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1.  Drug use and prisoners. 
BMJ : British Medical Journal  1991;302(6790):1464.
PMCID: PMC1670142  PMID: 2070118
2.  Evidence-based prevention of cannabis use in flanders is there a role for health economic evaluation? 
Archives of Public Health  2010;67(4):146-160.
Objectives
Cannabis is a popular drug in Flanders, in spite of the fact that the prevention of its use lists high on the Flemish political agenda. The Flemish Government aims to prevent cannabis use efficiently and in achieving this, a health economic analysis could be helpful. The possibilities and limitations of applying economic evaluation techniques to the prevention of substance (ab)use, are discussed in this paper.
Methods
A thorough literature search, interviews with key persons, an internet search and an analysis of unpublished reports and documents was performed.
Results
The interrelation between various forms of substance use, and of the array of strategies to prevent this (including the costs thereof), seems to demand a joint evaluation of multiple substances.
Conclusions
More than methodological difficulties, the general lack of knowledge on age- and time-specific health and income effects caused by various forms of substance (ab)use, currently makes the evidence-based evaluation of prevention of cannabis use in Flanders a virtually impossible undertaking.
doi:10.1186/0778-7367-67-4-146
PMCID: PMC3436675
Belgium; cannabis; evidence-based medicine; medical economics; prevention; programme effectiveness
3.  Differences in the perception of a mass media information campaign on drug and alcohol consumption 
Archives of Public Health  2010;67(4):161-168.
The two-month mass media campaign in Belgium on drug and alcohol consumption "Alcohol and other drugs. The facts and fictions" initiated in January 2008 has been evaluated shortly after by a phone survey. This article reports some indicators on the public awareness of the campaign, and the differences in the perception according to age groups and education levels.
About 1,000 respondents (n = 1,002) accepted to participate in the campaign evaluation. Response rate is 37.1%. Global perception of the campaign - measured by the capacity to identify the campaign adequately - is 18.8%. This perception varies between age groups and education levels: 30% of the youngest age group (14-35 yrs) have seen the campaign, 13% of people aged 56 and over (p<0.001). The lower the education level, the lower the probability to have seen the campaign (11% in the lowest group, 25% in the highest one, p<0.001).
Among the respondents who have seen the campaign, newspapers are the most often cited media for the oldest age groups. Inversely, young people have mainly identified the campaign on street boards or on post cards.
The privileged type of media is also function of the education level. People belonging to the lowest educational level report more often to have seen the campaign on TV (85% vs 51% in the highest group, p<0.01), while the reverse is true for seeing the campaign via the newspapers or the street boards.
The results indicate that there are socio-economic variations in the perception of the campaign. In health promotion, reaching lower socio-economic groups still remains a real challenge. Channels for such campaigns have to be carefully chosen to reach their target groups and ask to be complemented with community based interventions.
doi:10.1186/0778-7367-67-4-161
PMCID: PMC3436676
4.  Stimulant medication use among Flemish students: results from an exploring secondary data analysis1965-2005 
Archives of Public Health  2010;67(4):169-178.
Background/Aim
Recent media coverage in the Flemish media in Belgium reinforced the general public opinion on medication use among students, suggesting an alarming magnitude and a rising trend, with the use of stimulants as a specific element for enhancing study performances. These assumptions needed scientific verification, which we intended to do with this study.
Method
Secondary data analysis was conducted on four Belgian studies on medication use among students from 1965, 1969, 1993 and 2005. The 2005 survey data are also used to give an insight in prevalence and frequency of use during exams and in other periods and to widen the scope to poly-substance use.
Main Findings
All studies show prevalence figures for stimulant medication use under 10%. Prevalence and frequency of use is highest during exam periods. No gender differences were found for stimulant medication use. Living status on the other hand is an influential factor: students living away from the parental home report higher prevalence rates than students still living in their parents' house. Prescription regulations seem to have a declining impact on the most popular products.
Conclusions/Discussion
Students' medication use, more particularly during exam periods, appears to be an all-time reality in Flanders. No indications for a rising trend were found. Although the extent of stimulant medication use is relatively limited, a small minority shows more risky consumption patterns: daily use of stimulant medication (incl. risky side effects) during exam periods and higher prevalence of poly-substance use. More research is needed, particularly on the most consumed products (e.g. methylphenidates) and on the supplying sources of this medication.
doi:10.1186/0778-7367-67-4-169
PMCID: PMC3436677
Students; substance abuse; central stimulants; residence characteristics; gender
5.  Cannabis-Related treatment demands in Belgium: a socio-demographic and treatment seeking profile 
Archives of Public Health  2010;67(4):179-193.
Aims
Most people appear to stop using cannabis when getting older, but a certain subgroup becomes cannabis dependent, has problems in various life areas and needs treatment. Our aim is to compare a number of sociodemographic and treatment seeking variables between treatment seekers with primary cannabis problems and those with primary alcohol, opiate, amphetamine or cocaine problems. Understanding how primary canna-bis users seeking treatment differ from other treatment seekers may assist clinicians in better tailoring treatment processes to clients' needs.
Methods
For this purpose, intake information on 1,626 persons seeking treatment in one of 16 treat-ment agencies in the province of Antwerp (Belgium) was registered via an on-line web application. Primary cannabis users seeking treatment were compared with primary alcohol, opiate, amphetamine and cocaine users by means of bivariate analyses (Chi-square tests and analyses of variance), followed by four logistic regression analyses.
Findings
14.5% of all clients used cannabis as their primary drug. Compared to primary alcohol, opiate, amphetamine or cocaine users seeking treatment, cannabis users seeking treatment appeared to be more often male, younger than 30 years old, Belgian and student. They are often referred to treatment by police or justice and 43.6% of them can be considered single-substance users. Multivariate analyses showed that besides age and sex, using no other substances than the primary drug and being registered in outpatient facilities only were significant determinants for being a primary cannabis user seeking treatment.
Conclusions
Primary cannabis users can clearly be differentiated from other drug users seeking treatment. Although cannabis plays an important part in a polydrug use pattern, persons who have cannabis as their primary drug often use only this one substance. Since they regularly have brief contacts with treatment agencies, more research is needed to measure the effect of this brief intervention.
doi:10.1186/0778-7367-67-4-179
PMCID: PMC3436678
Cannabis; Treatment Demand; Substance Abuse Treatment; Drug Use; Demographics

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