Purpose The opioid epidemic in the USA, the new psychoactive substances emerging on the market and the recent increase in cocaine treatment demands in Western Europe, all emphasise the importance of monitoring the use and harms of drugs over time. To be informed about new consumption patterns, this study aims to study the trends among people entering treatment for substance use in Belgium. Design/methodology/approach Belgian data from the Treatment Demand Indicator collected between 2015 and 2019 were used. A reference group of treatment units was selected to allow for comparisons between the different years. Trend analysis was performed by using a joinpoint regression among different regions and groups of clients. Findings The drugs of choice that were most frequently mentioned among the 23,000 analysed treatment episodes were alcohol and cannabis. Both remained relatively stable over time. Heroin seemed to be decreasing significantly at the national level, but increased in Brussels. Benzodiazepines decreased significantly in Flanders and Brussels, but not in Wallonia. On the other hand, reports of crack cocaine increased significantly in the three regions with a more pronounced trend in Wallonia and Brussels. Substances such as fentanyl, methamphetamine, ketamine or volatile inhalants have been mentioned significantly more by people entering treatment in 2019, although their contribution to the total number is still limited. Originality/value To the best of the authors’ knowledge, this study is the first to evaluate trends for all drugs of choice at a national and regional level. These results might not only benefit national policymakers but also other countries with similar alcohol or drug use patterns.

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SamenvattingDe alomtegenwoordigheid en sociale aanvaarding van alcohol in België verbloemt in vele gevallen de schadelijke gevolgen die alcohol heeft. Om die gevolgen te reduceren, is er de afgelopen jaar veel onderzoek gedaan naar de effectiviteit van mogelijke overheidsmaatregelen. Onder andere de Wereldgezondheidsorganisatie adviseert landen over effectieve beleidsmaatregelen op basis van wetenschappelijke inzichten. Ondanks de aanbevelingen van de Wereldgezondheidsorganisatie en uit wetenschappelijke onderzoeken is er in België nog altijd geen sprake van een nationaal alcoholbeleidsplan waarin deze maatregelen integraal zijn opgenomen. Maatregelen op het vlak van preventie, hulpverlening, prijs, aanbod en marketing zijn noodzakelijk om de schadelijke gevolgen van alcohol effectief te reduceren.

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