Substance Abuse Among RefugeesRecent studies show that poverty and substance abuse have a strong correlation. Research from 2021 has found that people who experienced poverty during childhood are more likely to develop drug use disorders later in life. The mental health disorders, low self-esteem, stress, hopelessness and lack of access to healthcare that come with poverty also increase the risk of substance abuse.

Refugees and other immigrants are at higher risk for substance abuse due to the poverty they experience, regardless of the region they come from. More than 100 million people worldwide are displaced and 85% live in developing host countries that already struggle with high poverty rates. This reality puts refugees, especially the young, at a greater risk of developing substance use disorders.

Poverty as a Risk Factor

Poverty is one of the greatest risk factors for substance use and addiction. According to the United Nations Office on Drugs and Crime (UNODC), poverty and belonging to a disadvantaged community make young people more vulnerable to substance abuse and mental health issues. 

Researcher and UNODC adviser Maria Melchior confirms that people’s development of substance use issues and mental health disorders usually begins during childhood, and those from less advantaged backgrounds are at a higher risk. These individuals often struggle with substance use issues throughout parenthood, negatively affecting their children and causing them to develop similar habits.

Substance Use Prevalence

Studies have revealed elevated levels of substance abuse rates among refugees, given the high rates of poverty in refugee groups. A 2021 study on refugee youths in Serbia found that among the respondents, over a quarter regularly smoked tobacco, 13% consumed alcohol and many others tried marijuana, LSD, various forms of cocaine and other substances. The study also found that nearly half of the respondents demonstrated significant difficulties in peer relations and about 30% demonstrated emotional distress and issues of conduct. 

High rates of substance use and addiction can be found among refugees in developed countries as well. Due in large part to abuse, trauma and mental health challenges, many refugees cope by turning to alcohol and/or illicit drugs. For example, in the United States, more than one-third of Burmese refugees were found to have consumed alcohol in hazardous amounts, with similarly high rates among Ugandan and Nepalese male refugees as well.

Similar issues persist in Germany, a country that leads all developed countries in the number of refugees hosted. A study on refugees in Germany found that living conditions for refugees generally were dominant in refugees’ substance use habits and the availability of certain drugs. The data conveys the impression that most refugees who misuse substances live in refugee shelters. Along with living conditions, social relations with peers and families were also identified as important factors.

Prevention and Treatment

Experts have hope for potential solutions to substance abuse among refugee communities. A 2018 report by the United Nations High Commissioner for Refugees (UNHCR) suggests that community-based, peer-led programs and training healthcare workers in substance use treatment may be effective in low-resource and refugee settings. While more research is needed, similar approaches have proven to be successful in fighting diseases like HIV.

One successful program is Strong Families, which was launched in 2010 by the United Nations Office on Drugs and Crime (UNODC). The program aims to support caregivers in becoming better parents and strengthen positive family interactions. It helps families develop communication strategies around the issue of substance abuse to prevent coercive parenting. This approach was initially implemented in four Rohingya refugee camps in Bangladesh and is now being used in 22 countries.

Some of the results from this program have been very promising. For example, a 2020 study found that a Strong Families pilot program implemented in Afghanistan had a 93.1% retention rate and resulted in a 5% increase in the behavioral, emotional and social issues among enrolled children after several weeks. Parents in the program also demonstrated notable improvements in parenting skills.

Looking Ahead

While poverty and substance abuse demonstrate a strong correlation, there is hope for addressing these challenges, particularly among vulnerable populations such as refugees. Research and programs highlight the importance of early intervention and community-based approaches. Initiatives like the Strong Families program provide support to caregivers, empowering them to become better parents and fostering positive family dynamics. These efforts have shown promising results in improving parenting skills and the well-being of enrolled children. By focusing on prevention and treatment, there is potential to break the cycle of poverty and substance abuse, providing a brighter future for individuals and communities worldwide.

– Adam Cvik
Photo: Flickr

Vaccinating refugeesVaccine rollout plans around the world often overlook the world’s 26 million refugees. A whole 126 countries have refugee populations of more than 500 people. As refugees make up a significant part of the population, during a global health pandemic, the world will not truly be safe until nations safeguard the health of refugees too. Although many countries are making efforts to protect refugees, barriers remain prevalent. Global inequalities continue to exacerbate the situation. Wealthy countries administered 85% of the world’s vaccines, however, 85% of the world’s refugees live in developing countries that struggle to access vaccines. Bangladesh is prioritizing vaccinating refugees and the rest of the world needs to follow suit by including the most vulnerable populations.

Bangladesh’s Vaccine Campaign for Rohingya Refugees in Cox’s Bazar

In August 2017, spikes of violence in Myanmar forced 745,000 Rohingya citizens to flee into Cox’s Bazar, Bangladesh. Cox’s Bazar is now the world’s largest refugee settlement with more than one million refugees living in the cramped camps.

At the end of July 2021, devastating monsoons in Cox’s Bazar killed about eight refugees and displaced 25,000 people, simultaneously destroying thousands of facilities, including health clinics and latrines. Damaged roads hinder humanitarian access, making Rohingya refugees in Bangladesh more vulnerable than ever.

In addition to the recent natural disasters, Bangladesh is experiencing an upward trend in positive COVID-19 cases. Bangladesh authorities recognize the extreme vulnerability of the refugee population. As such, on August 9, 2021, Bangladesh launched a vaccine drive in the Cox’s Bazar refugee camps. With the help of the United Nations High Commissioner for Refugees (UNHCR), the World Health Organization (WHO) and other humanitarian organizations, Bangladesh plans to vaccinate all refugees in waves. The first cohort includes 65,000 refugees made up of community leaders, health volunteers and anyone older than the age of 55.

The Importance of Vaccinating Refugees

Although refugees seem to be the last group receiving vaccines, the WHO has placed refugees in the second priority group for vaccinations. Refugees fall into the same group as at-risk people and those suffering from serious health conditions because refugees tend to live in crowded communities that lack clean water and basic healthcare, making the spread of COVID-19 cases inevitable. No country can curb the spread of COVID-19 while the virus continues to ravage its way through refugee communities.

Barriers to Refugee Vaccination

Most countries understand how crucial vaccinating refugees is to ending the pandemic, however, these major barriers remain:

  • Language barriers lead to misinformation and vaccine distrust.
  • Online registrations exclude those who lack access to the internet.
  • Volunteers are registering refugees at camps, however, a portion of refugees do not live in camps, they live with relatives or family friends.
  • Many refugees fear arrest or deportation at vaccine sites.
  • Vaccine shortages as some countries like India paused vaccine exports due to rising cases in India.
  • The question of liability — who will take responsibility for refugees that suffer serious side effects from the vaccine?

The world not only needs to make vaccines accessible for refugees but must also make refugees feel safe enough to pursue vaccination. Refugees are among the most vulnerable people on the planet, therefore, it is imperative for the world to join Bangladesh in prioritizing the vaccination of refugees because no one is safe until everyone is safe.

– Ella LeRoy
Photo: Flickr