Substance use disorders in Belgium: the need to study rarely investigated high impact disorders

Although the problem of substance use disorders in Belgium may be seen as not that important or widespread as in some other developed countries such as the United States or the Middle Americas, statistical evidence from a growing number of epidemiological and clinical studies points to the importance of substance disorders in Belgium. From epidemiological studies it becomes clear that about 8 million Belgians have ever consumed alcohol, about 800,000 cannabis, and 120,000 cocaine (1). Recent epidemiological studies pointed to three critical issues concerning substance use disorders that should be taken into account. First, although the risk of developing substance use disorders remains generally low among persons who ever used substances (2), the use of substances is a community issue, and is not an isolated phenomenon. After all, the mere use of substances starts at very early ages, with late childhood and adolescence as critical risk periods for developing problematic use (3) and early adolescence as critical periods of developing substance use disorders (4). Following this, the implementation of both information campaigns on and prevention of use for high risk groups may be warranted, as is currently the case within the Flemish political context. It is crucial to study how an evidence-based prevention policy may be best implemented in order to maximize health gains against limited resources (5). In general, there is a lack of European studies in this field, and this emphasizes the strong need for studies on long-term health effects of cannabis use, factors that may stop or delay the transition from cannabis use to cannabis problems, and costs associated with the use of cannabis before an evidence based strategy may be implemented. In line with this, Godin et al. (6) investigated the effects of mass media campaigns on drug and alcohol consumption in Belgium. Although they found that the campaign was well-appreciated, only 19% of the respondents recollected the campaign, and not even 4% was able to name the organizing institution. More importantly , however, persons who did remember the campaign tended to forget the message of the campaign quickly. If we assume that health promotion and prevention of substance use problems may be achievable by, among others, broad dissemination of information on facts, fictions, and risks of the use of substances, well-designed campaigns may be quintessential. Second, whereas lifetime prevalence (i.e. the proportion of persons who meet criteria for a substance use disorder during lifetime) is …