New York 1998, p. 85-89.
2. The European politics concerning drug
· Most European countries grant the smallest priority of pursuit to the possession of small quantities of cannabis for a personal consumption (for example Belgium) or don't initiate of pursuit with regard to this type of acts (Netherlands, Denmark, Britain, Austria) or inflict financial fines for a first infringement of detention of cannabis for a personal consumption (Ireland) or send back this category of offenders to the structures of help and accompaniment (Sweden, France).
· To the exception of Spain, of Italy - and in the future - of Portugal, all member states of the European union follow the penal way. These three countries criminalized a set of acts and conferred them the statute of administrative infringement for which an administrative sanction is planned.
Spain:
· the culture and the purchase are penalized but the Spanish jurisprudence and the practice demonstrate than actually one doesn't think that these acts should be punished;
· the possession and the consumption in public places are punished administratively;
· the Spanish Supreme Court decided September 28, 1999 that is penal the detention for personal consumption, including in the private sphere.
Italy:
· The import, the fact to obtain and the detention for personal consumption is administrative infringements punished administratively among others by fines and the withdrawal of a whole set of permit, for example the driver's license or the permit of weapon port.
SOURCES
¨ DORN, N.en JAMISON, A., 'Room heart operates. Overview of comparative legal research into national drug laws France of, Germany, Italy, Spain, the Netherlands and Sweden and their relation to three international drugconventions, (based one research by year international team Yann Bisiou (France), Tom Blom (the Netherlands), Lorenz Böllinger (Germany), Maria Luisa Cesoni (Italy), José Luis of the Cuesta and Isidoro Blanco (Spain), and Josef Zila (Sweden)), London, 2000, 24p.
¨ OF RUYVER, B., Medisch in recreatief gebruik sieve cannabis, het juridisch kader in europees in V.N. perspectief, Vlaams Parliament, september 2000, Brussel.
¨ Europees Waarnemingscentrum Drugs voor in Drugsverslaving, jaarverslag over of stand sieve of drugsproblematiek in of Europese Unie, Lissabon 2000.
3. Conclusion
¨ The Treaty of the United Nations of 1988 relative to the traffic of drug obliges Belgium to oppose a legal reaction to the detention of drug - including the cannabis - for a personal consumption.
¨ A décréminalisation is possible but in this case, one is obliged to make the detention of drug for a personal consumption an administrative infringement and to foresee an administrative sanction as it was already the case in some countries of the European union.
¨ To the light of the philosophy of l' ultimum remedium and of the worry of a social answer individualized and adequate, he/it is right to prefer the penal way to the administrative treatment. Pénalement, the principle of the opportunity can be used and one has a large range of treatment possibilities individualized. The experiences Spanish and Italian demonstrate that an administrative sanction is mainly of patrimonial nature.
Modifications legislative and directive governmental coercive to the attention of the judiciary powers, the administrative authorities and the competent services of police concerning treatment of local questions bound to the drug, more specifically criminality and the nuisances bound to the drug
1. Principles
A modification brought to the Law drugs of February 24, 1921 in this sense that one operates a distinction between the cannabis and the other illegal drugs and that the consumption in group of illegal drugs is not penalized anymore. The Government decrees in application of the article 1st of the law of 1921 a coercive guideline that obliges the Government and the set of the actors of the politics - so much administrative that penal -, to proceed to the setting in work of a politics concerning drugs that integrates the prevention, help and the protection of the society in a concept of politics.
This guideline, that is integrated légistiquement in a royal decree only treating the problematic of the cannabis, constitute an adequate instrument to answer with suppleness the fast evolutions that characterize the phenomenon of the drug.
This guideline is the translation in terms of politics of the recommendations formulated by the parliamentary task group 'Drug' of the Room of the Representatives of Belgium that presented his/her/its report June 5, 1997 (Doc. parl., Room, 1996-1997, 1062/1 to 3). You will find these recommendations in annex. This guideline takes account of the assessment survey carrying on the application of the previous guideline (the guideline of relative May 1998 8 to the politics of pursuit concerning detention and retail trade of illegal narcotics).
