Abstract

Abstract Background Little is known about Syrian refugees ‘perspectives on substance use. Syrians have been the largest groups of refugees in Germany since 2014. To investigate Syrian refugees’ perspectives on substance use we applied a qualitative study design. Methods 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, and inductive thematic was analysis conducted. Results The following common themes were identified: (a) perception that substances are widely accepted and available in Germany; (b) availability of substances is linked to rules and norms in Germany which are different in Syria, (c) and to the intention to escape not only the past (d) but the present and finally that (e) mental health professional treatment for substance use is associated with shame. Conclusions Findings support Syrian refugees ‘perspectives of substance use as a way of escaping past and present in a socio-ecological understanding which includes past and present exposures. 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. Messages The intention to escape past and present elucidates links between the context of using substances and context of feeling rejected. Context specific knowledge of substance use is necessary which includes past and present factors.

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