Understanding and Responding to Substance Use and Abuse in the Palestinian Refugee Camps in Lebanon Prior to and During COVID-19 Times

Abstract

Due to its geographical proximity to the Syrian conflict and the occupied territories, Lebanon has experienced an influx of refugees in recent times. Palestinian refugees are an identified key vulnerable population, with displaced communities increasingly experiencing camp insecurity, vulnerability to drug use and related health harms. A qualitative study consisting of in-depth interviews and focus group discussions (FGDs) was undertaken as part of a regional exercise investigating Palestinian community experiences of substance and drug use in refugee camps. Thematic analysis triangulated the perspectives of 11 professional stakeholders representing United Nations, human rights and non-governmental organizations (NGOs), and eight Palestinian community members. Emerging themes centered on the interplay between socio-economic instability, lack of law enforcement and camp governance contributing to concerning levels of familial, drug and camp violence, trafficking and availability of drugs. Transactional sex and the exploitation of women and children in drug dealing, diversification toward drug manufacture and dealing of drugs with the outside community were described. There is a lack of harm reduction and rehabilitation supports for those in need. This study highlights the complexities in tackling drug dealing and related criminal activity within refugee camps and humanitarian settings, and the vulnerabilities of those living within to harmful drug use.

Using Theory of Change to Plan for the Implementation of a Psychological Intervention Addressing Alcohol Use Disorder and Psychological Distress in Uganda

“…A previous study in Uganda with refugees showed high prevalence of post-traumatic stress, major depressive, generalized anxiety and substance use disorders, all linked to unmet basic needs (Bapolisi et al, 2020). Conversely, interventions addressing social determinants, for example, income-generating programs, can act as protective factors against initial AUD development (Amosu et al, 2016;Aaraj et al, 2021;Naseh et al, 2021), while potentially preventing relapse posttreatment. Failing to recognize the impact of social determinants on mental health and AUDs will impede efforts in prevention, recovery and symptom reduction, especially in resource-poor settings.…”

Substance use and substance use disorders in relation to COVID-19: qualitative experiences of people who use drugs in Jordan

“…There is a scarcity of data about the health response and situation of people who use drugs (PWUD) during the pandemic in the Middle East and North Africa (MENA) region (Aaraj et al, 2021;Van Hout et al, 2022). A mixed method study was conducted by the MENA Harm Reduction Association (MENAHRA) to assess the situation of PWUD and impacts on harm reduction services in these countries, including Jordan, during COVID-19.…”

Moving from feasible to essential: Progress and future directions for promoting the implementation of substance use services for forcibly displaced populations in humanitarian settings

“…Replication studies are needed to adapt these interventions in diverse populations and to evaluate the consistency and sustainability of intervention effects. The unique context of forced displacement also necessitates a trauma‐informed approach and consideration of the social and structural determinants, including stigma and gender considerations, which influence SUD and engagement in care [17, 18]. Examples include integrating substance use services into existing and accessible systems of care to reduce stigma and tailoring outreach strategies by gender to promote acceptability and engagement.…”