The survey of assessment revealed that a nonuniform repression of the drug consumption by the different public prosecutor's office home. So much the range of measures presented in the guideline of May 8, 1998 that the vague criterias and the conceptual setting susceptible to be the subject of different interpretations proved to be in this respect insufficient. This guideline tried to indicate more clearly what are the margins of appreciation in the setting of the politics of research and pursuit. She/it must exclude the differences of interpretation as much that to make can itself in order to succeed to an uniform application.
Besides, and this element takes out again the survey of assessment, the pursuits and the prison sentence are enough often used, although the parliamentary task group concluded that a repressive intervention with regard to un(e) consommateur(trice) drug is only justified when the concerned person also committed the infringements that disrupt the law and order and require a social answer.
Besides, he/it is right to take into account the new organization of the services of police as well as the new structures setting up in this setting.
The management of local problems in the setting of which the prevention, help, the management of risk and struggle against the criminal and other nuisances must go from equal, is a devolved coercive mission to the local administrative authorities in dialogue with the King's District attorney who is responsible for the politics of research and pursuit. The zonal dialogue of security is the forum indicated to lead a local politics integrated concerning drug. Police's services must get their controlling authorities of the clear instructions.
The politics concerning research and the politics concerning pursuit is considered as the components of a politics. The politics concerning research must be a derivative of the politics concerning pursuit.
The accent is put on the application of the article 151, § 1st, of the Constitution and the article 143ter, second paragraph, of the Judicial Code,. The guideline is coercive for the set of the members of the public Ministry. He/it comes back well evidently to the public Ministry to bring the proof of the offense bound to the drug that he/it wishes to pursue.
The guideline centers in a politics of normalization, the aforesaid third way between the prohibition and the anti-prohibition, centered on a management rational of the risks and founded on three pillars: the prevention, help and the repression. The importance of a fast intervention of the help structures is underlined. The penal politics practiced with regard to the consumers of drug must be based on the following principles:
1. the penal intervention opposite him (of her) consommateur(trice) of drug constitutes the ultimate remedy always. Except specific at risk situations, as driven under influence and the fact to cause social nuisances, the consumption of drug doesn't constitute in itself a motive of repressive intervention.
2. The penal intervention takes into account the concerned person's individual situation. The more difficult consommateur(trice)s that enters in contact with the police or the justice will be oriented toward structures of help. The starting points are on the one hand the volontariat and the respect for the finality of the justice and help on the other hand.
3. The addiction doesn't constitute in anything a motive justifying that one excuses a criminal behavior.
The Minister of the Justice and the College of the attorneys general will decree a new guideline that corresponds to the modification of law and the principles and regulation fixed in the royal decree evoked higher.
2. Principles of the pursuit politics
In the setting of research and the pursuit, a distinction is operated on the one hand between the cannabis and other drugs and the three linked offense categories to the drug on the other hand.
You find the diagram in annex.
Starting points
General principle that browses the penal politics concerning drugs like a red thread, is the principle ultimum remedium, what implies that on every level of the fixing of the pain, as far as possible and certainly when he/it is problematic consumption question, a minimal penal intervention is aimed for the consumer of drugs. It is not worth for the production of drugs, nor for the traffic of drugs.
The critique on the previous guideline and on his/her/its application can sum up in three key notions, notably, imprecise, casual and disorganized
· Imprecise: the setting of notions used let too much space to an interpretation while causing a big legal precariousness because the justiciable didn't know what was penal anymore or no and, more particularly, what would be pursued or not.
· Casual: by the non uniform application in the practice, one is brought to note that every public prosecutor's office intervenes otherwise. The casual character in the penal reaction is pronounced that too much that for consequence a confusion in the chief of the justiciable.
· Disorganized: the lack of unit in the penal politics concerning drugs, caused by the space of again too big interpretation for the magistrate of the individual public prosecutor's office, suggest that the politics lacks organization.
