Yıl: 2020 Cilt: 7 Sayı: 4 Sayfa Aralığı: 253 - 276 Metin Dili: İngilizce DOI: 10.5152/ADDICTA.2020.20074 İndeks Tarihi: 07-10-2021

Exploring Alcohol and Substance Addiction among Syrian Migrants in Turkey: A Qualitative Study Integrating Perspectives of Addicts, Their Relatives, Local and National Institutions

Öz:
Turkey is the country that hosts most migrants worldwide. Although migrants are a risk group for alcohol and substance addiction (ASA), literature is limited. This study aims to explore and identify the present state and influencing factors of ASA among Syrian migrants in Turkey by integrating perspectives of addicts, their rela-tives, and local and national institutions. This qualitative study was designed by the grounded theory approach and took place in 5 cities in Turkey between 2018 and 2019. It is composed of 4 focus group discussions with 77 informants from local governmental, non-governmental, and academic organizations; 11 key person interviews with heads of national organizations; and in-depth interviews with 45 addicted Syrian migrants and 21 relatives. Themes that emerged from the data are characteristics of addicted migrants, types of addictions, predisposing and exacerbating factors, preventing factors, obtaining alcohol and substances, manners of use, consequences of use, public services and utilization of them, and the experiences of addicted migrants. The findings of this study provide guidance for future research and policies. Addicted migrants have awareness and motivation to quit but face many environmental barriers. Activities of institutions in Turkey on ASA in Syrian migrants are insufficient. Specific, well-coordinated action is needed. It should also utilize Syrian human resources.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • Beckerleg, S., & Sheekh, N. (2005). A view from the refugee camps: New Somali khat use in Kenya. Drugs and Alcohol Today, 5(3), 25-27. https://doi.org/10.1108/17459265200500043 [CrossRef]
  • Blanco, C., Morcillo, C., Alegría, M., Dedios, M. C., Fernández -Navarro, P., Regincos, R., & Wang, S. (2013). Acculturation and drug use disorders among Hispanics in the U.S. Journal of Psychiatric Research, 47(2), 226-232. https://doi.org/10.1016/j.jpsychires.2012.09.019 [CrossRef]
  • Bongard, S., Nakajima, M., & Al’Absi, M. (2015). Khat chewing and acculturation in East-African migrants living in Frankfurt am Main/Germany. Journal of Ethnopharmacology, 164, 223-228. https://doi.org/10.1016/j.jep.2015.01.034 [CrossRef]
  • Brune, M., Haasen, C., Yagdiran, O., & Bustos, E. (2003). Treatment of drug addiction in traumatised refugees: A case report. European Addiction Research, 9(3), 144-146. https://doi.org/10.1159/000070985 [CrossRef]
  • Buchanan, R. L., & Smokowski, P. R. (2009). Pathways from acculturation stress to substance use among latino adolescents. Substance Use and Misuse, 44(5), 740-762. https://doi.org/10.1080/10826080802544216 [CrossRef]
  • Canfield, M., Worrell, M., & Gilvarry, C. (2017). Determinants of substance use amongst Brazilians residing in the UK: The role of acculturation. Drug and Alcohol Review, 36(6), 751-760. https://doi.org/10.1111/dar.12530 [CrossRef]
  • De La Rosa, M. (2002). Acculturation and Latino adolescents’ substance use: A research agenda for the future. Substance Use and Misuse, 37(4), 429-456. https://doi.org/10.1081/JA-120002804 [CrossRef]
  • Dorn, T., Ceelen, M., Tang, M. J., Browne, J. L., De Keijzer, K. J. C., Buster, M. C. A., & Das, K. (2011). Health care seeking among detained undocumented migrants: A cross-sectional study. BMC Public Health, 11(1), 190. https://doi.org/10.1186/1471-2458-11-190 [CrossRef]
  • Ezard, N., Oppenheimer, E., Burton, A., Schilperoord, M., MacDonald, D., Adelekan, M., Sakarati, A., & Van Ommeren, M. (2011). Six rapid assessments of alcohol and other substance use in populations displaced by conflict. Conflict and Health, 5(1), 1. https://doi.org/10.1186/1752-1505-5-1 [CrossRef]
  • Furber, S., Jackson, J., Johnson, K., Sukara, R., & Franco, L. (2013). A qualitative study on Tobacco smoking and betel quid use among Burmese refugees in Australia. Journal of Immigrant and Minority Health, 15(6), 1133-1136. https://doi.org/10.1007/s10903-013-9881-x [CrossRef]
  • Gore, F. M., Bloem, P. J. N., Patton, G. C., Ferguson, J., Joseph, V., Coffey, C., Sawyer, S. M., & Mathers, C. D. (2011). Global burden of disease in young people aged 10-24 years: A systematic analysis. The Lancet, 377(9783), 2093-2102. https://doi.org/10.1016/S0140-6736(11)60512-6 [CrossRef]
  • Güler, Ç., & Akın, L. (Eds.). (2015). Halk Sağlığı Temel Bilgiler. Hacettepe Üniversitesi.
