Interventions to Support Substance Use Recovery Among Human Trafficking Survivors: A Scoping Review

Background and Purpose: Substance misuse and human trafficking share complex interrelationships. As substance misuse is a commonly reported condition among survivors of human trafficking, the objective of this scoping review is to identify the substance use treatment, harm reduction, and recovery support services empirically tested in trafficking survivors. This review has the following aims: assess the evidence base for interventions to support substance use recovery among child, adolescent, and adult sex or labor trafficking survivors; identify the settings in which interventions are implemented; and summarize how substance use treatment outcomes are operationalized.

Methods: Reviewers searched several databases, including Ovid-Medline All, Embase.com, CINAHL Plus, Scopus, and Web of Science and conducted forward and backward citation searching of eligible peer reviewed studies and grey literature. Eligible studies included child, adolescent, or adult sex or labor trafficking survivors, tested a specific intervention or program to promote substance use recovery, and reported treatment-related outcomes. At least two reviewers conducted title/abstract and full text screening and extracted data from included studies. Extracted data included bibliographic information, participant characteristics, study design, intervention characteristics, and primary substance use-related outcomes. Data elements were narratively summarized, with attention given to variation in interventions implemented across settings and variability in outcomes reported by participant characteristics.

Results: Five studies were included in this review. A total of 916 results were retrieved from the database literature search. After removal of duplicate citations (n = 501), 415 unique citations were uploaded to Covidence screening software. After title and abstract screening removed 391 studies, 19 full-text reports were screened. Five of the full-text reports were eligible for inclusion and were extracted. The studies were published between 2012-2024, and summarized rehabilitation and specialty court diversion programs for youth with experiences of commercial sexual exploitation/domestic minor sex trafficking. Programs in the US served youth from diverse backgrounds, with justice-involved settings serving mostly Black youth, one community-based program focusing on Indigenous youth, and one community-based program serving a majority of youth who identified as Black, Latine, or multiracial. Two programs were based in specialty courts in the United States (US) for trafficked youth, whereas the other three were multi-modal (housing, health services, basic needs) non-profit programs in the US (n = 2) and Israel (n = 1). Substance use outcomes were generally defined through self-reported frequency of use (n = 3), whereas one study used a standardized assessment, and one study reported referrals to SUD treatment/support groups as the primary outcome.

Conclusions and Implications: Although several published evidence syntheses have examined psychosocial interventions for trafficking survivors, this scoping review was the first to synthesize the literature on programs to improve substance use outcomes among survivors. Intervention characteristics were often underreported in included studies. Given the prevalence of SUD among trafficking survivors, it is surprising that no studies involving adult survivors were identified. Evaluation of evidence-based psychosocial interventions, such as harm reduction practices, CBT, contingency management, and integrated treatments for co-occurring disorders, are warranted to identify potential adaptations that would support substance use recovery among trafficking survivors.