The recommendations of the parliamentary task group concerning drugs, will be translated consequently in a guideline that will indicate this time with precision what are the margins of assessment in the politics concerning research and pursuit of cannabis and that must create THE CLARITY and THE ORGANIZATION in the politics concerning drugs. In addition, another guideline will be taken by the Minister of the Justice and the college of the district attorneys-general on the other aspects of the politics concerning the drug (other that the cannabis).
· Clarity: the guideline has like main objective to limit to a minimum spaces it of interpretation, in order to create a certainty with regard to the social reaction of the viewpoint of the justiciable. There is not a space therefore more for a casual action, but actions in conformity with an imperative action model are required. The imperative character will be achieved while imposing models of concrete actions.
· Organization: the imperative character must bring an unit in the politics led of the 27 public prosecutor's office of kingdom. Also, the organization must be everywhere more transparent and identical. Especially the insertion of a place-manager of the justice must guarantee an organized progress and uniform of the action of the MP everywhere in the country.
It is not superfluous to recall the philosophy of basis of the government concerning consumption of drugs and more especially concerning consumption of cannabis: the problematic of the drugs is a problem of society that must be considered from a global and integrated viewpoint and that asks a suitable approach therefore. The accent is put on the prevention and the professional help, with, so necessary, a repressive shutter. This guideline also has an educational aspect, that has for objective to make conscious the population and more especially the youth of this aspect. It is for this reason that the government doesn't want to suggest the idea that the use of cannabis must be considered like obvious, banal or normal absolutely. It is not at all so. It doesn't prevent that the authority must not invest its energy in an use responsabilisé and non problematic. The action of the authority, on the other hand, aim the young and same of the teenagers in the first place. It is therefore about an action that can don several shapes, while putting the accent on the benefit of help. With regard to the other shapes of offense bound to the drugs, the normal penal reactions remain possible.
In the politics of research and pursuits, the distinction is made between:
¨ Category 1: the import, the manufacture, the transportation, the detention of a small quantity of illegal drugs for the personal use;
¨ Category 2: the import, the manufacture, the transportation, the detention and the use in group of a quantity of illegal drugs that exceeds the qualification "detention to personal use" (category 1) and / or that are committed in the setting of the aggravations foreseen in the relative law to the drugs. (p.ex. the presence of age miners);
¨ Category 3: of the offenses bound to the drugs, others that those foreseen in the categories 1 and 2
The guideline is based on the following diagram, in which the three categories are treated:
Category 1: detention to personal use
A. Cannabis
1. At the time of research and the observation, a minutes is not written (in application of the article 28ter, §1 CIC.) to the attention of the King's District attorney. The drugs found (necessarily a small dose) won't be confiscated anymore. The obligation to pay for the expenses of justice subsists.
A police anonymous régistration will be foreseen (Polish, PIP, ISLP,…), bound to a monthly report to the PR on 'the evolution on the land.'
An exception will be made if it there usage clause that poses problem or of use with nuisances. A PV is written in this case with clear indication of the problematic use or the use with nuisances. By 'use that poses problem' it is necessary to hear an use that one doesn't master anymore, what appears among others by a dependence of the drugs, of criminality bound to the drugs,…. It means that a continuous personal use is not necessarily problematic. By 'situation to nuisances' it is necessary to hear the use in presence of age miners or in situations aimed in the New Local Law (art. 135, §2, 7°).
The politics of pursuit aims the situation as a priority to nuisances - or of the at risk situations as concentrations of consumers and/or traffickers in the surroundings of the schools, of the game plains, and other,…
2. Concerning pursuit the following hypotheses can distinguish themselves:
2.1 the detention limited for the personal use or an incidental use without indication or presumption of use that pose problem
Cf. supra concerning research; NOT of minutes, therefore not of penal consequence.
2.2 usage clause that poses problem
The PR returns to a place-manager of the justice, who returns on his/her/its turn toward the aid for therapeutic opinion. There are two possibilities to this moment: or the concerned person doesn't accept the return. In this case, the PR opts for a warning, an amicable settlement, a probation prétorienne, (below PP) or a penal pursuit. Or the concerned person accepts the return; in this case the continuation depends on the therapeutic opinion:
· positive opinion: there are also two possibilities, notably: or the concerned person accepts the treatment and the PR. chooses between a mediation in penal matters or PP. Or the concerned person doesn't accept the treatment and the PR chooses between the warning, an amicable settlement, a penal mediation, PP or penal pursuit.
