Historique
Article de Périodique
Impact of substance type and patient characteristics on the choice of treatment setting for substance use disorder in Belgium (2025)
Auteur(s) :
FERNANDEZ, K. ;
ANTOINE, J. R. M. ;
DAMIAN, E. ;
SINCLAIR, D. L. ;
COSGROVE, S. ;
DEVLEESSCHAUWER, B.
Année
2025
Page(s) :
art. 209561
Langue(s) :
Anglais
Domaine :
Alcool / Alcohol ; Autres substances / Other substances ; Drogues illicites / Illicit drugs
Thésaurus géographique
BELGIQUE
Thésaurus mots-clés
TRAITEMENT
;
ORIENTATION
;
DISPOSITIF DE SOIN
;
PSYCHOTHERAPIE
;
ADDICTOLOGIE
;
ALCOOL
;
PRODUIT ILLICITE
;
PRISE EN CHARGE
;
COMPARAISON
;
OPIOIDES
;
PSYCHOTROPES
Résumé :
Background: Specialised addiction treatment centers (SAC) and general mental health centers (GMHC) both offer care to people with substance use disorders (SUD) in Belgium, but these sectors often operate in parallel, with little collaboration. This fragmented system may lead to inefficiencies, particularly in the treatment of individuals with dual diagnoses. Despite the recognized challenges, there is limited understanding of the factors that influence whether patients with SUD are treated in SAC or GMHC.
Objectives: This observational study has two main objectives:
1. To examine whether and how the primary substance of abuse influences the choice of either SAC or GMHC.
2. To assess whether other factors (e.g. sociodemographics, institution or person who orientated the patient to treatment) play a significant role in determining the type of center where the patient is treated.
Methods: The study used routinely collected data from treatment centers in Belgium from 2019 (Belgian Treatment Demand Indicator). Logistic regression evaluated the weight of drug use and sociodemographic variables for people entering treatment for SUD for the first time (n = 8322). A random forest algorithm was used to study all patients' orientation toward both sectors, across all treatment episodes (n = 29,658).
Results: The study found that the primary substance significantly influences sector choice. Patients using illicit substances like cannabis, opiates, cocaine, and stimulants are 6-12 times more likely to be treated in an SAC than those using alcohol. Factors such as income source and referral source (e.g. self-referral, general practitioner, etc) also significantly impact patient orientation.
Conclusion: These findings highlight the need for better integration between SAC and GMHC to adequately address the complex needs of people with SUD, especially with dual diagnosis. [Author's abstract]
Highlights:
The primary substance is a key factor in treatment sector choice.
Illicit drug use greatly reduces the chance of treatment in GMHC.
Factors like income source or referral source affect patient direction.
Objectives: This observational study has two main objectives:
1. To examine whether and how the primary substance of abuse influences the choice of either SAC or GMHC.
2. To assess whether other factors (e.g. sociodemographics, institution or person who orientated the patient to treatment) play a significant role in determining the type of center where the patient is treated.
Methods: The study used routinely collected data from treatment centers in Belgium from 2019 (Belgian Treatment Demand Indicator). Logistic regression evaluated the weight of drug use and sociodemographic variables for people entering treatment for SUD for the first time (n = 8322). A random forest algorithm was used to study all patients' orientation toward both sectors, across all treatment episodes (n = 29,658).
Results: The study found that the primary substance significantly influences sector choice. Patients using illicit substances like cannabis, opiates, cocaine, and stimulants are 6-12 times more likely to be treated in an SAC than those using alcohol. Factors such as income source and referral source (e.g. self-referral, general practitioner, etc) also significantly impact patient orientation.
Conclusion: These findings highlight the need for better integration between SAC and GMHC to adequately address the complex needs of people with SUD, especially with dual diagnosis. [Author's abstract]
Highlights:
The primary substance is a key factor in treatment sector choice.
Illicit drug use greatly reduces the chance of treatment in GMHC.
Factors like income source or referral source affect patient direction.
Affiliation :
Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
Department of Special Needs Education, Ghent University (UGent), Ghent, Belgium
Department of Special Needs Education, Ghent University (UGent), Ghent, Belgium