This article reviews an emergency department-based clinical vignette of a trafficked patient with co-occurring pregnancy-related, mental health, and substance use disorder issues. The authors, including a survivor of human trafficking, draw on their backgrounds in addiction care, human trafficking, emergency medicine, and psychiatry to review the literature on relevant general health and mental health consequences of trafficking and propose an approach to the clinical complexities this case presents. In their discussion, the authors explicate the deleterious role of implicit bias and diagnostic overshadowing in trafficked patients with cooccurring addiction and mental illness. Finally, the authors propose a trauma-informed, multidisciplinary response to potentially trafficked patients.
Citation: Stoklosa, Hanni, Marti MacGibbon, and Joseph Stoklosa. 2017.
Human Trafficking, Mental Illness, and Addiction: Avoiding
Diagnostic Overshadowing. AMA Journal of Ethics 19 (1): 23-34.
Human trafficking and drugs—what’s the connection?
- Trafficking of illegal drugs and human trafficking often happen together. Drug traffickers may also be transporting people as another source of money.
- Human traffickers may also force their victims to smuggle drugs across borders.
- Human traffickers can use drugs as “bait” to recruit people who have a substance use disorder. Or they can use drugs to force a victim to obey their orders, or work harder or for longer hours.