· negative opinion: the penal file is classified without continuation
2.3 situation of nuisances and / or situations of risk
The PR distinguishes the demand and the offer. With regard to the demand, the PR chooses between the warning, the amicable settlement, the penal mediation, PP or pursuit. With regard to the offer, the PR. chooses between the penal pursuit and, if judged appropriate, the provocation of an administrative measure, in casu a prohibition of investment enacted by the local authorities (cf. art. 119bis; 123, 12°; 133; 134ter and 134quater New Local Law.).
B. Other illegal drugs
1. At the time of research and the observation, a PV is written. The use of other illegal drugs that the cannabis is by definition considered like problematic in the setting of research.
The politics of research aims situations of nuisances as a priority and to risks, as concentrations of users and/or traffickers on the outskirts of the schools, of the plains of games etc.….
2. Concerning pursuit, the following hypotheses can be distinguished:
2.1 limited detention to personal or incidental use without indication of use that poses problem
Subject to a decision on the expenses of justice and the drugs confiscated and/or other goods, the PR chooses between a warning or an amicable settlement.
2.2 indication of use that poses problem
The PR returns to a place-manager of the justice who returns on his/her/its turn to an aid for therapeutic opinion. To this moment has two possibilities: or the concerned person doesn't accept the return. In this case, the PR opts for a warning, an amicable settlement, a probation prétorienne or a penal pursuit. Or the concerned person accepts the return; in this case the continuation depends on the therapeutic opinion:
· positive opinion: there are also two possibilities, notably: or the concerned person accepts the treatment and the PR chooses between a mediation in penal matters or PP. Or the concerned person doesn't accept the treatment and the PR chooses between the warning, an amicable settlement, a penal mediation, PP or penal pursuit.
· negative opinion: the penal file is classified without continuation.
2.3 situation of nuisances and / or at risk situations
The PR distinguishes the demand and the offer. With regard to the demand, the P.D.R. chooses between the warning, the amicable settlement, the penal mediation., PP or pursuit. With regard to the offer, the P.D.R. chooses between the penal pursuit and, if judged appropriate, the provocation of an administrative measure, in casu a prohibition of investment enacted by the local authorities (cf. art. 119bis; 123, 12°; 133; 134ter and 134quater New Local Law.).
Category 2: The import, the manufacture, the transportation, the detention of a quantity of illegal drugs that exceeds the qualification 'detention to personal use' (category 1) and / or that are committed in the setting of the aggravations foreseen in the relative law to the drugs. (p.ex. the presence of age miners)
1. At the time of research and the observation, a PV is written with clear indication of the quantities of attached drugs and, possibly, detailed mention of the indications of a problematic use.
The politics of pursuit aims the situations as a priority to nuisances - or of the at risk situations (cf. supra) and the big dealers.
2. Concerning pursuit the following hypotheses can distinguish themselves:
2.1 the offenses foreseen in the category 2, committed to provide to his/her/its personal consumption,
One has the choice between two options. The choice is determined by the fact that there is or no a problematic use and by the gravity of the facts.
In a first option, the PR returns to a place-manager of the justice, who returns on his/her/its turn toward the aid for therapeutic opinion. There are two possibilities to this moment:
· positive opinion: there are also two possibilities, notably: or the concerned person accepts the treatment and the PR chooses between a mediation in penal matters or PP. Or the concerned person doesn't accept the treatment and the PR chooses between the warning, an amicable settlement, a penal mediation, PP or penal pursuit.
· negative opinion: (not of help demand and/or not of dependence) the PR makes a choice between the warning, the penal mediation (pain of training or pain of work), PP or pursuits.
In the second option, the PR starts some pursuits.
