The burden of substance use and (mental) distress among asylum seekers: a cross sectional study

Abstract

BackgroundAsylum seekers are a particularly vulnerable population due to a wide range of external stressors. Traumatic events and difficult social/economic prospects can lead to an elevated susceptibility for substance use disorders. The aim of the present study was to determine whether asylum seekers suffering from mental or physical distress present higher levels of substance use disorder (SUD) in a state reception center in Germany and whether there are identifiable risk or protective factors.MethodsWe performed a hierarchical logistic regression on data of N = 238 people who had applied for asylum in Germany to analyze the SUD variance explanation by (1) sociodemographic, (2) flight-specific, and (3) psychometric (ERQ, SOC-9 L, SCL-K9) variables. On level (4), we included the location of data collection (walk-in clinic or accommodation,) as an indicator of individual’s need for a psychologist’s or General practitioner’s help in order to assess for the participant’s (mental) distress.ResultsLow educational level, lower sense of coherence, and mental distress (location of data collection in the psychosocial or general medical outpatient clinic) were associated with SUD. Those suffering from SUD seemed to be less aware of external stressors as SUD was also associated with low levels of reported post-migratory stress.DiscussionThe association of SUD with psychological distress and lower education reaffirms the concept that some vulnerable groups are at a higher risk for substance-related difficulties. Strengthening the sense of coherence with targeted interventions might enable at-risk groups to cope better with forthcoming burdens and help with abstaining from current or future consumption.

A Multi-Level Analysis of Biological, Social, and Psychological Determinants of Substance Use Disorder and Co-Occurring Mental Health Outcomes

“…Emerging evidence shows that low Socioeconomic Position (SEP) is an important determinant of many mental disorders, including substance use disorders [54][55][56]. In a cohort study involving 1.6 million individuals in the Stockholm region [54], alcohol and drug use disorders were more common among individuals with lower levels of education compared to those with higher levels of education, both in males and females.…”