The Occupied Territories of Palestine (OtP) consists of the non-contiguous West Bank including East Jerusalem, and the Gaza Strip. Political and economic tensions and its dense populations compound the impact of drug abuse and addiction in the home. A qualitative study using four focus groups (n = 42) was conducted in West Bank and Gaza Strip explored the experiences of professionals working with Palestinian families and children affected by substance use and addiction in the home. Data were analysed using thematic analysis (TA), and four themes emerged. These were 'The rising and shifting problem of drug use in Palestine'; 'Psychosocial causal factors of drug use in Palestine'; 'The consequences for children and families living with drug use'; and 'Potential solutions to the problem are complex and multi-faceted.' The study paints a concerning picture of how drug abuse impacts on Palestinian families subjected to multiple pressures, stigmas, risks and harms relating to their situation.

Context: The occupied Palestinian territories (oPt) consists of the non-contiguous West Bank including East Jerusalem and the Gaza Strip. It is densely populated within these confines, and has a unique socio-economic context characterized by political and economic tensions . Around 2.2 million Palestinians are displaced and living in the ten UNRWA refugee camps in Jordan. Palestinian communities are exposed to a double burden of disease caused by the severe economic, social and health consequences of Israeli occupation and resultant displacement. Exposure to political violence, economic hardship, fragmentation of Palestinian families, unemployment, trauma and community stress underpin a reported rise in drug abuse. . Method: A qualitative study using focus groups ( n =3) with a convenience sample of health care and educational professionals was conducted in two UNRWA camps ( Al-Zarka, Al-Wehdat ) in Jordan. Guided discussions explored the experiences of these professionals in working with Palestinian families and children affected by substance/drug use and drug use disorder in the home. Data were analysed using thematic analysis (TA). Results: Five themes emerged from the TA. These were: 1)Access to drugs was perceived to be relatively easy in the camps; 2) Attitudes towards drugs appear to have desensitised, yet stigma persists; 3) Families of drug users are affected by fear, social and economic poverty, with significant physical and psychological cost to children; 4) Powered by Editorial Manager® and ProduXion Manager® from Aries Systems CorporationCauses of substance/drug use in Palestinian communities living in Jordanian UNRWA camps is multifactorial; 5) Solutions are multi-faceted and indicative of the need for prevention and support for those at risk, and affected . Conclusions: Threats to UNRWA from the current political climate and the reducing investment in services may exacerbate this public health and security issue. For an evidence based approach to have credibility in the camp communities, there is a need for accurate, factual information, along with robust epidemiological data, relating to the extent, characteristics and harms associated with drug use.