Background: Refugees face numerous pre, during and post migration risk factors for substance use (SU) such as post-traumatic stress as well as (structural) discrimination. Moreover, Non-Belgian nationals are underrepresented in residential SU treatment (SUT), with language being an exclusion criterion.
Methods: Replicating a European study, DrugInt studied SU patterns among applicants of international protection (AIP), training and intervention needs in the Belgian reception setting. The study employed an online survey completed by 273 respondents, including a representative sample of professionals working for the Federal Agency for the Reception of Asylum Applicants (Fedasil), complemented by 49 qualitative interviews.
Results: Mirroring other EU countries, tobacco, alcohol, and cannabis are the most commonly observed substances used, with notably high levels of non-medical psychotropic medication use. Alcohol-related incidents are the primary SU-related problems in centres. Interventions prioritise safety over evidence-based psycho-social support. When applicants access residential SUT, it typically involves brief admissions to psychiatric (crisis) units.
Conclusions: The study yielded 10 recommendations for various stakeholders, including Fedasil headquarters, reception centres, SUT services, and policymakers. Based on identified reception setting needs, an infographic, information clip, and Basic Drug Training were developed and disseminated to over 130 Fedasil staff. The reception setting is crucial for prevention and early intervention, highlighting the need to address both individual mental health determinants, like coping mechanisms, and structural factors, including housing and asylum procedures. Concerning treatment and harm reduction, structural barriers need to be address to reach equitable access for AIP.