Social reintegration

Measures to deal with social exclusion among groups with or without drug addiction problems and with the social consequences of drug use/abuse are set out in the European countries and Norway.

On the basis of the European Union drugs strategy (2000–04) (Council of European Union, 2000) and a specific study on social reintegration in the EU and Norway (EMCDDA, 2003b), social reintegration could be defined as ‘any integrative efforts for drug users in the community’.

Social reintegration interventions target both current and former problem drug users, ranging from well-functioning ‘clean’ former addicts and long-term methadone clients to very deprived street addicts. A treatment component, whether medical or psychosocial, is not necessarily required. This also implies that social reintegration does not necessarily take place after treatment but can take place irrespective of prior treatment, being either the final step in a treatment process or a separate and independent post-treatment intervention carried out by non-treatment services with their own goals and means. Social reintegration services do not target problem drug users exclusively but may target all kinds of addicts (including those addicted to alcohol and legal drugs) or even all socially excluded groups (e.g. homeless people and rough sleepers).

Figure 23

Main provision modes for social reintegration for problem drug users in the EU and Norway

Figure 23

A quantitative overview of social reintegration measures in EU Member States is impossible to achieve, as the term ‘social reintegration’ is not used consistently. Although different services may exist alongside each other, at country level there are typically general ‘provision modes’ for social integration

It is difficult to quantify the availability of social reintegration services and assess the adequacy of service provision although the evidence would suggest that the number of facilities is probably inadequate. For example, Germany estimates that it needs around 25 000 social reintegration places, whereas the actual number available is roughly 4 000. An employment project in Austria registered twice as many applications as places and had to turn down an average of 15 persons a day.

Social reintegration can be broken down into three main types of interventions: education (which includes training), housing and employment.

Many drug users have a poor level of education, and many national reports describe a poor relationship between problem drug users and the labour market (Greece (Kavounidi, 1996), Denmark (Stauffacher, 1998), the Netherlands (Uunk and Vrooman, 2001)). Hence, interventions aimed at upgrading academic, technical or practical skills would improve clients’ chances in the labour market.

Employment measures can take many different forms, for example providing financial support to companies which employ a drug user in a competitive job, as is reported from Greece. Other measures include setting up employment services, such as the Vienna Job Exchange in Austria, or helping clients to establish their own businesses, as also occurs in Greece as well in Spain under the auspices of the employment programme ‘Self-employment promotion’ (this kind of intervention overlaps with education/training).

Finally, providing housing or assistance to find housing aims at bringing some stability into clients’ lives. Offering housing can be an intervention in itself but will often be accompanied by psychosocial assistance and some degree of supervision. An example of parallel psychosocial care is Haus am Seespitz in the Tyrol, which runs an open after-care group for clients that meets in housing facilities. In Belgium, ‘Habitations protégées’ provides both housing and psychiatric care. Research performed in Ireland (Irish national report (Hickey 2002)) showed that 79 % of female and 76 % of male ex-prisoners indicated that finding suitable housing was their main problem and reason for their social exclusion, suggesting that housing is an important social reintegration intervention.

(105) For more in-depth information and country overviews see the study ‘Social reintegration in the European Union and Norway’.