By Katherine Chon, Director, Office on Trafficking in Persons (OTIP)
Dr. Hanni Stoklosa is an emergency physician at Brigham and Women’s Hospital and Executive Director of HEAL Trafficking. She recently joined a panel of experts to brief the HHS Task Force to Prevent and End Human Trafficking. OTIP interviewed Dr. Stoklosa to learn more about the links between opioid abuse and human trafficking.
Dr. Stoklosa, as an emergency medicine physician, has the opioid epidemic impacted what you are seeing in human trafficking?
The opioid epidemic is changing the landscape of trafficking. I work in a busy urban emergency department in Boston where in any given week we identify one to three survivors of trafficking. Based on our records, over 50% of these patients struggle with opioid addiction.
Anecdotally, my trafficked patients tell me opioids either led them to being trafficked or kept them trapped in this cycle of exploitation.
[To give an example,] Beth (not her real name) is a twenty-year-old white female, addicted to heroin. As a teenager, she started using oxycodone pills and then graduated to heroin. She enrolled in various addiction treatment programs over the years but remains addicted. Last fall, as she left a detox facility she met a man who offered her heroin. Ultimately, the man trafficked Beth, locking her in a motel room in Rhode Island for a week. She was forced to have commercial sex with about 200 men. From there she found her way to my emergency department.
Beth’s case is just one example of similar stories we see in Boston. As Executive Director of the HEAL Trafficking network, I know this happens frequently around the country.
Like any drug, opioids are an effective tool traffickers use to keep victims trapped in these situations. We also see patients who start using after they are trafficked as a way of numbing emotional pain.
Why is the combination of opioid addiction and trafficking so powerful?
The physical craving the body develops for opioids is profound and unrelenting. Add extreme brainwashing, psychological manipulation, and physical trauma and you end up with someone who is trapped in a cycle. The power of addiction combined with the coercion of a trafficker can be a lethal combination. We have seen a number of these patients die from overdose, suicide, and infections.
What are the solutions?
This is clearly a public health crisis. We must tackle both opioid addiction and trafficking through prevention and treatment. There are no quick fixes here. Substance abuse treatment must be coupled with a trauma-informed approach to mental health. High quality and long-term treatment should be available to victims. Trafficking survivors need specialized addiction resources because of their extensive histories of trauma.
What happened to your patient, Beth?
She waited for our team to find a program that could help her with her addiction and depression, which had put her at high risk for trafficking. No beds were available. Beth decided to take her chances on her own and walked out of our emergency department after waiting a day.
The system must change so that we have the comprehensive resources available to care for other trafficking survivors. The next time a victim of trafficking walks into an emergency department, they should end up getting services, not heading back to the streets on their own.
Last March, HHS announced an Opioid Initiative to reduce prescription opioid and heroin related overdose, death, and dependence, including over $100 million in grants to increase treatment services. This year, the President proposed $1.1 billion in new investments to help individuals seek treatment, successfully complete treatment, and sustain recovery.
The White House – Fact Sheet: Obama Administration Announces Additional Actions to Address the Prescription Opioid Abuse and Heroin Epidemic. (March 29, 2016)