Escaping the past and living in the present: a qualitative exploration of substance use among Syrian male refugees in Germany

Abstract

Background Syrians have been the largest group of refugees in Germany since 2014. Little is known about Syrian refugees` perspectives on substance use. The aim of this study is to investigate the perspective of male refugees from Syria and to foster specific knowledge and understanding of substance use. Methods We applied a qualitative study design. Five semi-structured focus group discussions with a total of 19 refugees were conducted in 2019 among the difficult to reach population of Syrian refugees. Audio recordings were translated and transcribed. We used a hybrid approach by integrating inductive and deductive thematic frameworks. Results We identified common themes. Firstly, refugees perceived that substances are widely available and accepted in Germany. Secondly, refugees perceived that rules and norms in Germany differ from rules and norms in the home country and favor availability of substances. Thirdly, substance use is related to the intention to escape the past. Fourthly, substance use is related to living in the present through connecting with others and being part of the community. Finally, mental health professional treatment for substance use is associated with shame. Conclusions Findings support Syrian refugees` perspectives of substance use as a way of both escaping the past and coping with psychosocial difficulties in the present in a socio-ecological understanding. Understanding the explanatory model of Syrian refugees can inform future interventions to prevent substance abuse and design tailored interventions. Further studies with Syrian refugees in more countries are needed to better understand resettled refugees` perspectives on substance use.

Alcohol use among Congolese Babembe male refugees in Tarrant County: A qualitative study

“…Young refugees are particularly vulnerable to loss of cultural identity. Coming from conservative societies where they are not allowed to consume alcohol, young refugees experience the pressure to conform to their new environment where alcohol consumption is normalized [ 17 ].…”

“…Similar to findings from our study, refugees resettled in Western countries perceive their new environments to be conducive to alcohol abuse. In most cases, alcohol is widely available and easily accessible to newly resettled refugees [ 17 ]; offering them a readily available coping mechanism to deal with post-traumatic stress and acculturation challenges. Babembe refugees in North Texas have mainly been resettled in neighborhoods where alcohol and drug abuse is prevalent [ 23 ].…”

“…Findings from this study linking forced migration and alcohol abuse are consistent with existing literature. Refugees often experience conflict-related trauma that increases their risks for mental health disorders and alcohol abuse [17][18][19][20][21]. Prolonged stay in harsh refugee camp settings has also been associated with substance abuse among refugees [19].…”

Substance (mis)use among refugees as a matter of social ecology: insights into a multi-site rapid assessment in Germany

“…Beyond family, the data substantiate that the sense of belonging to a community is offered (or opposed) by substance (mis)use (cf. [43]).…”

Addressing the Mental Health Challenges of Refugees—A Regional Network-Based Approach in Middle Hesse Germany

“…Refugees and asylum-seekers are known to constitute a highly vulnerable group with an increased risk of developing mental illnesses. According to international studies, 30 to 70% of refugees are suffering from trauma-related disorders such as post-traumatic stress disorders (PTSD), depression, and anxiety [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. The high prevalence of mental illnesses among refugees is exacerbated by limited medical treatment options in the psychiatric field, a problem that persists for various reasons.…”