Considering Substance Use in Trafficking Victims
Victims of Trafficking in Persons, whether in the case of sexual exploitation or for forced labor, are at high risk for developing substance use disorders. In some cases, the traffickers provide or force consumption of drugs. In other cases, the victims initiate drug use during or after their captivity as a means of coping with the trauma they have suffered.
The U.S. Department of State's Bureau of International Narcotics and Law Enforcement Affairs (INL) worked with three international organizations (UNODC, OAS, and Colombo Plan) to conduct a mission that examined the relationship between drug use and trafficking in the Peruvian region of Madre de Dios, Peru.
The outcomes of this mission will inform a forthcoming project through UNODC to develop 1) an intervention to address substance use in this population with special clinical needs, 2) training curriculum to develop the knowledge and skills of professionals working with these victims, and 3) a technical guide for member states highlighting the issue and available interventions and resources.
We welcome ISSUP members to contribute their experiences, ideas, and perspectives on the issue in this network forum in order to contribute to the development of the three products mentioned above.
Thank you, Brian
Refugees and drugs
Refugees experience a broad range of adversity that puts them at risk for mental, neurological and substance use (MNS) issues such as psychological distress, major depression, anxiety disorders and posttraumatic stress disorder (PTSD). The epidemiological literature on alcohol and other drugs use problems in refugee settings is scarce. Luitel et al. found that among those who reported drinking any alcohol in a camp in Nepal, the proportion who drank at problematic levels was high and similar to that seen among populations in high-income countries despite a cultural taboo on alcohol use in the campgrounds. Alcohol and substance use are also critical concerns among other displaced populations in Africa and Asia.
A study (Kane et al., 2014) that analyzed data from 90 refugee camps in 15 countries found much higher rates of alcohol/substance use visits among males as compared to females, confirming findings from studies in general populations in high-, middle- and low-income countries and specifically among forcibly displaced people. Concerningly, the literature indicates that women are often less likely to seek services for alcohol and substance use problems than men.
Refugees, as with other populations in LMIC, are likely to first solicit services for mental health care within their families and with traditional and religious healers. If they perceive these services as helpful, they will not seek services from health clinics. An essential determinant of help-seeking behavior is the interpretation of symptoms by the refugees themselves. Given the limited resources for mental health in low- and middle-income countries (LMIC), most service providers have to make difficult choices as to which capacities to prioritize. There is, therefore, an urgent need to explore how best to develop interventions to serve refugees with mental, neurological and substance use disorders that currently do not get appropriate treatment.
References
Kane, J. C., Ventevogel, P., Spiegel, P., Bass, J. K., Van Ommeren, M., & Tol, W. A. (2014). Mental, neurological, and substance use problems among refugees in primary health care: analysis of the Health Information System in 90 refugee camps. BMC medicine, 12(1), 228.
Luitel NP, Jordans M, Murphy A, Roberts B, McCambridge J: Prevalence and patterns of hazardous and harmful alcohol consumption assessed using the AUDIT among Bhutanese refugees in Nepal. Alcohol Alcohol 2013, 48:349–355.