2.2. The offenses foreseen in the category are committed by pure decoy of the gain or with aggravations foreseen by the law on the drugs.
In this case, the PR starts some pursuits.
Category 3: Linked offenses to the drugs others that those foreseen in the categories 1 and 2
1. The aimed offenses are:
i. the offenses bound to the acquirement of serious nature drugs (pickpocketing, armed attack)
ii. expressive offenses of serious nature (assault and battery, stern threats, taken of hostage)
iii. consensual offenses of serious nature (to be member of a criminal organization implied in the production of drugs, traffic of drugs, production and on a big scale trade,….)
2. The politics of research will pay a particular attention there. At the time of the observation, a PV will be written. If there is, in opposition to the delinquent, of the indications of an use that pose problem, he/it is made mention of it in an explicit manner in the PV.
3. Concerning pursuit, The PR that must judge these categories must take into account the following considerations:
i. the fact that an offense is bound to the drugs doesn't constitute an extenuating circumstance or a reason of excuse for the delinquent. In other words: the PR must, at the time of the judgment, to take into account the gravity of the facts.
ii. The presence of an use that poses problem. As far as possible, the protective beginnings of the society (gravity of the facts) and an individualized therapeutic intervention and as fast as possible (use that poses problem) are reconciled.
The PR. distinguish:
1. of the offenses bound to the drugs for which there is, in the delinquent's chief, of the indications of use that pose problem,
The first possibility is that the PR judges that the gravity of the facts incriminated doesn't prevent an individualized treatment, on demand in therapeutic sense. In this case, the PR returns to a place-manager of the justice, who orients on his/her/its turn toward the aid for therapeutic opinion. There are two possibilities then:
* positive opinion: the PR proposes PP or mediation with aid;
* negative opinion: (not of help demand and/or not of dependence) the PR makes a choice between the warning, the penal mediation (pain of training or pain of work), PP or pursuits.
The second possibility is that the PR judges that the gravity of the facts, coupled or no to the delinquent's social gravity doesn't prevent an individualized treatment but makes obstacle with regard to the pursuits. In this case, the PR starts some pursuits because of the gravity of the facts. It doesn't yet exclude that the PR declares d 'agreement at the time his/her/its indictment, for a suspension of probation or a probationary reprieve.
2. of the offenses bound to the drugs for which him n' doesn't have there, in the delinquent's chief, of the indications of use that pose problem,
In this case, the PR starts some pursuits.
Some principles organisatoires
1. It is necessary to conceive a system efficient of internal checking so that the content of the guideline can be adapted in a real way on the land. He/it will be called on the King's District attorney, so much with regard to the numbers so much with regard to the decisions of bottom.
2. One or several magistrates are put in charge of the file concerning drugs, while implying that there is only a magistrate of public prosecutor's office by public prosecutor's office, the supposedly 'magistrate drugs of reference' that has the final responsibility for the treatment of the problematic concerning drugs in the precinct.
Thus, all magistrates who are not active in a section of drugs or in a section that is among others about business bound to the drugs, should always refer to the magistrate of reference, so that this last can verify if the politics projected concerning drugs is followed, not only by the specialized magistrates, but also by the magistrates who enter by chance in contact with business bound to the drugs (for example during the service of night or weekend). So there will be a certainty that, in a same public prosecutor's office, all magistrates adopt the same attitude.
3. The magistrates drugs of reference of all public prosecutor's office meet regularly (p. ex. 4 times per year) in order to discuss and to assure the follow-up of the evolution of the politics concerning drugs. In this way, the public prosecutor's office can learn their mutual contacts how some problems can be managed and the option "best-practice" will be applied effectively on the land. This method can also entail some discussions in the setting of the activities of the Council of the King's District attorneys.
4.Il are obvious that the final responsibility of the politics led is incumbent upon the District attorney of the very King.
5. The operational, simple and uniform measurement instrument (registration and statistical), that has been announced already in a circular previous, will be developed in the briefest delays and will make the object of a circular ulterior.
Ø Responsible Minister
The Minister of the Public health is responsible for the regulation of the cannabis. The Minister of the Justice is responsible for the execution of the new guideline.
