Drinking and Displacement: A Systematic Review of the Influence of Forced Displacement on Harmful Alcohol Use

Abstract

This paper systematically reviews evidence about factors associated with harmful alcohol use amongst forcibly displaced persons, including refugees and internally displaced persons. Bibliographic and humanitarian-related databases were searched. The number of quantitative and qualitative studies that were screened and reviewed was 1108. Only 10 studies met inclusion criteria. Risk factors identified included gender, age, exposure to traumatic events and resulting posttraumatic stress disorder, prior alcohol consumption-related problems, year of immigration, location of residence, social relations, and postmigration trauma and stress. The evidence base was extremely weak, and there is a need to improve the quantity and quality of research about harmful alcohol use by forcibly displaced persons.

RÉSUMÉ

La consommation d’alcool et le déplacement de populations: enquête systématique concernant l’influence du déplacement forcé sur la consommation morbide d’alcool

Cette communication article examine de façon systématique les facteurs associés à la consommation morbide d’alcool parmi les populations déplacées de force, en incluant les réfugiés et les personnes déplacées à l’intérieur de leur propre pays. Les bases de données bibliographiques et liées au travail humanitaire ont été triées et examinées. 1108 enquêtes quantitatives et qualitatives ont été de même examinées et contrôlées. Seules dix études correspondaient à nos critères. Les facteurs de risque identifiés comprennent le sexe, l’âge, l’exposition aux événements traumatiques et le syndrome de stress post-traumatique afférent, une consommation excessive antérieure d’alcool, l’année de l’immigration, le lieu de résidence, les relations sociales et les traumas et stress post-migratoires. Les preuves résultant de ces études étant très faibles, il est indispensable d’améliorer la recherche, qualitativement et quantitativement, quant à la consommation morbide d’alcool des populations déplacées de force.

RESUMEN

El consumo de alcohol y el desplazamiento de poblaciones: una evaluación sistemática de la influencia del desplazamiento forzado sobre el consumo patológico del alcohol.

Este articulo revisa de manera sistemática la evidencia sobre los factores asociados con el consumo patológico de alcohol entre las personas desplazadas por fuerza incluyendo a los refugiados y las personas desplazadas al interior de sus países. Bases de datos bibliográficos y relacionados al trabajo humanitario han sido examinado. 1108 estudios cuantitativos y cualitativos han sido examinados y revisados. Solo diez estudios correspondieron con los criterios de inclusión. Los factores de riesgo identificados incluyeron genero, edad, exposición a acontecimientos traumáticos y el síndrome de estrés pos-traumático correspondiente, un previo consumo excesivo de alcohol, año de inmigración, lugar de residencia, relaciones sociales y traumas y estrés pos-migración. Siendo la base de evidencia de estos estudios muy débil es indispensable mejorar la investigación, cualitativa y cuantitativamente, sobre el consumo patológico de alcohol entre poblaciones desplazadas a la fuerza.

Keywords :

• alcohol
• war
• refugees
• internally displaced persons
• addiction

THE AUTHORS

Heather Weaver is an occupational therapist and has spent time working in Bosnia and Sierra Leone, and with the innercity population in Canada. At the time of submission, Heather was posted in Haiti as a community-based rehabilitation project manager.

Bayard Roberts is a lecturer of public health. He has been involved in academic research and programme management in conflict-affected and transitional societies on mental health, social determinants of health, and reproductive health.

Notes

1 The reader is asked to consider that concepts and processes such as “risk” and “protective” factors are often noted in the literature, without adequately delineating their dimensions (linear, nonlinear), their “demands,” the critical necessary conditions (—endogenously as well as exogenously; micro to macro levels), which are necessary for them to operate (begin, continue, become anchored and integrate, change as de facto realities change, cease, etc.) or not to operate and whether their underpinnings are theory-driven, empirically based, individual and/or systemic stake holder bound, historically bound, based upon “principles of faith” or what. This is necessary to clarify, if possible, if these terms are not to remain as yet additional shibboleths in a field of many stereotypes. Editor's note.

2 The reader is referred to Hills's criteria for causation that were developed in order to help assist researchers and clinicians determine if risk factors were causes of a particular disease or outcomes or merely associated. (Hill, A. B. (1965). The environment and disease: associations or causation? Proceedings of the Royal Society of Medicine 58: 295–300.). Editor's note.