Disasters and Substance Abuse

United States

NIDA Organizers: Samia Noursi, Ph.D.; Jackie, Kaftarian, Ph.D.; Elizabeth Lambert, M.Sc.; Jerry Flanzer, Ph.D.

Meeting Purpose:

• Review the current knowledge/existing research on:
  • The epidemiology and etiology of drug abuse, mental illness, and other health problems, including HIV/AIDS and co-infections, during and after natural and man-made disasters.
  • The nature and extent of needs for prevention, crisis interventions, and service delivery among drug abusers and other vulnerable individuals affected by disaster situations.
• Identify new and emerging research findings for the optimal delivery of services to those in need in disaster situations.
• Identify gaps in research on the epidemiology of drug abuse, prevention and intervention services, and strategies for bridging research to practice.

Brief Discussion of Meeting Outcome:

Meeting participants were asked to address one of three broad areas of research.

(1) Epidemiology and etiology of substance abuse, mental illness, and other health consequences associated with disasters focused on current data on substance abuse patterns and trends among adults and adolescents affected by hurricanes or the terrorist attacks of September 11. The panel discussed the importance of such concepts as correlation and causality, and interactions between pre- and post-disaster risk behaviors. They also examined the potential of a disaster or trauma situation to serve as an opportunity, from a service delivery perspective, to engage individuals who otherwise may have been unwilling to enter drug treatment.

(2) Prevention, crisis intervention, and service delivery needs of drug abusers described the different types of efforts made to provide services and interventions in the aftermath of natural disasters and terrorist attacks. Discussions that followed highlighted the importance of preparedness research to better prescribe interventions to meet the immediate service needs of substance abuse populations exposed to a trauma as well as those that change over time, underscoring how populations affected by disasters often need multiple and sequential types of care.

(3) New strategies for effectively bridging research to practice focused on the best ways of implementing evidence-based practices in disaster situations. These included discussions of findings on different types of care for individuals in the immediate aftermath of a disaster and over time during the recovery process; the potential of community-based interventions at different time points following a disaster; and the importance of an ongoing synthesis of the science to optimize preparedness, clinical care, and public health services in response to future disaster situations.

General Discussion - The meeting concluded with a broad discussion of the most pressing questions facing researchers and treatment providers working with substance abuse populations affected by a disaster. Some of the questions raised were:

• What groups are at greatest risk in disaster situations, and how best can they be identified, and reached when disasters strike?
• What is the trajectory of substance use and abuse after a disaster?
• What role does substance use and abuse play in influencing other morbidities?
• Could a disaster situation present a unique opportunity to treat a preexisting or new disorder?
• What gaps and needs should be addressed to synthesize research findings and lessons learned from disasters and improve our public health preparedness and effectiveness in response to those that follow?