Ø Calendar
This point of action should be achieved for the end of 2001.
Ø Valued budget
This point of action doesn't have a budgetary impact.]
Ø Summary
To avoid the condemnation of the police record, the first deferred sentence won't be mentioned anymore on the extract from police records (necessary at the time of an employment application) as far as it relates to linked facts to the drug (other that the traffic). The deferred sentence (as well as the suspension) will be however always registered in the police record so that the police and the justice are not deprived of this information.
The law on the probation offers to the judge a large range of possibilities of individualization of the pains pronounced in opposition to those that contravene the legislation concerning drug. The imposition of probation conditions individualized requires an extension of the application of the formula of the social investigation however. The magistrates should be encouraged (possibly by the slant of a modification of the legislation) to resort as often as possible to the law on the probation. The prison sentence with reprieve or the fine is again too often pronounced. The relative private bill to the alternative pains will allow the judges to the penal to replace the prison sentences by more discriminating pains.
If the King's District attorney doesn't ask for the enforcement of law on the probation with regard to the users of drugs having committed no other offense, he should motivate his/its decision henceforth.
Ø Responsible Minister
The Minister of the Justice is responsible for the application of this point of action.
Ø Calendar
¨ Extension of the recourse to the probation: end 2001
¨ Condemnation of the police record: July 2002
¨ Opinion Commission Holsters: end 2001
Ø Valued budget
The Minister of the Justice has a sufficient budget to achieve this point of action.
Ø Summary
The therapeutic opinion is a method of work that has for goal to establish a contact between the consumers of drugs illegal arrêté(e)s by the police and the aid, this gait remaining placed under the control of the office of the Prosecutor, in the goal to specify if an accompaniment is indicated. An opinion concerning aid is formulated on the basis of this screening. The aid analyzes the problematic domains of the drug addict's life and throw a process of awareness. The drug addict's will is decisive here. On present hour, these projects depend on the one hand on local conventions of cooperation between the police and the public prosecutor's office, and the aid on the other hand. The projects are not, at present, financed not again by the public powers.
The federal government will insist by the Communities so that these last recognize this method of work legally. The federal government will free some credits to finance this instrument, in the setting of the contracts of security and society, of the contracts of prevention and the contracts drug. Funds can also be freed to this effect via the department of Justice, in the context of the alternative pains, the penal mediation or probation prétorienne.
Ø Responsible Minister
The Minister of the Justice is responsible for the execution of this point of action. He/it negotiates with the Communities and confer with the Minister of the Public health, the Minister of the inside and the Minister of the social Business.
Ø Calendar
This point of action will be executed after the creation of the Cell Drugs.
Ø Valued budget
The Minister has a sufficient budget to achieve this point of action.
4.5.6. Confiscation of the money of the drug
Ø Summary
The federal government will examine the possibility to invest money confiscated coming from the drug in the aid and the prevention concerning drug (in this included the therapeutic opinion). It is especially the financing of the handling of the drug addicts without funds by the health insurance that could be improved. The law foresees, from now on, the possibility to confiscate money coming from the drug (and the vehicles used for the transportation of the drugs) and, in the same way, to confiscate goods and securities that are substituted themselves of it also and of the incomes descended of the funded earnings. These possibilities seem however little applied. Especially the roadbed of the is confiscated seems to pose a problem. The Minister of the Justice will insist from then on in his/her/its guideline, on the fast confiscation of the money of the drug. He/it will also refine the laws in force. The Minister of the Justice will take some initiatives in the goal to arrive to the effective confiscation of the product estimated of the drug traffic. In any case, he/it seems unadvisable to impose with reprieve the accessory penalty of confiscation.
The federal government wishes to recall here the article 35 encores of the criminal instruction Code (attached conservatory by the King's District attorney) and the article 43 of the Criminal code (obligatory specific confiscation)
Resources of the technique said "of asset-sharing" in the setting of the international collaboration should also be studied.
