Addiction has a complex relationship with human trafficking: it can exacerbate a trafficked person’s vulnerability, be part of a captor’s means of coercing a captive person to submit, be part of a captor’s means of incentivizing a captive person to remain captive, and be used by the captive person as a mechanism of coping with the physical and mental traumas of being trafficked [9, 13]. The first explanation appears to be the most common, although research is limited. For example, an anti-trafficking service provider in Maine found that 66 percent of its clients reported that substance use led to their being trafficked while only 4.5 percent reported that it arose after their being trafficked . A broader survey of US survivors of sex trafficking found that 84.3 percent used substances during their trafficking exploitation. Alcohol, marijuana, and cocaine were each used by more than 50 percent of respondents and nearly a quarter (22.3 percent) used heroin .
Opioids in particular are an effective coercion tool for traffickers because they numb both emotional and physical pain; clinicians have noted clear links between the current US opioid epidemic and trafficking . Some traffickers recruit directly from substance use disorder treatment facilities . Moreover, high rates of opioid-overdose death underscore the potentially lethal consequences of an opioid addiction for trafficked persons . Therefore, as in this case, opioid addiction in and of itself may be a red flag for clinicians to screen for trafficking. Link to full article and citation
Homelessness is a leading root cause of human trafficking and exploitation, in particular, the trafficking of LGBTQ youth, who are disproportionately represented among our homeless youth population. In 2017, nearly thirty percent of youth identifying as LGBTQI are abandoned or thrown away to the streets by caregivers. Once on the streets, many youth are preyed upon by traffickers. Food, shelter, drugs and other necessities are used as bait to lure young people into exploitation and violence.
Male youth servicing the sex trade in the United States are more at risk for being infected with HIV, developing AIDS-defining infections and diseases, and for dying prematurely than any other group of youth in the USA, according to Smash Street Boys, a safe house protection for male adolescents living with HIV/AIDS-defining infections & diseases (also at-risk for psychological, neurological, and developmental challenges due to sexual abuse, gang violence, addiction, human trafficking, and cyclical prostitution). Link to full article and citation
Mental Health & Suicide
Clinicians should be aware that mental health can be an indicator that a patient is being trafficked and should raise a clinician’s index of suspicion that they are being exploited. Studies have shown that people with a known major mental health issue like schizophrenia are more likely to be victimized physically than those without mental health issues . Moreover, intense, complex trauma could develop in a person who is trafficked. This is strongly associated with a patient’s development of psychosis, including schizophrenia [19, 20]
Trafficked persons with psychotic disorders and experiences of violence prior to being trafficked are likely to require more therapeutic support than patients with non-psychotic disorders or those suffering from psychological distress . Research conducted in many countries demonstrates that, in addition to psychosis, survivors of labor and sex trafficking experience high rates of depression, anxiety, and post-traumatic stress disorder (PTSD), self-harm, and attempted suicide [23-25]. Link to full article and citations. A recent study found that human trafficking survivors have an alarming higher-than-average rate of suicidal thoughts with a percentage of 23% of survivors having attempted suicide, compared with 3% of the population with no prior domestic violence exposure. A survey was conducted and revealed that the suicide rate is increasing in victims of human trafficking. Link to full article and citation