125 Substance use and intervention needs in the European and Belgian refugee reception setting

Abstract PTH 4: Mental Health and Refugees 2, B307 (FCSH), September 4, 2025, 14:00 - 14:48 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, migrants face inequities in European mental health care services, including SU treatment (SUT). In Belgium, third country nationals are underrepresented in residential SUT, with language being an exclusion criterion. Methods Replicating a European study conducted in collaboration with the European Drugs Agency (EUDA), the DrugInt project studied substance use, training and intervention needs in the Belgian reception setting. An online survey was completed by 273 respondents, including a representative sample of professionals working for the Federal Agency for the Reception of Asylum Applicants (Fedasil). Additionally, 49 qualitative interviews were conducted with staff in both reception centres and substance use treatment. 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 substance use related problem in centres. The identified interventions in the Belgian reception setting prioritise safety over evidence-based psycho-social support, highlighting the urgent need to invest in cost-effective evidence-based early intervention and prevention. When applicants access residential SUT, it typically involves brief admissions to psychiatric (crisis) units without necessary follow-up, highlighting the need to increase the accessibility of treatment services by adapting to the needs of these populations. Conclusions The study yielded 10 recommendations for various stakeholders (policy makers, reception centres, SUT services) ranging from the need to adapt substance use treatment services, over implementing early intervention and prevention in the reception setting to ensuring basic human rights with special attention to housing and health needs. Based on the identified reception setting needs, an infographic, an information clip, and a Basic Drug Training were developed and disseminated among over 130 Fedasil staff members in Belgium.