Escaping the past and living in the present: a qualitative exploration of substance use among Syrian male refugees in Germany

Ingo Schäfer,Ulrike Neuendorf,Jutta Lindert,Marta Natan

doi:10.1186/s13031-021-00352-x

Ingo Schäfer, Ulrike Neuendorf + Show 2 more

Open Access

https://doi.org/10.1186/s13031-021-00352-x

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Abstract

BackgroundSyrians have been the largest group of refugees in Germany since 2014. Little is known about Syrian refugees` perspectives on substance use. The aim of this study is to investigate the perspective of male refugees from Syria and to foster specific knowledge and understanding of substance use.MethodsWe applied a qualitative study design. Five semi-structured focus group discussions with a total of 19 refugees were conducted in 2019 among the difficult to reach population of Syrian refugees. Audio recordings were translated and transcribed. We used a hybrid approach by integrating inductive and deductive thematic frameworks.ResultsWe identified common themes. Firstly, refugees perceived that substances are widely available and accepted in Germany. Secondly, refugees perceived that rules and norms in Germany differ from rules and norms in the home country and favor availability of substances. Thirdly, substance use is related to the intention to escape the past. Fourthly, substance use is related to living in the present through connecting with others and being part of the community. Finally, mental health professional treatment for substance use is associated with shame.ConclusionsFindings support Syrian refugees` perspectives of substance use as a way of both escaping the past and coping with psychosocial difficulties in the present in a socio-ecological understanding. Understanding the explanatory model of Syrian refugees can inform future interventions to prevent substance abuse and design tailored interventions. Further studies with Syrian refugees in more countries are needed to better understand resettled refugees` perspectives on substance use.

Highlights

Understanding substance use among forcibly displaced persons remains limited despite the increasing number of forcibly displaced persons globally [1,2,3] and increasing knowledge on mental disorders among refugees [4–Lindert et al Conflict and Health (2021) 15:269]
– Perceptions prevail that family norms and societal norms contribute to substance abuse
– Intentions to escape the past and live in the present are associated with substance use

Summary

Introduction

Understanding substance use among forcibly displaced persons remains limited despite the increasing number of forcibly displaced persons globally [1,2,3] and increasing knowledge on mental disorders among refugees [4–Lindert et al Conflict and Health (2021) 15:269]. Refugees from Syria have faced war-related violence, including massacres, murder, torture and stressful situations including poverty and limited access to food in their home country [11]. They often face difficult situations such as poverty, loss of family and community support and lack of employment in displacement [12]. These pre-, during-, and post-flight events have been associated with mental health problems among refugees including problematic substance use [13, 14]. The aim of this study is to investigate the perspective of male refugees from Syria and to foster specific knowledge and understanding of substance use

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