Substance use among populations displaced by conflict: a literature review.

This paper reviews the literature on substance use among populations displaced by conflict. Of the 17 publications presenting primary data retained for review, all consider populations in or recovering from protracted conflict, the majority (10) in non-camp settings. Most studies (10) offer prevalence estimates, suggesting that substance use (such as of alcohol, opiates, or minor tranquilizers) is common in some displaced settings. Five describe harmful consequences of substance use among displaced populations (such as HIV transmission, tuberculosis treatment failure, gender-based violence, and economic problems). Three studies suggest risk factors for substance use problems (such as gender, trauma-related conditions, pre-displacement substance use, and socio-economic factors); two examine qualitatively the gendered nature of alcohol-related harm and its links with gender-based violence. One study examines an intervention. The evidence base is weak. Findings are used to develop a conceptual framework emphasizing the risk environment to inform further research, to encourage debate among researchers and practitioners, and to enable the development of interventions.