Why This Matters
• Cocaine now dominates treatment demand: Over 60% of first-time drug treatment seekers in Malta are dealing with cocaine addiction, a dramatic shift from historical heroin-focused cases.
• New synthetic drugs are circulating: Substances like CC9 (synthetic cannabinoid) triggered acute hospital admissions in April 2025; Pink cocaine, Ketamine-based "Tusy," and others have entered local markets.
• Government has committed substantial funds: A €2.3 million three-year agreement (April 2026) represents a nearly 20% funding increase for OASI's prevention, residential, and aftercare services.
• Help is accessible: Free services operate via SEDQA (179), CARITAS (22 199 000), OASI (21 563 333), with specialized units at St Luke's and Saint James Anew in Gozo.
The OASI Foundation in Gozo reached a sobering milestone in June 2026: after 35 years of operation, it has assisted more than 6,000 individuals grappling with substance dependency. Yet this marker of decades of recovery work arrives amid a profoundly different drug landscape than the one the organization encountered when it opened in 1991. The potency is higher, the variety is broader, and the velocity of change—driven by online markets and laboratory-produced synthetics—has forced Gozo's premier addiction service to constantly recalibrate its clinical approach and staffing capacity.
Geographic Scope: Understanding the Data
OASI Foundation operates primarily in Gozo, but the trends it documents mirror patterns across both Malta and Gozo. Statistics cited from European Drug Reports and government sources reflect Malta as a whole unless otherwise specified. This article examines national trends through OASI's lens while highlighting how Gozo residents and those seeking services island-wide can access support.
The Shifting Substance Profile
Cocaine's dominance tells the story most starkly. In 2022 alone, OASI treated over 500 individuals, with 44% presenting cocaine-related dependency and 41% struggling with alcohol. A mere 6% sought help for cannabis issues that year—a sharp drop from 12% in 2020, though CEO Noel Xerri cautions this does not signal declining use but rather delayed help-seeking, as cannabis consumers may not yet recognize they need intervention.
The European Drug Report for 2025 validates Gozo's experience as a microcosm of continental patterns. Across the European Union, approximately 5.5 million people used cocaine in 2024, with 2.6% of young adults (15-34) reporting recent consumption. Cocaine seizures in Malta during the first half of 2026 have already exceeded all of 2025, suggesting either increased trafficking flows or enhanced law enforcement activity—likely both.
What complicates this picture is polysubstance use: the simultaneous consumption of multiple drugs. A person might combine cocaine with alcohol, cannabis, and MDMA in a single session, multiplying overdose risk and creating clinical unpredictability. The European Union Drugs Agency (EUDA) documents that THC potency in cannabis has climbed and cocaine purity continues to strengthen, making even experienced users vulnerable to miscalculation.
Gozo's tight-knit communities feel these shifts acutely. The island's isolation—what locals term "double insularity," meaning geographic separation from Malta compounded by cultural conservatism—creates a unique challenge: everyone often knows everyone's business, making confidential treatment-seeking particularly daunting even as online drug markets make substances more accessible.
Emerging Threats on the Ground
New lab-made drugs have arrived in local markets. In April 2025, a synthetic cannabinoid known as CC9 triggered multiple acute hospitalizations in Malta, forcing emergency departments to confront a drug few clinicians had previously encountered. Other novel psychoactive substances circulating locally include Pink cocaine (2CB), Ketamine-based compounds branded as "Tusy," and Molly (MDMA)—all produced in clandestine laboratories and sold through encrypted messaging platforms.
The United Nations Office on Drugs and Crime (UNODC) documented an "unprecedented spike" in such synthetics: 755 new psychoactive substances were identified globally in 2024 alone. Each represents a moving target for treatment protocols and harm reduction education. OASI staff cannot counsel residents about a drug if clinical literature barely exists.
Drug-related fatalities in Malta during 2023 numbered 18, with 13 attributed to cocaine and 5 to heroin, predominantly claiming individuals aged 40 and above. Across the European Union that same year, approximately 7,500 drug-related deaths occurred, translating to 24.7 deaths per million population aged 15-64. Malta's trajectory suggests it will track upward unless intervention capacity expands proportionally.
The Family and Community Toll
Addiction does not isolate itself within the user. In Gozo and across Malta, families face social, financial, and emotional devastation when a member's substance use accelerates. Crime rates rise; hospitalizations climb; children face elevated risk of neglect and abuse. The ripple effect extends through school performance, workplace productivity, and social trust.
Mental health intertwines inextricably with addiction here. Substance use can trigger or worsen anxiety and depression, while individuals already struggling psychiatrically often self-medicate with drugs, creating a destructive feedback loop. A person diagnosed with anxiety might reach for cocaine to feel confident at work, only to experience rebound panic and increased dependency within weeks.
