Ancella Voets has worked in harm reduction for over 20 years. Besides doing outreach work in the Netherlands, she has spent several years managing harm reduction programmes in Tanzania and Mozambique. She currently leads the Knowledge, Learning and Partnerships team at Mainline, which focuses on (inter)national harm reduction capacity strengthening.

This SEMID-EU project aimed at developing understanding of needs and responses for persons with a migration background who use drugs and live in vulnerable situations in Amsterdam, Athens, Berlin and Paris, identifying challenges and good practices related to migration and drug use in the EU.

The study employed semi-structured interviews with marginalised persons with a migration background who use drugs, and focus groups with service providers. 98 participants from 43 different countries of origin and 45 nationalities, recruited through purposeful sampling, were interviewed. Interview and focus group data were transcribed verbatim from the original interview language, translated to English and analysed thematically.

Study participants with a migration background who use drugs lived in precarious situations. Many mentioned substance use as a coping mechanism for facing homelessness and psychological issues. Participants had limited social networks. Stigma and misinformation among healthcare providers and a lack of legal documents pose barriers to healthcare. Participants relied on harm reduction services for urgent medical needs. Having an asylum or refugee status, or another residence status, significantly decreased barriers. The importance of peer workers in harm reduction services was stressed, as well as the need for culturally sensitive and linguistically accessible information on safer drug consumption.

People with a migration background who use drugs face many barriers towards exercising their basic rights, perpetuating drug dependence, homelessness, unemployment, financial hardship and related crime. More resources are needed to provide housing and emergency health care, and to increase opportunities for work, mental health support and recovery. Culturally and linguistically relevant support addressing complex, interrelated needs is needed, with outreach as an important component. Harm reduction is a lifesaver for people with a migration background who use drugs. (Legal) barriers to care should be systematically erased and we call for an end to criminalisation of irregular migration and homelessness.