Towards improved access for people with a migration background to harm reduction and health services.

Background
The project 'Services for Vulnerable Migrants who Use Drugs in the European Union' (2022-2023) focused on filling knowledge and practice gaps in drug use and migration in Europe. Although many migrant groups in Europe have lower rates of substance use than the populations in the countries where they live, several risk factors make them more vulnerable to engage in problematic drug use. These risk factors include traumatic experiences, disengagement with society, unemployment and poverty. Harm reduction and health services and municipalities throughout the European Union are faced with the challenge to address these migrants’ needs, as a growing number of people with diverse migration backgrounds mix with the homeless population across European cities. The SEMID-EU project wanted to contribute to understanding the needs of vulnerable - often street-based - migrants who use drugs (MWUD) with the aim to improve local responses throughout Europe. The general objectives of the project were to improve the wellbeing and reduce the harms of vulnerable migrants who use drugs by: 1) improving knowledge and understanding among policymakers and practitioners; and 2) strengthening capacities of healthcare and support services working with these groups.

Methods
Over the course of the project a consortium of seven organisations - Mainline, ISGlobal, Ghent University, Correlations-EHRN, Gaia Paris, Fixpunkt and Postive Voice - engaged in a literature review, a Delphi round, a community-based-participatory research and in the creation of several policy papers and fact sheets, the publication of a digital magazine and a broad dissemination strategy.

Results
SEMID-EU was successful in offering a platform to the voices of people with a migration background who use drugs in four European cities (Amsterdam, Athens, Berlin and Paris). Their stories paint a picture of poor access to health care and constant harassment by law enforcement. The project also underscores how central harm reduction organisations are in the first response to the many needs of this group of people. But we also noted the difficulties at service level: the capacity of organisations is under pressure due to financial stress and the lack of political support. The needs of migrants who use drugs are complex and staff needs to be equiped to work in trauma-informed and culturally sensitive approaches. Furthermore, urgent local, national and European advocacy is needed to counter populist views and policies that hinder the access that migrants have to their human rights, including their right to health and their right to shelter. 

Conclusions
During this workshop we seek interaction with civil society, policy makers and researchers to improve the service access of migrants who use drugs. A short presentation will be followed by an interactive dialogue that seeks to ignite an agenda for change in practice, research and policy.