Intersections of Human Trafficking and the Opioid Epidemic, and Barriers to Data Collection in Human Trafficking
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CitationCeasar, Danial. 2019. Intersections of Human Trafficking and the Opioid Epidemic, and Barriers to Data Collection in Human Trafficking. Doctoral dissertation, Harvard Medical School.
AbstractAbstract for Appendix I
TITLE: Human Trafficking and the Opioid Epidemic: Quelling a Growing Problem
Hanni Stoklosa, MD, Danial Ceasar
Purpose: To further elucidate the contributors to the intersection between human trafficking and the opioid epidemic, discuss the barriers to providing aid to this specific population, and create recommendations for best steps forward in both coming to full understanding of the scope as well as enabling practitioners to address the needs of these patients effectively.
Methods: A literature search was conducted by standard means to understand the current state of the field. Phone interviewers were then conducted with current experts in the field and the interviews were analyzed via thematic content analysis. Conclusions were drawn based on broad themes identified across interviews.
Results: Broad themes in this intersection fit into 3 main categories- Intentional Perpetrator Patterns of Behavior (IPPB), Systemic Societal & Medical Barriers (SSMB), and Long-Term Barriers to Treatment (LTBT). Intentional Perpetrator Patterns of Behavior included targeting vulnerable peoples, promising drugs to addicted peoples, threatening victims with withdrawal, exploiting chronic pain disorders, and sabotaging recovery efforts among others. Systemic Barriers included possible entrapment by legal policies regarding immigration and child services, difficulty rapport building, and lack of ubiquitous trauma-informed approaches to care. Long-Term Barriers include ineffective identification of coping mechanisms and inability to permanently extricate victims from high-risk, familiar environments.
Conclusions: In order to properly treat this patient population in an effective and durable manner, identifying and traversing each barrier is necessary. Solutions to this problem must be comprehensive in approach both in any given clinic and from a clinic to governmental standpoint. Effective treatment mechanisms and plans have been identified in small clinics, but must be better funded, popularized, and adopted widely. This should occur in conjunction with pushes for research on the interventions of these clinics and strong policy reform to minimalize the penalties that have historically been given to these victims.
Abstract for Appendix II
TITLE: The Role of U.S. State and Territorial Health Organizations in Human Trafficking Data Collection and Other Activities (Working Title)
Susie Baldwin, MD, MPH; Brian Willis, JD, MPH, Maggie Carlin (ASTHO), Danial Ceasar
Purpose: To better elucidate the role of public health entities and the barriers faced in data collection on Human Trafficking
Methods: A survey was sent to all 59 members of the Association of State and Territorial Health Organizations (ASTHO). The survey was created by the primary authors of the paper through a collaborative process and both quantitative and qualitative questions. The data was then collected and analyzed.
Results: Almost half (48%) of the organizations that participated in the study reported that they had no plans of doing data collection in HT at the time of the survey. Many reported that it was the responsibility of other agencies. Other barriers implicated in the results were funding and lack of personnel to carry out the task of data collection.
Conclusion: The baseline data collection of many public health institutions in the country does not begin to address the need of human trafficking. Because of this, there is a lack of data on the scope of the problem and this creates a barrier within itself to good, evidence-based treatment strategies and action plans. In order to create more robust responses nationwide, both the medical and public health sectors must push for better data collection rather than deferring responsibility to other agencies.
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