Forced Migration, War, Trauma, and Substance Use
"As noted in a systematic review by Horyniak and colleagues (2016), forced migrants have commonly witnessed and personally experienced pre- and post-migration stress and trauma, including loss of homes and livelihoods, violence, and family separation . Among this population, the prevalence of mental health disorders, specifically depression and post-traumatic stress disorder, are particularly high due to this lived experience [9–11]. In past studies, comorbidity between mental health and substance use disorders has been well documented in the general population [12–14]. An emerging literature has begun on substance use as coping mechanism to document comorbidity among forced migrant populations [15–17].
"Also, forced migrants experience acculturation challenges, the process of cultural and psychological change that follows contact with a culture other than one’s own . It has been hypothesized that migrants who are highly engaged in the host culture (‘assimilation’) may engage in substance use and addiction in order to adhere to mainstream norms and gain acceptance in their new communities [18–20]. Acculturation is an especially important factor for younger migrants, whose experiences are compounded by intergenerational conflict, and peer pressure as found in previous studies among Sudanese and Latino adolescents [19–23]. For example, in a study among ninth-grade adolescents, low levels of interest in maintaining their native culture alongside low levels of participation in their new culture, often due to discrimination and exclusion, has been associated with substance use  Additionally, forced migrants, commonly experience social and economic inequality, marginalization and discrimination [25–28]. These factors have been shown to be important determinants of health, and could contribute to feelings of stress and powerlessness, which may contribute to substance use [29–31]. In addition, forced migrants could be exposed to illicit drugs as well through their residence in disadvantaged neighborhoods where drugs may be readily available leading to increased morbidity and mortality [32,33]. As a contributing factor, the HIV outbreak in Ukraine has spread throughout the nation. According to Public Health Center of the Ministry of Health of Ukraine, Ukraine continues to have high rates of HIV infection in Eastern Europe and Central and Eastern Asia ."
Patel, S. S., Zvinchuk, O., & Erickson, T. B. (2020). The Conflict in East Ukraine: A Growing Need for Addiction Research and Substance Use Intervention for Vulnerable Populations. Forensic science & addiction research, 5(3), 406–408.