Epidemiology of Substance Use among Forced Migrants: A Global Systematic Review
Identifieur interne : 000429 ( Pmc/Curation ); précédent : 000428; suivant : 000430Epidemiology of Substance Use among Forced Migrants: A Global Systematic Review
Auteurs : Danielle Horyniak [États-Unis, Australie] ; Jason S. Melo [États-Unis] ; Risa M. Farrell [États-Unis] ; Victoria D. Ojeda [États-Unis] ; Steffanie A. Strathdee [États-Unis]Source :
- PLoS ONE [ 1932-6203 ] ; 2016.
Abstract
Forced migration is occurring at unprecedented levels. Forced migrants may be at risk for substance use for reasons including coping with traumatic experiences, co-morbid mental health disorders, acculturation challenges and social and economic inequality. This paper aimed to systematically review the literature examining substance use among forced migrants, and identify priority areas for intervention and future research.
Seven medical, allied health and social science databases were searched from inception to September 2015 in accordance with PRISMA guidelines to identify original peer-reviewed articles describing any findings relating to alcohol and/or illicit drug use among refugees, internally displaced people (IDPs), asylum seekers, people displaced by disasters and deportees. A descriptive synthesis of evidence from quantitative studies was conducted, focusing primarily on studies which used validated measures of substance use. Synthesis of evidence from qualitative studies focused on identifying prominent themes relating to the contexts and consequences of substance use. Critical Appraisal Skills Programme (CASP) checklists were used to assess methodological quality of included studies.
Forty-four quantitative (82% cross-sectional), 16 qualitative and three mixed-methods studies were included. Ten studies were rated as high methodological quality (16%), 39 as moderate quality (62%) and 14 as low quality (22%). The majority of research was conducted among refugees, IDPs and asylum seekers (n = 55, 87%), predominantly in high-income settings. The highest-quality prevalence estimates of hazardous/harmful alcohol use ranged from 17%-36% in camp settings and 4%-7% in community settings. Few studies collected validated measures of illicit drug use. Seven studies compared substance use among forced migrants to other migrant or native-born samples. Among eight studies which conducted multivariable analysis, male sex, trauma exposure and symptoms of mental illness were commonly identified correlates of substance use.
Our understanding of substance use among forced migrants remains limited, particularly regarding persons displaced due to disasters, development and deportation. Despite a growing body of work among refugee-background populations, few studies include refugees in low and middle-income countries, where over 80% of the global refugee population resides. Findings suggest a need to integrate substance use prevention and treatment into services offered to forced migrants, particularly in camp settings. Efforts to develop and evaluate interventions to reduce substance use and related harms are needed.
Url:
DOI: 10.1371/journal.pone.0159134
PubMed: 27411086
PubMed Central: 4943736
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Epidemiology of Substance Use among Forced Migrants: A Global Systematic Review</title>
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<front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Introduction</title>
<p>Forced migration is occurring at unprecedented levels. Forced migrants may be at risk for substance use for reasons including coping with traumatic experiences, co-morbid mental health disorders, acculturation challenges and social and economic inequality. This paper aimed to systematically review the literature examining substance use among forced migrants, and identify priority areas for intervention and future research.</p>
</sec>
<sec id="sec002"><title>Methods</title>
<p>Seven medical, allied health and social science databases were searched from inception to September 2015 in accordance with PRISMA guidelines to identify original peer-reviewed articles describing any findings relating to alcohol and/or illicit drug use among refugees, internally displaced people (IDPs), asylum seekers, people displaced by disasters and deportees. A descriptive synthesis of evidence from quantitative studies was conducted, focusing primarily on studies which used validated measures of substance use. Synthesis of evidence from qualitative studies focused on identifying prominent themes relating to the contexts and consequences of substance use. Critical Appraisal Skills Programme (CASP) checklists were used to assess methodological quality of included studies.</p>
</sec>
<sec id="sec003"><title>Results</title>
<p>Forty-four quantitative (82% cross-sectional), 16 qualitative and three mixed-methods studies were included. Ten studies were rated as high methodological quality (16%), 39 as moderate quality (62%) and 14 as low quality (22%). The majority of research was conducted among refugees, IDPs and asylum seekers (n = 55, 87%), predominantly in high-income settings. The highest-quality prevalence estimates of hazardous/harmful alcohol use ranged from 17%-36% in camp settings and 4%-7% in community settings. Few studies collected validated measures of illicit drug use. Seven studies compared substance use among forced migrants to other migrant or native-born samples. Among eight studies which conducted multivariable analysis, male sex, trauma exposure and symptoms of mental illness were commonly identified correlates of substance use.</p>
</sec>
<sec id="sec004"><title>Conclusion</title>
