Relationship between social exclusion and drug use

More data are available on social conditions among the treated population. Socioeconomic factors related to drug use include low educational levels, early school leaving and drop-out; unemployment, low salaries and difficult jobs; low income and debt; insecurity of accommodation and homelessness; mortality and drug-related diseases; poor access to care; and social stigma (Table 5).

Relevant differences in the social conditions of drug use are found by substance used and drug use patterns; the worst conditions are found among heroin and opiates users and chronic drug addicts.

Table 5: Social conditions (education, labour status, housing) of clients in treatment in EU Member States in 2001

Social conditions

Drug users in treatment (valid %) (1)

Education (n = 98 688)

Never went to school/never completed primary school


Primary level of education


Labour status (n = 100 000)



Economically inactive


Housing (n = 41 299)

Unstable accommodation




(1) Percentages are calculated on the total number of cases reported under each single item; the total does not sum to 100 % as only the values of interest for this chapter are reported (never went to school, unemployed, etc.); for the complete figures, see Figure 55 OL: Level of education among all clients by country; Figure 56 OL: Labour status among all clients by country; and Figure 57 OL: Living conditions among all clients by country.

Source: Reitox national reports – TDI data 2001.

Some 47 % of all clients in treatment in 2001 never went to school or only completed primary school; high rates of early school leaving and drop-out are also frequent among drugs users. Differences are found according to main drug used and by country (Figure 55 OL): opiates users (in particular heroin users) have the lowest educational level (National reports, 2002).

Because of their precarious social conditions, drug users also have problems related to labour status; unemployment rates are very high compared with the general population (47.4 % among drug clients compared with 8.2 % (104) in the general population); finding a job is difficult and it is rare for drug addicts to keep a job for long or to progress in a career (DrugScope, 2000) (Figure 56 OL). A precarious labour status can lead to financial problems; drug addicts frequently have low income or no financial resources (32–77 % of clients in treatment survive on social benefits). Debts are also common.

The living conditions of drug users are often reported to be very poor: 10.4 % of clients live in unstable accommodation and 7.5 % live in an institution. Furthermore, many countries report high homelessness rates (up to 29 %) among drug addicts (Figure 57 OL).

With regard to nationality, characteristics resemble the general population structure (Figure 58 OL); clients are mainly nationals of the country where they request treatment, and the number of clients from other countries (European or non-European) is consistent with the proportion of foreigners in the general population. However, it should be remembered that in some countries registration of clients’ nationality/ethnicity is not allowed and consequently such information is not consistently available.

Apart from direct health consequences (see ‘Drug-related infectious diseases’ and ‘Drug-related deaths’), drug users can find it difficult to access care because of a reluctance to deal with services or poor education, a low degree of acceptance by mainstream medical services and unique health problems for which appropriate services are not available.

Finally, drug users suffer from a negative social image and may face hostility from the general population and public authorities. Research conducted in a prison in Vienna found that drug users may experience violence and abuse from police officers or other public officials (Waidner, 1999).

(104) Average unemployment rate among the 15 Member States (Eurostat, 2002).