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Six rapid assessments of alcohol and other substance use in populations displaced by conflict
Open accessAbstract
BACKGROUND: Substance use among populations displaced by conflict is a neglected area of public health. Alcohol, khat, benzodiazepine, opiate, and other substance use have been documented among a range of displaced populations, with wide-reaching health and social impacts. Changing agendas in humanitarian response-including increased prominence of mental health and chronic illness-have so far failed to be translated into meaningful interventions for substance use. METHODS: Studies were conducted from 2006 to 2008 in six different settings of protracted displacement, three in Africa (Kenya, Liberia, northern Uganda) and three in Asia (Iran, Pakistan, and Thailand). We used intervention-oriented qualitative Rapid Assessment and Response methods, adapted from two decades of experience among non-displaced populations. The main sources of data were individual and group interviews conducted with a culturally representative (non-probabilistic) sample of community members and service providers. RESULTS: Widespread use of alcohol, particularly artisanally-produced alcohol, in Kenya, Liberia, Uganda, and Thailand, and opiates in Iran and Pakistan was believed by participants to be linked to a range of health, social and protection problems, including illness, injury (intentional and unintentional), gender-based violence, risky behaviour for HIV and other sexually transmitted infection and blood-borne virus transmission, as well as detrimental effects to household economy. Displacement experiences, including dispossession, livelihood restriction, hopelessness and uncertain future may make communities particularly vulnerable to substance use and its impact, and changing social norms and networks (including the surrounding population) may result in changed - and potentially more harmful-patterns of use. Limited access to services, including health services, and exclusion from relevant host population programmes, may exacerbate the harmful consequences. CONCLUSIONS: The six studies show the feasibility and value of conducting rapid assessments in displaced populations. One outcome of these studies is the development of a UNHCR/WHO field guide on rapid assessment of alcohol and other substance use among conflict-affected populations. More work is required on gathering population-based epidemiological data, and much more experience is required on delivering effective interventions. Presentation of these findings should contribute to increased awareness, improved response, and more vigorous debate around this important but neglected area.
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“alcohol and drug misuse are neglected issues”
From Mental health and psychosocial support in humanitarian settings: linking practice and research (2011) · cites this paper as [87]
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Metadata
- Authors
- Ezard, N., Oppenheimer, E., Burton, A., Schilperoord, M., Macdonald, D., Adelekan, M., Sakarati, A., & van Ommeren, M.
- Affiliations
- Office of the United Nations High Commissioner for Refugees (CH)
- Royal Blackburn Teaching Hospital (GB)
- Corresponding author
- Schilperoord, Marian
- Venue
- Conflict and Health
- Published
- 2011-02-11
- Volume
- 5
- Issue
- 1
- Pages
- 1-1
- ISSN
- 1752-1505 (ISSN-L)
- PMC
- PMC3050731
- OpenAlex
- W2112278442
- Cited by
- 160
- References
- 92
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 10 · 2023: 8 · 2022: 11 · 2021: 24 · 2020: 6 · 2019: 9 · 2018: 18 · 2017: 12 · 2016: 8 · 2015: 15 · 2014: 11 · 2013: 12 · 2012: 4
- FWCI
- 7.23
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Conflict and Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Greater South Information System
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Health Professions › General Health Professions › Health and Conflict Studies
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Keywords
- alcohol consumption, substance use, internally displaced persons, protracted displacement, humanitarian response, opiates, khat, benzodiazepines, HIV risk behavior, gender-based violence, household economy, health care access, rapid assessment, social norms, Kenya, Liberia, Northern Uganda, Iran, Pakistan, Thailand
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