Yet Gozo's community-based mental health initiatives provide a counternarrative. The Sunrise Project and Dar il-Kantuniera have demonstrated measurable success supporting young Gozitans and those with dual diagnoses—meaning concurrent mental health and substance abuse challenges. Participation in these programs has reduced hospital readmissions dramatically, proving that intensive, culturally informed local care works.
Government Response and Resource Mobilization
The Malta Cabinet's April 2026 social agreement with OASI signals genuine policy commitment. A €2.3 million allocation over three years—a near-20% increase from the previous funding cycle—will strengthen residential capacity, aftercare services, and prevention education across OASI's Gozo-based programs while supporting referrals from Malta residents. This is not rhetoric; it is fiscal responsibility meeting clinical need.
President Myriam Spiteri Debono framed the government's stance explicitly: prevention, education, support, and treatment form the strategic pillars. The National Drug Policy 2023 articulated a deliberate pivot toward harm reduction, meaning treatment and dignity-centered support rather than criminalization of users. This reflects international best practice and acknowledges that supply-side enforcement alone has never arrested demand.
OASI's prevention arm extends beyond crisis intervention. The foundation operates "Youths 4 Youths," a youth-led prevention initiative scheduled for September 16, 2026, and backed by the HSBC Malta Foundation. The program combines first aid training, life skills workshops for young people, and team-based activities designed to build resilience and healthy coping skills before addiction becomes relevant. Early intervention—teaching teenagers how to manage stress without substances—remains the most cost-effective public health strategy.
Recognition of proactive local leadership matters too. OASI bestowed its "Ġieħ l-OASI" prize upon the Għajnsielem local council for banning recreational nitrous oxide—a particular scourge in Gozo where laughing gas has become normalized at social gatherings despite posing serious neurological risks with repeated use.
Practical Steps for Prevention
Preventing addiction begins before crisis intervention becomes necessary. Residents can take concrete action:
• Parents: Watch for behavior changes. Unexplained expenses, social withdrawal, sudden mood shifts, and new peer groups warrant early, non-accusatory conversation. Early discussions matter far more than confrontation.
• Young people: Practice peer refusal. Pressure to try drugs peaks in social settings. Practicing refusal scripts with trusted friends—"No thanks, I have to drive" or "That's not for me"—builds confidence to say no in the moment.
• Educators and youth workers: Connect with free school prevention programs. OASI's prevention initiatives are available to schools and youth groups at no cost. Contact OASI at 21 563 333 to schedule.
The Support Architecture
Residents of Malta and Gozo confronting addiction—whether their own or a family member's—navigate a multilayered support system:
SEDQA operates a helpline at 179, offering guidance and referral pathways accessible from both islands. CARITAS (telephone 22 199 000) coordinates residential rehabilitation alongside evening outreach programs across Malta. The OASI Foundation itself can be reached at 21 563 333 and provides the full spectrum of services.
Malta residents can access SEDQA and CARITAS services island-wide, while OASI's Gozo-based residential programs accept referrals from both Malta and Gozo residents. Transportation support may be available through SEDQA coordination.
Saint James Anew, located in Gozo since 2006, specializes in individuals who have lost control over their addiction and require structured inpatient care. The Substance Misuse Outpatient Unit (SMOPU) at St Luke's Hospital offers walk-in access for those managing co-occurring psychiatric and substance use conditions. General practitioners serve as gateways to Community Mental Health Centres or emergency departments for acute crises.
The Anti-Poverty Forum Malta, partnering with Caritas, provides a therapeutic package coupled with weekly financial stipends—acknowledging that poverty and addiction frequently coexist and that economic instability itself is a relapse risk factor.
Telephone-based support operates through the Mental Health Helpline (1579) and the Richmond Foundation line (1770). Digital platforms including Kellimni.com and OLLI Chat extend reach to those who prefer remote, anonymous contact.
A Landscape in Motion
OASI's 35-year trajectory from single-issue advocacy—establishing alcohol as a treatable addictive disorder—to today's multifaceted service delivery reflects genuine progress. Thousands have rebuilt lives through the foundation's interventions. Yet the drug market evolves faster than any single institution can adapt. Online distribution channels have shattered geographic containment, and laboratory chemists continuously synthesize novel compounds designed to evade legal classification.
Xerri acknowledged at the anniversary event that Malta and Gozo's addiction challenges demand sustained vigilance. The prevalence of dual diagnosis—simultaneous mental health and substance abuse—means prevention campaigns must address psychological wellbeing as fundamentally as they address drug education. The 35-year investment has created institutional knowledge and community trust; the next decade's challenge is scaling that capacity while remaining nimble enough to respond to substances that barely existed two years ago.
For residents, the practical reality is clear: help exists, is free, and can be accessed quietly if privacy is a concern. But reaching that threshold—acknowledging a problem and making a call—remains the steepest barrier, particularly in communities where shame operates as a powerful isolating force.
