Substance use disorder and trauma 

It is imperative that healthcare professionals acknowledge the intersection of trauma, sex work, and substance use. Many HCPs tend to focus on how the substance abuse contributed to the trauma, instead of recognizing how the trauma could be impacting the substance use. HCPs can ask about alcohol and/or substance misuse and explore this in an open and non-judgmental manner.  Substance misuse is commonly coupled with depression and physical ailments that are prevalent in this population. “In many settings, trafficked persons are provided with alcohol and drugs during their abuse to reduce their resistance and increase their dependence on traffickers. Their use may have become a way of coping with intense, painful emotions”  (Caring for trafficked persons, 2009, p.139).

Healthcare professionals can:

• Show respect for how the individual has coped thus far, even if their coping mechanisms were maladaptive, e.g., substance abuse and self-harm. 

• Give non-judgmental, supportive advice about alcohol and substance misuse. Help patients set goals for ceasing consumption when ready and encourage them to express their own motivations for reducing consumption. 

• Accept the patient and provide needed care if possible even if patient presents
  to clinic under the influence of alcohol or other substances, acknowledging
  that consent for invasive exams or procedures cannot be obtained if patient is
  not sober

• Make it clear that sobriety is not a condition needing to be met before the HCP will provide help to the patient

• Attend to the intoxicated patient’s personal safety throughout the
  healthcare encounter