Forced Displacement and Alcohol Use in Two Karen Refugee Communities: A Comparative Qualitative Study

Harmful alcohol use is a growing problem in refugee camps and in refugee resettlement communities in the USA. Exposure to conflict-related trauma, isolation and hopelessness in protracted refugee camp settings, and resettlement stress all contribute to potentially elevated levels of alcohol use. To date, there has been little academic research into the ways in which conflict-related displacement impacts harmful alcohol use and there exist almost no evidence-informed, culturally relevant interventions specifically for refugees. This paper describes a qualitative study that utilised semi-structured individual and focus group interviews with sixty-two Karen refugees in a refugee camp region in Thailand and a resettlement community in the USA. Spradley's Developmental Research Sequence was used to analyse the data and elucidate six key themes in two categories. Participants reported that both culture and displacement significantly impact the way alcohol is used and, in particular, that displacement and resettlement damage culture and lead to an increase in harmful alcohol use. Negative consequences such as interpersonal violence and legal consequences appear to increase due to displacement, as well. Finally, differences in geographic location suggest multiple approaches to prevention and intervention may be appropriate.