  • Gunn, A., & Guarino, H. (2016). “Not human, dead already”: Perceptions and experiences of drug-related stigma among opioid-using young adults from the former Soviet Union living in the U.S. International Journal of Drug Policy, 38, 63-72. https://doi.org/10.1016/j.drugpo.2016.10.012 [CrossRef]
  • Hall, B. J., Chen, W., Wu, Y., Zhou, F., & Latkin, C. (2014). Prevalence of potentially traumatic events, depression, alcohol use, and social network supports among Chinese migrants: an epidemiological study in Guangzhou, China. European Journal of Psychotraumatology, 5(1), 26529. https://doi.org/10.3402/ejpt.v5.26529 [CrossRef]
  • Horyniak, D., Higgs, P., Cogger, S., Dietze, P., & Bofu, T. (2016). Heavy alcohol consumption among marginalised African refugee young people in Melbourne, Australia: Motivations for drinking, experiences of alcohol-related problems and strategies for managing drinking. Ethnicity and Health, 21(3), 284-299. https://doi.org/10.1080/13557858.2015.1061105 [CrossRef]
  • Horyniak, D., Melo, J. S., Farrell, R. M., Ojeda, V. D., & Strathdee, S. A. (2016). Epidemiology of Substance Use among Forced Migrants: A Global Systematic Review. PLOS ONE, 11(7), e0159134. https://doi.org/10.1371/journal.pone.0159134 [CrossRef]
  • Kamperman, A. M., Komproe, I. H., & De Jong, J. T. V. M. (2007). Migrant mental health: A model for indicators of mental health and health care consumption. Health Psychology, 26(1), 96-104. https://doi.org/10.1037/0278-6133.26.1.96 [CrossRef]
  • Karriker-Jaffe, K. J. (2011). Areas of disadvantage: A systematic review of effects of area-level socioeconomic status on substance use outcomes. Drug and Alcohol Review, 30(1), 84-95. https://doi.org/10.1111/j.1465-3362.2010.00191.x [CrossRef]
  • Kluttig, T., Odenwald, M., & Hartmann, W. (2009). Fatal violence - From trauma to offence: A case study in forensic psychotherapy and trauma therapy with a migrant patient. International Forum of Psychoanalysis, 18(1), 42-49. https://doi.org/10.1080/08037060802658512 [CrossRef]
  • Larrance, R., Anastario, M., & Lawry, L. (2007). Health Status Among Internally Displaced Persons in Louisiana and Mississippi Travel Trailer Parks. Annals of Emergency Medicine, 49(5). https://doi.org/10.1016/j.annemergmed.2006.12.004 [CrossRef]
  • Liang, W., Chikritzhs, T., & Lenton, S. (2011). Affective disorders and anxiety disorders predict the risk of drug harmful use and dependence. Addiction, 106(6), 1126-1134. https://doi.org/10.1111/j.1360-0443.2011.03362.x [CrossRef]
  • Lim, S. S., Vos, T., Flaxman, A. D., Danaei, G., Shibuya, K., Adair-Rohani, H., Amann, M., Anderson, H. R., Andrews, K. G., Aryee, M., Atkinson, C., Bacchus, L. J., Bahalim, A. N., Balakrishnan, K., Balmes, J., Barker-Collo, S., Baxter, A., Bell, M. L., Blore, J. D., … Ezzati, M. (2012). A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010. The Lancet, 380(9859), 2224-2260. https://doi.org/10.1016/S0140-6736(12)61766-8 [CrossRef]
  • Miller, T., & Hendrie, D. (2008). Substance Abuse Prevention Dollars and Cents: A Cost-Benefit Analysis (DHHS Pub. No. (SMA) 07-4298). Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/sites/default/files/cost-benefits-prevention.pdf
  • Norcross, J. C., & Goldfried, M. R. (1994). Handbook of Psychotherapy Integration. American Journal of Psychiatry, 151(1), 141. https://doi.org/10.1176/ajp.151.1.141 [CrossRef]