<p>Our understanding of substance use among forced migrants remains limited, particularly regarding persons displaced due to disasters, development and deportation. Despite a growing body of work among refugee-background populations, few studies include refugees in low and middle-income countries, where over 80% of the global refugee population resides. Findings suggest a need to integrate substance use prevention and treatment into services offered to forced migrants, particularly in camp settings. Efforts to develop and evaluate interventions to reduce substance use and related harms are needed.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id>
<journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id>
<journal-id journal-id-type="publisher-id">plos</journal-id>
<journal-id journal-id-type="pmc">plosone</journal-id>
<journal-title-group><journal-title>PLoS ONE</journal-title>
</journal-title-group>
<issn pub-type="epub">1932-6203</issn>
<publisher><publisher-name>Public Library of Science</publisher-name>
<publisher-loc>San Francisco, CA USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">27411086</article-id>
<article-id pub-id-type="pmc">4943736</article-id>
<article-id pub-id-type="doi">10.1371/journal.pone.0159134</article-id>
<article-id pub-id-type="publisher-id">PONE-D-15-53846</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject>
<subj-group><subject>Nutrition</subject>
<subj-group><subject>Diet</subject>
<subj-group><subject>Alcohol Consumption</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject>
<subj-group><subject>Nutrition</subject>
<subj-group><subject>Diet</subject>
<subj-group><subject>Alcohol Consumption</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject>
<subj-group><subject>Psychology</subject>
<subj-group><subject>Addiction</subject>
<subj-group><subject>Alcoholism</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Social Sciences</subject>
<subj-group><subject>Psychology</subject>
<subj-group><subject>Addiction</subject>
<subj-group><subject>Alcoholism</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject>
<subj-group><subject>Mental Health and Psychiatry</subject>
<subj-group><subject>Substance-Related Disorders</subject>
<subj-group><subject>Alcoholism</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject>
<subj-group><subject>Public and Occupational Health</subject>
<subj-group><subject>Substance-Related Disorders</subject>
<subj-group><subject>Alcoholism</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Research and Analysis Methods</subject>
<subj-group><subject>Research Design</subject>
<subj-group><subject>Cross-Sectional Studies</subject>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject>
<subj-group><subject>Pharmacology</subject>
<subj-group><subject>Behavioral Pharmacology</subject>
<subj-group><subject>Recreational Drug Use</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject>
<subj-group><subject>Pharmacology</subject>
<subj-group><subject>Behavioral Pharmacology</subject>
<subj-group><subject>Recreational Drug Use</subject>
<subj-group><subject>Cannabis</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject>
<subj-group><subject>Mental Health and Psychiatry</subject>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Research and Analysis Methods</subject>
<subj-group><subject>Research Design</subject>
<subj-group><subject>Qualitative Studies</subject>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject>
<subj-group><subject>Health Care</subject>
<subj-group><subject>Health Services Research</subject>
</subj-group>
</subj-group>
</subj-group>
</article-categories>
<title-group><article-title>Epidemiology of Substance Use among Forced Migrants: A Global Systematic Review</article-title>
<alt-title alt-title-type="running-head">Systematic Review of Substance Use among Forced Migrants</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Horyniak</surname>
<given-names>Danielle</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff002"><sup>2</sup>
</xref>
<xref ref-type="aff" rid="aff003"><sup>3</sup>
</xref>
<xref ref-type="corresp" rid="cor001">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Melo</surname>
<given-names>Jason S.</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Farrell</surname>
<given-names>Risa M.</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ojeda</surname>
<given-names>Victoria D.</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Strathdee</surname>
<given-names>Steffanie A.</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
</contrib>
</contrib-group>
<aff id="aff001"><label>1</label>
<addr-line>Division of Global Public Health, University of California San Diego, La Jolla, CA, 92093, United States of America</addr-line>
</aff>
<aff id="aff002"><label>2</label>
<addr-line>Centre for Population Health, Burnet Institute, Melbourne, VIC, 3004, Australia</addr-line>
</aff>
<aff id="aff003"><label>3</label>
<addr-line>School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia</addr-line>
</aff>
<contrib-group><contrib contrib-type="editor"><name><surname>Correa-Velez</surname>
<given-names>Ignacio</given-names>
</name>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
</contrib-group>
<aff id="edit1"><addr-line>Queensland University of Technology, AUSTRALIA</addr-line>
</aff>
<author-notes><fn fn-type="conflict" id="coi001"><p><bold>Competing Interests: </bold>
The authors have declared that no competing interests exist.</p>
</fn>
<fn fn-type="con" id="contrib001"><p>Conceived and designed the experiments: DH VO SS. Analyzed the data: DH. Wrote the paper: DH JM RF VO SS. Conducted literature searches and extracted data: JM RF DH.</p>
