14. Overall conclusions

This pilot study has highlighted the vulnerability of migrant populations in selected EU cities to the risk of drug and alcohol abuse. It has shown that the problem among some migrant groups may be more severe than had previously been thought and certainly calls for more attention by municipal, regional and national health authorities. The fact that so many municipal authorities participated actively in the project demonstrates the their willingness to take up this issue. To do this, however, more detailed information will be required about the dynamics of drug and alcohol abuse in migrant communities. In particular much more needs to be known about how migrants cope with stress, and what types of stress move them to use drugs and alcohol. There is also a need to understand why such a large proportion of migrants were gratuitously exposed to drugs. The role of the family and other informal support networks also needs to be addressed, especially given the large number of drug using migrants who appeared not to be able to have recourse to family members.

What role health and social services should be encouraged to play also calls for more operational research and training. The barriers to better identification of problem situations and to dealing with people at risk appear to be a mix of linguistic and cultural problems. More effective use of people from migrant communities as mediators and as para-health staff needs to be explored. Similarly, the role of law enforcement with respect to drug abuse among migrant communities needs to be better understood. The pilot study pointed to a higher than average involvement of migrants in confrontations with the law. Whether this was justified or not should be assessed, especially given the fact that so many respondents in the pilot study referred to this as indicative of discrimination.

The pilot study has also demonstrated that data of the kind that are needed to reduce the risk of drug and alcohol abuse among migrant populations can be generated. There was little resistance to this project by either migrants or local authorities and staff. The project also highlighted the fact that there may be ways of generating data that indirectly sensitise all concerned to the problem of drug abuse in migrant populations, and involve them more in discussing how best to resolve the problem.