  • O’Brien, B. C., Harris, I. B., Beckman, T. J., Reed, D. A., & Cook, D. A. (2014). Standards for Reporting Qualitative Research. Academic Medicine, 89(9), 1245-1251. https://doi.org/10.1097/ACM.0000000000000388 [CrossRef]
  • Ojeda, V. D., Robertson, A. M., Hiller, S. P., Lozada, R., Cornelius, W., Palinkas, L. A., Magis-Rodriguez, C., & Strathdee, S. A. (2011). A qualitative view of drug use behaviors of Mexican male injection drug users deported from the United States. Journal of Urban Health, 88(1), 104-117. https://doi.org/10.1007/s11524-010-9508-7 [CrossRef]
  • Priebe, S., Giacco, D., & El-Nagib, R. (2016). Public health aspects of mental health among migrants and refugees: a review of the evidence on mental health care for refugees, asylum seekers and irregular migrants in the WHO European Region. Health Evidence Network Synthesis Report 47, ix-pp. http://www.euro.who.int/__data/assets/pdf_file/0003/317622/HEN-synthesis-report-47.pdf?ua=1
  • Priest, N., Paradies, Y., Trenerry, B., Truong, M., Karlsen, S., & Kelly, Y. (2013). A systematic review of studies examining the relationship between reported racism and health and wellbeing for children and young people. Social Science and Medicine, 95, 115-127. https://doi.org/10.1016/j.socscimed.2012.11.031 [CrossRef]
  • Qureshi, A., Garcia Campayo, J., Eiroa-Orosa, F. J., Sobradiel, N., Collazos, F., Febrel Bordejé, M., Roncero, C., Andrés, E., & Casas, M. (2014). Epidemiology of substance abuse among migrants compared to native born population in primary care. American Journal on Addictions, 23(4), 337-342. https://doi.org/10.1111/j.1521-0391.2013.12103.x [CrossRef]
  • Rachlis, B., Brouwer, K. C., Mills, E. J., Hayes, M., Kerr, T., & Hogg, R. S. (2007). Migration and transmission of blood-borne infections among injection drug users: Understanding the epidemiologic bridge. Drug and Alcohol Dependence, 90(2-3), 107-119. https://doi.org/10.1016/j.drugalcdep.2007.03.014 [CrossRef]
  • Reid, G., Aitken, C., Beyer, L., & Crofts, N. (2001). Ethnic communities’ vulnerability to involvement with illicit drugs. Drugs: Education, Prevention and Policy, 8(4), 358-374. https://doi.org/10.1080/09687630110028280 [CrossRef]
  • Saunders, J. B., Aasland, O. G., Babor, T. F., De La Fuente, J. R., & Marcus, G. (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption‐II. Addiction, 88(6), 791-804. https://doi.org/10.1111/j.1360-0443.1993.tb02093.x [CrossRef]
  • Schuckit, M. A. (2006). Comorbidity between substance use disorders and psychiatric conditions. Addiction, 101(SUPPL. 1), 76-88. https://doi.org/10.1111/j.1360-0443.2006.01592.x [CrossRef]
  • Sphere Association. (2018). The Sphere Handbook Humanitarian Charter and Minimum Standards in Humanitarian Response. http://www.spherestandards.org/handbook
  • Streel, E., & Schilperoord, M. (2010). Perspectives on alcohol and substance abuse in refugee settings: lessons from the field. Intervention, 8(3), 268-275. https://doi.org/10.1097/wtf.0b013e328341315f [CrossRef]
  • Stuart, G. L., Moore, T. M., Kahler, C. W., & Ramsey, S. E. (2003). Substance abuse and relationship violence among men court‐referred to batterers’ intervention programs. Substance Abuse, 24(2), 107-122. https://doi.org/10.1080/08897070309511539 [CrossRef]
