“…are generally denied full rights to political, economic and societal integration (employment, property ownership), are restricted access to public education, public health care and social services, and consequently experience acute socio-economic deprivation ( Habib et al., 2012 ; Kitamura et al., 2018 ). Further to the political insecurity, complicated by the impending angst around the ‘right to return’, Palestinian refugee communities in the drug transit and drug production countries of Lebanon, Jordan, Syria, West Bank and Gaza are reported to increasingly experience camp insecurity and drug related health threats and vulnerabilities ( Thabet & Dajani, 2012 ; UNRWA/UNICEF, 2018 ; Massad et al., 2016 ; Al-Afifi et al., 2019 ; Damiri, 2019 ; Syam et al., 2019 ; Van Hout et al., 2019 ; Wazaify et al., 2020 ). These conditions inside camps, along with tensions with the outside or host communities collectively increase their risk of substance use and high-risk drug use ( Afifi et al., 2019 ; Anera, 2019 ).…”