Drug use and access to drug dependency services for vulnerable migrants who use drugs in the European Union: Consensus statements and recommendations from civil society experts in Europe

Selm, Lena van; White, Trenton M; Picchio, Camila A; Requena‐Méndez, Ana; Busz, Machteld; Bakker, Ingrid; Romero, Diana; Gayo, Roberto Perez; Pouille, Aline; Vanderplasschen, Wouter; Lazarus, Jeffrey V.

doi:10.1016/j.drugpo.2023.104087

Cited by 3 publications

(3 citation statements)

References 23 publications

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“…Improving access to health and social services, including harm reduction services, for migrants who use drugs is crucial for promoting public health. MWUD may be at a higher risk of infectious diseases, such as HIV and viral hepatitis, due to unsafe drug use practices [ 18 – 20 ], poor living conditions and, in some cases, higher prevalence of these diseases in their country of origin. For example, in 2022, the prevalence of HIV in the EU increased, which has been largely attributed to refugees living with HIV that arrived from Ukraine [ 21 ].…”

Section: Public Health Benefits Of Improved Healthcare For Migrant Wh...mentioning

confidence: 99%

“…For example, including interpreters or cultural mediators in healthcare services improves the quality of care for patients [ 26 , 27 ]. Civil society and health experts working with migrants who use drugs in the European Union recently published recommendations in four areas as part of an EU-funded project “Services for vulnerable migrants who use drugs in the EU (SEMID-EU)” [ 18 ] (Table 1 ).…”

Section: Recommendations From Civil Society Experts On Improving Heal...mentioning

confidence: 99%

“…The civil society and health experts agreed that addiction services available in EU countries are often not sensitive to the specific needs of migrants [ 18 ]. Further, a literature search conducted in 2022 revealed no published studies on the self-reported needs of MWUD [ 2 ].…”

Section: Including the Voices Of Migrants Who Use Drugsmentioning

confidence: 99%

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A call to create integrated services to better address the needs of migrants who use drugs in Europe

van Selm,

White,

Picchio

et al. 2024

Harm Reduct J

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Each year, thousands of migrants enter the EU. Data on drug use in migrant populations are scarce and inconclusive. However, several risk factors make them particularly vulnerable to engaging in problematic drug use. In this perspective, we summarize the limited information that is available on migrants who use drugs and make a case as to why it is essential to improve access to health and social services, including harm reduction services, for this population. With this aim, we call for the co-creation of integrated services that better address the needs of migrants who use drugs in Europe.

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Section: Public Health Benefits Of Improved Healthcare For Migrant Wh...mentioning

confidence: 99%

Section: Recommendations From Civil Society Experts On Improving Heal...mentioning

confidence: 99%

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A call to create integrated services to better address the needs of migrants who use drugs in Europe

van Selm,

White,

Picchio

et al. 2024

Harm Reduct J

Self Cite

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Challenges and support needs among persons with a migration background who use drugs in four European metropolitan cities

Pouille,

De Ruysscher,

van Selm

et al. 2024

Harm Reduct J

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Background Persons who migrate for economic reasons, along with asylum seekers and refugees, face multiple personal experiences and societal inequalities that increase the risk of mental health problems and substance dependency, compounded by intersectional social and economic vulnerabilities. The precarious situation and limited access to care of persons with a migration background who use drugs (PMWUD) in Europe raises concern. Therefore, this qualitative study explores the challenges and support needs of a sample of PMWUD in vulnerable situations living in Amsterdam, Athens, Berlin and Paris. Methods This study employed a community-based participatory approach. Through semi-structured interviews with PMWUD (n = 99), we identified (service) needs of a diversity of PMWUD in Europe. Participants were recruited through a combination of community gatekeepers, venue-based sampling, and snowball sampling. Trained community researchers conducted the interviews, which focused on participants’ living situation, substance use, physical and mental health, and employment opportunities. Results Despite substantial heterogeneity among the PMWUD, several common themes emerged across all groups. Participants frequently mentioned early childhood adversity, limited social networks leading to loneliness, medical, psychological, and substance use issues, histories of personal violence or poverty, homelessness, lack of necessary documents for health care, social security, and employment, and encounters with the criminal justice system. These intertwined and mutually reinforcing factors simultaneously functioned as barriers to care and support, alongside other barriers such as linguistic and cultural differences, and stigma and discrimination. Due to social exclusion, migration, and substance dependence, participants had limited reliable social networks. Therefore, they often had to rely on accessible and low-threshold services. Harm reduction services played a significant role in providing support to PMWUD. Most PMWUD indicated that basic needs for hygiene and food were met thanks to local organizations. Differences in housing opportunities and access to harm reduction services were identified in each city. Conclusion Structural barriers toward treatment and care, often related to administrative requirements, stand in the way of appropriate care for PMWUD. Linguistically and culturally sensitive outreach activities with limited practical requirements could break down social and treatment barriers.

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Challenges and support needs among persons with a migration background who use drugs in four European metropolitan cities

Pouille,

De Ruysscher,

Selm

et al. 2024

Preprint

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Background Substance dependence amongst persons who immigrate for economic reasons, asylum seekers and refugees is gaining attention in several European countries. This qualitative study describes the needs of Persons with a Migration background Who Use Drugs (PMWUD) living in Amsterdam, Athens, Berlin and Paris. Methods This study employed a community-based participatory approach. Through semi-structured interviews with PMWUD (n = 99), we tried to identify (service) needs of PMWUD. Participants were recruited through a combination of community gatekeepers, venue-based sampling, and snowball sampling. Trained community researchers conducted the interviews, which focused on participants' living situation, substance use, physical and mental health, and employment opportunities. Results Despite substantial heterogeneity among the PMWUD, several common themes emerged across all groups. Participants frequently mentioned early childhood adversity, limited social networks leading to loneliness, medical, psychological, and substance use issues, histories of personal violence or poverty, homelessness, lack of necessary documents for health care, social security, and employment, and encounters with the criminal justice system. These intertwined and mutually reinforcing factors simultaneously functioned as barriers to care and support, alongside other barriers such as linguistic and cultural differences, and stigma and discrimination. Due to social exclusion, migration, and substance dependence, participants had limited reliable social networks. Therefore, they often had to rely on accessible and low-threshold services. Harm reduction services played a significant role in providing support to PMWUD. Most PMWUD indicated that basic needs for hygiene and food were met thanks to local organizations. Differences in housing opportunities and access to harm reduction services were identified in each city. Conclusion Structural barriers toward treatment and care, often related to administrative requirements, stand in the way of appropriate care for PMWUD. Linguistically and culturally sensitive outreach activities with limited practical requirements could break down social and treatment barriers.

show abstract

Drug use and access to drug dependency services for vulnerable migrants who use drugs in the European Union: Consensus statements and recommendations from civil society experts in Europe

Cited by 3 publications

References 23 publications

A call to create integrated services to better address the needs of migrants who use drugs in Europe

A call to create integrated services to better address the needs of migrants who use drugs in Europe

Challenges and support needs among persons with a migration background who use drugs in four European metropolitan cities

Challenges and support needs among persons with a migration background who use drugs in four European metropolitan cities

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