  • Szaflarski, M., Cubbins, L. A., & Ying, J. (2011). Epidemiology of alcohol abuse among US immigrant populations. Journal of Immigrant and Minority Health, 13(4), 647-658. https://doi.org/10.1007/s10903-010-9394-9 [CrossRef]
  • Teunissen, E., Sherally, J., Van Den Muijsenbergh, M., Dowrick, C., Van Weel-Baumgarten, E., & Van Weel, C. (2014). Mental health problems of undocumented migrants (UMs) in the Netherlands: A qualitative exploration of help-seeking behaviour and experiences with primary care. BMJ Open, 4(11), 5738. https://doi.org/10.1136/bmjopen-2014-005738 [CrossRef]
  • Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349-357. https://doi.org/10.1093/intqhc/mzm042 [CrossRef]
  • Toole, M. J., & Waldman, R. J. (1997). The public health aspects of complex emergencies and refugee situations. Annual Review of Public Health, 18, 283-312. https://doi.org/10.1146/annurev.publhealth.18.1.283 [CrossRef]
  • Turkey Republic Ministry of Interior. (2018). Genel Nüfusta Tütün Alkol ve Madde Kullanımına Yönelik Tutum ve Davranış Araştırması. http://www.narkotik.pol.tr/turkiyede-genel-nufusta-tutun-alkol-ve-madde-kullanimina-yonelik-tutum-ve-davranis-arastirmasi-raporu-yayimlanmistir
  • UN Refugee Agency. (n.d.). Refugee Statistics. Retrieved August 11, 2020, from https://www.unhcr.org/refugee-statistics/
  • UN Refugee Agency. (2014). Global Trends 2014. https://www.unhcr.org/statistics/country/556725e69/unhcr-global-trends-2014.html
  • UNODC. (2018). World Drug Report 2018, Executive Summary, Conclusions and Policy Implications. https://www.unodc.org/wdr2018
  • Vaughn, M. G., Salas-Wright, C. P., Maynard, B. R., Qian, Z., Terzis, L., Kusow, A. M., & DeLisi, M. (2014). Criminal epidemiology and the immigrant paradox: Intergenerational discontinuity in violence and antisocial behavior among immigrants. Journal of Criminal Justice, 42(6), 483-490. https://doi.org/10.1016/j.jcrimjus.2014.09.004 [CrossRef]
  • Whitley, R., Wang, J., Fleury, M. J., Liu, A., & Caron, J. (2017). Mental Health Status, Health Care Utilisation, and Service Satisfaction among Immigrants in Montreal: An Epidemiological Comparison. Canadian Journal of Psychiatry, 62(8), 570-579. https://doi.org/10.1177/0706743716677724 [CrossRef]
  • Zaller, N., Huang, W., He, H., Dong, Y. Y., Song, D., Zhang, H., & Operario, D. (2014). Risky alcohol use among migrantwomen in entertainment venues in China. Alcohol and Alcoholism, 49(3), 321-326. https://doi.org/10.1093/alcalc/agt184 [CrossRef]
APA Tasdemir M, Küçükali H, Ucar A, SUR H (2020). Exploring Alcohol and Substance Addiction among Syrian Migrants in Turkey: A Qualitative Study Integrating Perspectives of Addicts, Their Relatives, Local and National Institutions. , 253 - 276. 10.5152/ADDICTA.2020.20074
Chicago Tasdemir Mustafa,Küçükali Hüseyin,Ucar Abdullah,SUR HAYDAR Exploring Alcohol and Substance Addiction among Syrian Migrants in Turkey: A Qualitative Study Integrating Perspectives of Addicts, Their Relatives, Local and National Institutions. (2020): 253 - 276. 10.5152/ADDICTA.2020.20074
MLA Tasdemir Mustafa,Küçükali Hüseyin,Ucar Abdullah,SUR HAYDAR Exploring Alcohol and Substance Addiction among Syrian Migrants in Turkey: A Qualitative Study Integrating Perspectives of Addicts, Their Relatives, Local and National Institutions. , 2020, ss.253 - 276. 10.5152/ADDICTA.2020.20074
