Can the migration process influence the clinical expression of heroin use disorder in migrants to Italy?

Abstract

Background. For some time now, there has been a strong consensus that the migration process can influence the onset, course, development, outcome, and clinical aspects of psychiatric pathologies. Methods. In this study, we have analyzed the influence of the migration process on the clinical expression of heroin use disorder (HUD). In a naturalistic case–control study, we compared, both at univariate and multivariate level, 30 migrant HUD (M-HUD) patients with 30 age/gender-matched Italian HUD (IT-HUD) patients. We also analyzed demographic data, drug addiction history, psychopathological symptoms, addictive behavior, and emotional reactivity to life events. Results. Compared with IT-HUD pairs, at HUD Agonist Opioid Treatment, M-HUD patients were characterized by inadequate income and the presence of legal problems. They were more frequently at stage 3 of heroin addiction, with a concomitantly less frequent use of stimulants. Their age at the onset of heroin use was greater than that of subjects in the IT-HUD group. HUD post-traumatic stress disorder spectrum was present and was more severe in all M-HUD patients, but grief reactions and maladaptive behavior were the most discriminant traits. No differences were found in terms of addictive behaviors related to heroin craving or with respect to the severity/typology of psychopathology specific to HUD. Conclusions. The migratory process does not seem to be correlated with addictive behaviors or with psychopathology specific to HUD. It partly affects HUD history, and specifically correlates with emotional reactivity to loss and traumatic life events, so suggesting that in M-HUD individuals, the link between the migratory syndrome and HUD is very close.

The association between posttraumatic disorder symptoms and addictive behaviours in Macao within a sample of female Filipino migrant workers: a network analysis

“…As a potential explanation for their findings, they suggested that individuals who chose to migrate may be younger and healthier. However, Maremmani et al’s ( 2021 ) research suggested that migrants reported greater PTSD symptom severity than Italian patients. Lastly, very few studies have examined nuanced item-level associations between PTSD symptoms and addictive behaviours (Armour et al, 2020 ; Yuan et al, 2022 ).…”

“…First, fewer studies have examined the comorbidity of PTSD and addictive behaviours in Asian cultures (Li et al, 2021 ; Yuan et al, 2022 ) compared to Western cultures. Second, empirical data exploring PTSD and addictive behaviour comorbidity among vulnerable migrants generate contradicting results (Brune et al, 2003 ; Harris et al, 2019 ; Maremmani et al, 2021 ). For instance, Harris et al ( 2019 ) have discovered that Sweden-born individuals had 2 times higher PTSD symptom severity compared to migrants and refugees with any substance use disorders.…”