Ø Responsible Minister
The Minister of the Justice is responsible for the execution of this point of action. Him it devises with the Treasury secretary (administration land-registry, registrations and domains).
Ø Calendar
Legislative and other initiatives: June 2001
Ø Budget
The confiscation of the money of the drug has positive budgetary repercussions.
4.5.7. A coherent penitentiary politics concerning drug
Ø Summary
A circular relative to the penitentiary politics concerning drug was finalisée.
The circular is based on the results of research ordered by the SSTC and, more particularly, on the leading principles follows:
1. about the half of the prison population is familiarized with the illegal drugs. The drug is a daily reality in all establishments. All parts concerned, to all levels, must tackle the problem;
2. the concentration raised of convicts having a problem of addiction generates the development of illicit real circuits of distribution and use in the jails. Some measures should also be taken to avoid that the drugs don't penetrate in the jails, this in the respect of the human rights and the maintenance of the socio-emotional ties of the convicts;
3. the approach will be based on the accompaniment of the consumer of drugs;
4. during his/her/its detention, the consumer of drugs must be able to count on the same quality of care that the one of which he could benefit if he was not detained;
5. an intensive politics of prevention must be developed. The staff of the penitentiaries will be informed regularly and will follow some instruction courses with regard to the prevention of the addiction and the reduction of his/her/its harmful consequences.
The principles generated the following lines of force above:
1. the directions of the penitentiaries must allow external professionals of the aid to intervene preventively and curatively within the jails. The directions will address, in the first place, to the services that validated the agreements of cooperation between the Communities and the Minister of the Justice. But other external services must be able to benefit from the same easiness. Philosophy and the activities of these services must respect and must make respect the principles of order and indispensable security in penitentiary environment;
2. a penitentiary is not an establishment of care, nor a mental hospital. A penitentiary is the structure in which exercises itself the deprivation of liberty. Let's underline the obligation however to answer the medical and psychosocial problems of the convicts, in order to manage the situations of crisis and to orient the convicts toward an adequate solution;
3. in every establishment of care, a physician attached to the psychosocial service will be the physician of reference of the convict. He/it will be responsible for his/her/its treatment and will be careful notably to assure the continuity of the treatment in the case where the prisoner would be transferred in another establishment. He/it will also take, as soon as possible, personally contact with the external services of aid in case of liberation of the convict. The physician of reference will assure the pursuit of the substitution treatment if the convict is transferred;
4. the treatments of substitution will especially be reserved to the pregnant women, to the convicts having to execute short pains, to the seropositive convicts or carriers of the hepatitis virus. The tie between the transferable illnesses and the consumption of drugs imposes the besides setting in work of an active politics of vaccination and tracking. In all others cases, the treatments of substitution won't be prescribed (under the direction of the responsible physician) that in a curative goal, in order to put a term progressively to the dependence, and in return for the establishment with the convict of a severance program. In this case, the convict and the physician will sign the proposed program, possibly in dialogue with an external aid service;
5. in order to permit the convict's reinsertion and to avoid the recidivisms, it is primordial that the convict can maintain, during his/her/its incarceration, of contacts with at least an external aid service that will take the relief of the accompaniment as the prisoner is put back in liberty. The director of the jail will inform the person responsible of the external service aimed about the date planned for the convict's liberation as quickly as possible;
6. at the time of the release, the responsible physician will communicate all useful information to the physician charged of the follow-up and this to a double condition: the convict must give his agreement writes and the professional secrecy must be respected;
7. the sections "without drugs" and the similar projects will be valued.
8. some measures will be taken to counter the surreprésentation of the drug-addicted allochtones in the jails. It is necessary that they can resort to the regular aid, all as the autochthonous drug addicts.
Ø Responsible Minister
The Minister of the Justice is responsible for the execution of this point of action. He/it confers with the Minister of the Public health and negotiate with the Communities about the organization of the aid, of the campaigns of prevention and the formation of the staff of the penitentiaries.
Ø Calendar
The new penitentiary politics concerning drug will be implemented this year again.
Ø Valued budget
The Minister of the Justice has a sufficient budget to achieve this point of action.