AMA Tasdemir M,Küçükali H,Ucar A,SUR H Exploring Alcohol and Substance Addiction among Syrian Migrants in Turkey: A Qualitative Study Integrating Perspectives of Addicts, Their Relatives, Local and National Institutions. . 2020; 253 - 276. 10.5152/ADDICTA.2020.20074
Vancouver Tasdemir M,Küçükali H,Ucar A,SUR H Exploring Alcohol and Substance Addiction among Syrian Migrants in Turkey: A Qualitative Study Integrating Perspectives of Addicts, Their Relatives, Local and National Institutions. . 2020; 253 - 276. 10.5152/ADDICTA.2020.20074
IEEE Tasdemir M,Küçükali H,Ucar A,SUR H "Exploring Alcohol and Substance Addiction among Syrian Migrants in Turkey: A Qualitative Study Integrating Perspectives of Addicts, Their Relatives, Local and National Institutions." , ss.253 - 276, 2020. 10.5152/ADDICTA.2020.20074
ISNAD Tasdemir, Mustafa vd. "Exploring Alcohol and Substance Addiction among Syrian Migrants in Turkey: A Qualitative Study Integrating Perspectives of Addicts, Their Relatives, Local and National Institutions". (2020), 253-276. https://doi.org/10.5152/ADDICTA.2020.20074
APA Tasdemir M, Küçükali H, Ucar A, SUR H (2020). Exploring Alcohol and Substance Addiction among Syrian Migrants in Turkey: A Qualitative Study Integrating Perspectives of Addicts, Their Relatives, Local and National Institutions. Addicta: The Turkish Journal on Addictions, 7(4), 253 - 276. 10.5152/ADDICTA.2020.20074
Chicago Tasdemir Mustafa,Küçükali Hüseyin,Ucar Abdullah,SUR HAYDAR Exploring Alcohol and Substance Addiction among Syrian Migrants in Turkey: A Qualitative Study Integrating Perspectives of Addicts, Their Relatives, Local and National Institutions. Addicta: The Turkish Journal on Addictions 7, no.4 (2020): 253 - 276. 10.5152/ADDICTA.2020.20074
MLA Tasdemir Mustafa,Küçükali Hüseyin,Ucar Abdullah,SUR HAYDAR Exploring Alcohol and Substance Addiction among Syrian Migrants in Turkey: A Qualitative Study Integrating Perspectives of Addicts, Their Relatives, Local and National Institutions. Addicta: The Turkish Journal on Addictions, vol.7, no.4, 2020, ss.253 - 276. 10.5152/ADDICTA.2020.20074
AMA Tasdemir M,Küçükali H,Ucar A,SUR H Exploring Alcohol and Substance Addiction among Syrian Migrants in Turkey: A Qualitative Study Integrating Perspectives of Addicts, Their Relatives, Local and National Institutions. Addicta: The Turkish Journal on Addictions. 2020; 7(4): 253 - 276. 10.5152/ADDICTA.2020.20074
Vancouver Tasdemir M,Küçükali H,Ucar A,SUR H Exploring Alcohol and Substance Addiction among Syrian Migrants in Turkey: A Qualitative Study Integrating Perspectives of Addicts, Their Relatives, Local and National Institutions. Addicta: The Turkish Journal on Addictions. 2020; 7(4): 253 - 276. 10.5152/ADDICTA.2020.20074
IEEE Tasdemir M,Küçükali H,Ucar A,SUR H "Exploring Alcohol and Substance Addiction among Syrian Migrants in Turkey: A Qualitative Study Integrating Perspectives of Addicts, Their Relatives, Local and National Institutions." Addicta: The Turkish Journal on Addictions, 7, ss.253 - 276, 2020. 10.5152/ADDICTA.2020.20074
ISNAD Tasdemir, Mustafa vd. "Exploring Alcohol and Substance Addiction among Syrian Migrants in Turkey: A Qualitative Study Integrating Perspectives of Addicts, Their Relatives, Local and National Institutions". Addicta: The Turkish Journal on Addictions 7/4 (2020), 253-276. https://doi.org/10.5152/ADDICTA.2020.20074