Deterrence, stigma and Maltese society: One pill too far? | Karen Mamo

Karen Mamo, Drug policy researcher

Jekk taqa’ nkompli ntik! [if you trip, I will beat you more] and donkey hats for disobedient school children where the main educational tools used across Malta until the early 2000s.

Today, we are all more conscious of the psychological harms induced by similar abusive tools and we have now replaced deterrence and shame with positive parenting and an educational system focused on empowerment.

The stigma and the physical pain were intended to instil fear. We all know, fear lulls the mind to sleep. That is why, hearing professionals working across the addiction treatment field calling for tough enforcement and harsh sanctions acting as deterrence to address personal drug use remains highly concerning. What is even more troubling, is the repeated dogma ‘Malta has a drug problem’, without timely and representative data monitoring exercises clearly mapping the state of legal and illegal drug use in Malta.

In fact, despite being members of the EU for over 20 years, Malta is the only member state which does not share on a yearly basis drug consumption levels and trends with colleagues at the European Union Drugs Agency (EUDA). This gap in data collection remains unexplainable and is not related to demographics or size. In fact, other small member states, such as Luxembourg and Cyprus provide data on drug use.

Domestically, the General Population Survey by the National Drugs and Addictions Unit is the only tool measuring the use of alcohol, tobacco, drugs, and (some) prescribed medications across the population. The survey is carried out once every 10 years and focuses on adults between 18 and 65 years old divided between males and females. The most recent one mapping trends between 2013 and 2023 was published in December 2025.

Cannabis consumption continues to be a popular activity, with last month consumption reported at 3.2% as opposed to 0.5% in 2001. On average, 6.1% consume cannabis daily whilst 71.5% consume it on a weekly basis. Interestingly, whereas in previous years consumption of cannabis for the age group between 40 and 65 years old was predominantly reported as non-existent, the General Population Survey shows that older adults are now more confident to speak about their cannabis consumption. From a harm reduction perspective, data related to older cohorts is a positive development, indicating that legal changes linked with depenalisation and decriminalisation are necessary to help uncover and understand previously thought inexistent realities.

On the worrying side, one finds that data shows consistent levels of alcohol use, with 58% consuming in the last month out of which 12% consume daily. Gozo registered the highest increases in alcohol consumption across all levels. Moreover, whilst cigarette smoking has decreased by 9.4% when compared to 2001, the rise in the use of nicotine vapes (standing at 37.6% daily) suggests a switch in the method of consumption. From an addiction perspective, this change brought no significant impact in reducing the demand associated with nicotine-based products. When looking at risky behaviour and addiction, lottery gambling increased from 55.4% in 2001 to 90.1% in 2023. Sports betting, most popular with young adults under 25 years old also experienced a marked increase, jumping from 3.3% in 2001 to 8.8% in 2023. These figures are concerning, especially when considering that both Lotto and Super 5 are being drawn twice a week. From an industry perspective, this is increasing the profit margin. From a prevention perspective this is creating unnecessary pressures on vulnerable groups enticed through adverts and public figures further pushing for the normalisation of gambling.

Alarmingly, the rate of prescribed anti-depressants in Malta is at an all-time high standing at 36.4% daily use. The highest increase in prescribed anti-depressants is attributed to those between 18 and 39 years old, in particular females. These numbers could be indicative of numerous factors, including: Increased awareness and reach-out to psychiatrists; over prescription of anti-depressants; and an over-all decline in mental health well-being and resilient coping mechanisms across the islands.

Looking north, Gozo represents special and most notable developments. In fact, whereas in 2001 and 2013 Gozo reported no drug use, the island registered 0.3% in 2023. Current use in the past month of prescribed anti-depressants shot up from 5% in 2013 to 8.4% in 2023. Gozo has also the highest levels of medicinal cannabis prescriptions when compared to other regions in Malta. These new developments observed in Gozo merit a unique country specific report giving increased opportunities to monitor and prevent an escalation of risks and harms.

Such as the European Drugs Report published on an annual basis by the European Union’s Drugs Agency gathers drug use prevalence levels across all member states, Malta requires a similar data collection framework, thus further aligning policy and data collection with the methodology and parameters adopted in the EU.

These little snippets highlight Malta’s recurring drug policy and data collection limitations, with minority groups such as the LGBTIQ community completely ignored. Furthermore, lack of meaningful representation continues to hinder the full realisation of Malta’s ambitious drug policy framework running until 2033. In fact, the National Addiction Advisory Board remains a politically appointed body with no member hailing from a human rights background, no member representative of the LGBTIQ community, and no member representative of the needs and rights of people who use drugs. How can the principles of democratisation and inclusivity be respected?

Ensuring drug laws, policies, and data collection in Malta fulfil their purpose of preventing health, social and legal harms remain a wishful dream for people who use drugs.

Our new dogma for drug policy and laws? Jekk taqa’, LE ma rridx inkompli ntik! [If you trip, NO, I do not want to keep on beating you].

A renaissance in drug policy reform is possible; we just need to remove the shackles of the present ancien régime and replace deterrence and fear, with inclusivity, representation, and empowerment.