Short abstract
Substance use disorders (SUDs) are common among sex trafficking victims. In this article, researchers describe the results of a panel in which participants discussed the intersections between SUDs and sex trafficking and how they complicate victims' identification, screening, and ability to access treatment and legal remedies. The research also presents recommendations for service providers, victim advocates, and criminal justice practitioners.
Keywords: Health Risk Behaviors, Sexual Abuse, Substance Use, Substance Use Harm Reduction, Violent Crime
Abstract
Substance use disorder (SUD) is common among victims of sex trafficking. Traffickers may exploit individuals’ existing opioid use or other SUDs to coerce them into sex trafficking, or they may facilitate substance use to keep trafficking victims from exiting. Additionally, trafficking victims may use substances to cope with trauma.
The intersections of sex trafficking and SUD complicate both legal responses and victim advocate responses to sex trafficking cases. Victim SUD can lead to challenges for law enforcement and prosecutors in developing cases against traffickers. On the provider side, traditional victim services are often insufficient for victims of trafficking with SUDs, who face substantial barriers to accessing services. A better understanding of the nexus between sex trafficking and SUDs is critical for implementing victim-centered and trauma-informed responses to this vulnerable population.
In this article, the authors describe an online panel, convened in April 2021 by RTI International and the RAND Corporation on behalf of the National Institute of Justice, in which subject-matter experts and criminal justice practitioners discussed how SUDs and sex trafficking complicate the identification and screening of victims and victims’ ability to access treatment and legal remedies. The panel participants identified 21 high-priority needs to support a better understanding of sex trafficking and SUDs and a variety of solutions for addressing these intertwined issues.
A better understanding of the intersections between sex trafficking victimization and substance use disorders (SUDs)1 is critical to implementing victim-centered and trauma-informed approaches to identifying sex trafficking victims, holding perpetrators accountable, and ensuring that victims and survivors with SUDs can access services that are responsive to their needs. Law enforcement and prosecutors can face significant challenges in identifying sex trafficking victims and developing cases against traffickers when the victims have SUDs. For example, an SUD can make it difficult for a victim to recall events that are key to building a case against the trafficker in a detailed and consistent manner. Victims with SUDs who need services and support to separate from traffickers encounter additional barriers related to substance use. Shelters often have policies against substance use, and criminal convictions for drug offenses further hurt a survivor's chances of finding stable employment and housing. Stigma around substance use can limit the quality and type of assistance and services that survivors receive from criminal legal system agencies and from community providers.
On behalf of the National Institute of Justice, RTI International and the RAND Corporation convened a virtual workshop to develop a prioritized list of needs for addressing the intersections between sex trafficking and substance use, focusing on identification of and response to these problems by community members, victim service practitioners, law enforcement and first responders, and court practitioners in the United States. Through a series of individual interviews and virtual group discussions, the participants shared their experiences with responding to and serving victims of sex trafficking who also have co-occurring SUDs. Participants provided their perspectives on needs and opportunities for improving the identification of survivors involved in sex trafficking; reducing entry into sex trafficking; increasing the viability of exiting; and reducing long-term consequences that hinder recovery, especially for persons who are highly dependent on drug use.
The participants identified and prioritized a total of 58 needs, or combinations of potential solutions that address 26 key problems or challenges. This study details the 21 needs deemed by participants to be the highest priority and provides additional context on these issues and solutions from workshop discussions. These high-priority needs relate to the identification of sex trafficking; the provision of services to victims and survivors; and the improvement of criminal justice approaches to serving and supporting persons involved in sex trafficking, including best practices related to the intersection of sex trafficking and substance use. Specifically, there is a need for better education, training, and tools to assist first responders and members of the community in recognizing and responding to a potential victim of sex trafficking. With regard to treatment and services, programs need to be better equipped to address both complex trauma and SUDs. Finally, the criminal justice response must recognize survivors’ distrust of criminal legal system actors, address issues related to the perceived credibility of persons dealing with trauma and SUDs through the system, and develop innovative strategies for ensuring that trafficking offenders and their associates are prosecuted to the full extent of the law. Although the participants did discuss specific needs associated with juvenile victims, the top-tier needs focus primarily on adult victims of sex trafficking.
What We Found
The co-occurrence of sex trafficking victimization and victim SUDs creates challenges for the identification of victims, the provision of treatment and services for victims, and the criminal justice response to sex trafficking.
Participants noted that considerable training and education are needed to change the stigmatization of SUDs and to help community members, advocates, law enforcement and first responders, and other criminal justice practitioners recognize and identify trafficking victims as victims. This need to change mindsets regarding trafficking and SUDs is particularly important when it comes to communities of color, where systemic bias results in greater criminalization of behaviors associated with trafficking and substance use. Furthermore, sex trafficking awareness, training, and assistance capacity are often severely lacking in rural and other nonmetropolitan areas.
Because victims of sex trafficking suffer from complex trauma, meaning that they have experienced multiple traumatic events, it is essential to have programs specifically to address these associated issues. These programs should use mentors with lived experience when possible; prioritize efforts to address SUDs, particularly ahead of participation in criminal justice processes; and “meet victims where they are” by using harm reduction approaches to providing services.2
Trafficking victims with SUDs often distrust law enforcement and other criminal justice practitioners, particularly when they have experienced repeated arrests for offenses stemming from their victimization. To ensure that victims get help and traffickers are brought to justice, criminal justice practitioners must work with advocates in the community and engage in training and education to develop trauma-informed practices and procedures for engaging with sex trafficking victims.
Finally, building cases against sex traffickers can be difficult, particularly because of the challenges in having victims with SUDs participate in the criminal justice process and be perceived as reliable witnesses. Successful prosecution of these cases requires coordination across agencies and jurisdictions and innovative strategies for building cases that do not center on trafficking victims’ participation.
Selected Priority Needs
Identification and Screening
Ongoing diversity and inclusion training and cultural competency training should be developed for communities, first responders, and those working in the criminal justice system.
Training for law enforcement, medical providers, service providers, and other first responders on the impacts of trauma and on trauma-informed approaches to working with sex trafficking victims should be developed and implemented.
Treatment and Services
Strategies for providing victims with rapid access to SUD treatment should be developed.
Long-term sustainable care plans, peer support, and survivor-led services should be developed that incorporate harm reduction strategies and recognize that relapse can be a part of the process of overcoming an addiction and exiting trafficking.
Criminal Justice Response
Feedback and guidance should be sought from advocates, including those with lived experience, on how to make criminal justice practices and procedures more trauma-informed and victim-centered and provide commercial sexual exploitation education.
The use of expert witnesses to educate the jury and court about the effects of trauma and substance use should be considered.
Policies should be developed to ensure that services for victims are not tied to a requirement to participate in the criminal justice process.
Notes
The Substance Abuse and Mental Health Services Administration defines SUDs as occurring when the recurrent use of alcohol, drugs, or both causes clinically significant impairment (Substance Abuse and Mental Health Services Administration, 2020).
Harm reduction approaches focus on reducing adverse consequences of substance use while recognizing that abstinence might not be realistic. In the context of programs for trafficking victims, this means not imposing stringent requirements for consistent participation in these programs, which trafficking victims with SUDs likely will not be able to meet.
The research described in this article was supported by the National Institute of Justice and conducted by the Justice Policy Program within RAND Social and Economic Well-Being.
Reference
- Substance Abuse and Mental Health Services Administration. Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health. Rockville, Md.: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration; 2020. : , HHS Publication No. PEP20-07-01-001, . [Google Scholar]