This miniguide is one of a larger set, which together comprise Health and social responses to drug problems: a European guide. It provides an overview of the most important aspects to consider when planning or delivering health and social responses for migrants who use drugs, and reviews the availability and effectiveness of the responses. It also considers implications for policy and practice.

Migrants are a highly heterogeneous segment of the population, and the links between migration and drug use are complex.

On arrival, there is in generally a lower prevalence of drug use among migrants than is found in the host country. Nevertheless, some migrants may have already been using drugs prior to arrival and require drug-related medical care. Ensuring continuity of care for those receiving opioid agonist treatment and/or antiretroviral therapy is especially important, but there may be difficulties in determining medication equivalences and communicating the clinical management practices of the host country.

Other migrants may be more vulnerable to problem substance use after arrival for a range of reasons, including trauma, unemployment and poverty, and the loss of family and social support. Drugs may be used by migrants to cope with trauma, boredom, and uncertainty and frustration in relation to their immigration status. Migrants’ vulnerability may be further aggravated by a lack of information about healthcare services and difficulties in accessing treatment.

Data and literature on the prevalence and patterns of substance use among migrant populations in Europe are scarce, and this deficit inhibits a thorough assessment of the needs of this group (Humphris and Bradby, 2017; Blom et al., 2016).