Are drug users’ needs being met thanks to treatment services in Ghent? – Freya Vander Laenen

Recently, a study was conducted on behalf of the MSOC, the Medical Social Care Center in Ghent. The MSOC provides accessible care for users of illegal drugs, especially opioid users. During this project, it was determined which population is effectively reached (or not quite), what the needs and profiles of these users are, and recommendations were made to expand the services. The findings of the project were incorporated into the local drug policy plan of the city of Ghent for the period 2020-2025, an initiative of the local drug coordinator and the mayor of the city.

An innovative feature of the project is that from the beginning relevant stakeholders were involved at three levels:

  • The MSOC provided privileged access to the field and allowed the research design to reflect the needs of practitioners;
  • A Steering committee from the city of Ghent guided the development of the study through the participation of prevention and (drug) treatment experts and law enforcement agencies;
  • Drug users themselves were given the opportunity to have their voices heard and their needs highlighted.

This multi-level collaboration not only promoted their participation in the research design, but also facilitated the flow of information to stakeholders. The MSOC and the Steering Committee were provided with recommendations for improving drug policy after they had the opportunity to discuss the results. A return to the field was also planned for the study participants, but due to COVID-19 this was postponed. One challenge that the project successfully addressed and added value, both scientifically and in terms of societal impact was how access was gained to this very hard to reach population. Unlike other studies, the subjects were not users of drug treatment services, such as the MSOC, but rather they were those who are currently just barely involved in some form of treatment. To reach the sample of 47 problematic drug users, field workers and street workers were essential connections between the researchers and this marginalised community.

These drug users are important stakeholders in this type of research. Unfortunately, their perspectives are too often overlooked in policy and research environments. During the project, they were given the opportunity to formulate their own recommendations and discuss their needs. The intention to give this community a voice was balanced with the commitment to maintain scientific independence by selecting some of these recommendations through scientific standards and including them in the findings.

Points of vulnerability were also found within this already marginalised and hard-to-reach community and incorporated into the policy recommendations. Not only were alcohol users identified as needing more specific care, even when not using illegal substances, but the Roma community was also found to be highly vulnerable. This led to the inclusion of special provisions for this group in the city’s drug policy plan. Special emphasis was also placed on users who live in extreme isolation, and living in squats, and have little or no contact with social services, but no provisions have been made for this so far.

One of the strengths of the project is that it posited the need for comprehensive treatment for these users by gaining a better understanding of their needs through their recommendations. This also made the recommendations relevant to policy makers and practitioners. This is a reflection of the interdisciplinary focus of the research, which is not so focused on criminology, but more on (mental) health, including insights from sociology, criminology, law, and others. As such, the recommendations are broader than legal policy, and although the context of the study is more likely to be criminal justice, the scope does extends to social policy measures as well.

The main recommendations that emerged from the study were the importance of extending care to areas such as dental care. The placement of bins for syringes should also be expanded.  These are recommendations that are already included in the policy plan. Another finding of the study was that the population on which MSOC had the study focused, namely users of illegal drugs, could in fact be expanded to include alcohol users, as it was determined that this population also needs urgent care. Moreover, while similar research often focuses on the continuum of care, this project found that the provision of care by the same person is often important as well, thus suggesting instead the need for a continuum of care providers.

Over the next five years, most of the recommendations resulting from this project will be able to be put into practice through the Ghent Drug Policy Plan, a key tool for the prevention of drug-related harm. These guides plan the actions of social services in an effort to promote social inclusion within these communities. The project has potential implications for researchers across the country and abroad who want to engage with hard-to-reach communities and draw inspiration from these creative solutions.