Migrants and drugs — need to scale up specialised drug services in Europe


Health and social responses for migrants who use drugs are explored in a new EMCDDA miniguide launched today to mark International Migrants Day. The resource is one of a series of miniguides making up the agency's latest overview of actions and interventions to respond to the consequences of illicit drug use. Presenting key issues related to migrants and drug use, the miniguide reveals gaps in service provision and limited knowledge on the extent and nature of drug problems in this group.  

Substance use prevalence rates among migrants are generally lower than those of the host populations. Nevertheless, some migrants may have already been using drugs prior to arrival and require drug-related medical care. Other migrants may be vulnerable to substance use problems over time, with risk factors including trauma, unemployment and poverty, family separation, stress and social exclusion.

According to the miniguide, while broader aspects of migrant health are often addressed, few interventions exist in Europe that focus specifically on their drug-related needs. Overcoming barriers which limit migrants' access to specialist drug services is a key issue. Migrants requiring support for a drugs problem, for example, may be unaware of available treatment services, or be reluctant to disclose their drug use out of fear of losing custody of their children or forfeiting residency rights.

Despite the low provision of services, the report does outline some positive developments, with a 'limited but growing range of drug-related services interventions in European countries specifically targeting migrants with drug problems'. These services include:

  • translation and interpretation — helping migrants to access and adhere to treatment programmes;
  • cultural mediation — facilitating communication between different linguistic and cultural groups;
  • cultural competency training — empowering health professionals to be culturally sensitive;
  • peer work — involving migrants in developing interventions for migrants;
  • gender-responsive approaches — focusing on women-only and non-stigmatising services;
  • trauma-informed approaches — helping to recognise signs of trauma and restore feelings of safety.

The EU Drugs Strategy 2021–2025 acknowledges that migrants may have complex or specific care needs. In this context, the guide underlines the importance of: screening and needs assessment for migrants on arrival for potential substance use problems; brief interventions within facilities housing applicants for international protection; continuity of care in the host country for those needing opioid agonist treatment and/or antiretroviral therapy; integrated health services addressing substance use and mental health disorders and social reintegration services facilitating integration into the host community.

Finally, the guide provides key points to consider for those planning or delivering health and social responses for migrants who use drugs and presents implications for policy and practice.

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