</fn>
<corresp id="cor001">* E-mail: <email>dhoryniak@uscd.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="epub"><day>13</day>
<month>7</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="collection"><year>2016</year>
</pub-date>
<volume>11</volume>
<issue>7</issue>
<elocation-id>e0159134</elocation-id>
<history><date date-type="received"><day>11</day>
<month>12</month>
<year>2015</year>
</date>
<date date-type="accepted"><day>28</day>
<month>6</month>
<year>2016</year>
</date>
</history>
<permissions><copyright-statement>© 2016 Horyniak et al</copyright-statement>
<copyright-year>2016</copyright-year>
<copyright-holder>Horyniak et al</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>
, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
</license>
</permissions>
<self-uri content-type="pdf" xlink:href="pone.0159134.pdf"></self-uri>
<abstract><sec id="sec001"><title>Introduction</title>
<p>Forced migration is occurring at unprecedented levels. Forced migrants may be at risk for substance use for reasons including coping with traumatic experiences, co-morbid mental health disorders, acculturation challenges and social and economic inequality. This paper aimed to systematically review the literature examining substance use among forced migrants, and identify priority areas for intervention and future research.</p>
</sec>
<sec id="sec002"><title>Methods</title>
<p>Seven medical, allied health and social science databases were searched from inception to September 2015 in accordance with PRISMA guidelines to identify original peer-reviewed articles describing any findings relating to alcohol and/or illicit drug use among refugees, internally displaced people (IDPs), asylum seekers, people displaced by disasters and deportees. A descriptive synthesis of evidence from quantitative studies was conducted, focusing primarily on studies which used validated measures of substance use. Synthesis of evidence from qualitative studies focused on identifying prominent themes relating to the contexts and consequences of substance use. Critical Appraisal Skills Programme (CASP) checklists were used to assess methodological quality of included studies.</p>
</sec>
<sec id="sec003"><title>Results</title>
<p>Forty-four quantitative (82% cross-sectional), 16 qualitative and three mixed-methods studies were included. Ten studies were rated as high methodological quality (16%), 39 as moderate quality (62%) and 14 as low quality (22%). The majority of research was conducted among refugees, IDPs and asylum seekers (n = 55, 87%), predominantly in high-income settings. The highest-quality prevalence estimates of hazardous/harmful alcohol use ranged from 17%-36% in camp settings and 4%-7% in community settings. Few studies collected validated measures of illicit drug use. Seven studies compared substance use among forced migrants to other migrant or native-born samples. Among eight studies which conducted multivariable analysis, male sex, trauma exposure and symptoms of mental illness were commonly identified correlates of substance use.</p>
</sec>
<sec id="sec004"><title>Conclusion</title>
<p>Our understanding of substance use among forced migrants remains limited, particularly regarding persons displaced due to disasters, development and deportation. Despite a growing body of work among refugee-background populations, few studies include refugees in low and middle-income countries, where over 80% of the global refugee population resides. Findings suggest a need to integrate substance use prevention and treatment into services offered to forced migrants, particularly in camp settings. Efforts to develop and evaluate interventions to reduce substance use and related harms are needed.</p>
</sec>
</abstract>
<funding-group><award-group id="award001"><funding-source><institution-wrap><institution-id institution-id-type="funder-id">http://dx.doi.org/10.13039/501100000925</institution-id>
<institution>National Health and Medical Research Council</institution>
</institution-wrap>
</funding-source>
<award-id>1092077</award-id>
<principal-award-recipient><name><surname>Horyniak</surname>
<given-names>Danielle</given-names>
</name>
</principal-award-recipient>
</award-group>
<award-group id="award002"><funding-source><institution>UCSD Center for US-Mexican Studies</institution>
</funding-source>
<principal-award-recipient><name><surname>Ojeda</surname>
<given-names>Victoria D.</given-names>
</name>
</principal-award-recipient>
</award-group>
<funding-statement>DH is supported by an Australian National Health & Medical Research Council Early Career Fellowship (#1092077; <ext-link ext-link-type="uri" xlink:href="http://www.nhmrc.gov.au">www.nhmrc.gov.au</ext-link>
). VO is supported in part by a Fellowship provided by the UCSD Center for US-Mexican Studies (<ext-link ext-link-type="uri" xlink:href="https://usmex.ucsd.edu/">https://usmex.ucsd.edu/</ext-link>
). SS is supported by NIDA Merit Award R37DA019829. The funding bodies played no role in the study design, data analysis, decision to publish, or preparation of the manuscript.</funding-statement>
</funding-group>
<counts><fig-count count="4"></fig-count>
<table-count count="6"></table-count>
<page-count count="34"></page-count>
</counts>
<custom-meta-group><custom-meta id="data-availability"><meta-name>Data Availability</meta-name>
<meta-value>All relevant data are included in the article text.</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
<notes><title>Data Availability</title>
<p>All relevant data are included in the article text.</p>
</notes>
</front>
</pmc>
</record>
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