ABSTRACT
Postdisaster ........................................................................................................................... 320 18.3 Dynamics of Substance Abuse Postdisaster ......................................................................... 321
18.3.1 Increase of Substance Use in the General Population to Cope with Stress .............. 321 18.3.2 Persons Nearing Substance Abuse or Dependence Cross the Line .......................... 321 18.3.3 Persons in Active Addiction Increase Use of Substances ......................................... 322 18.3.4 Persons in Recovery Experience Relapse ................................................................. 322 18.3.5 Persons Experiencing Posttraumatic Stress Disorder or Depressive Symptoms
Increase Use of Substances ....................................................................................... 322 18.3.6 Persons in Other At-Risk Groups, Such as First Responders, Increase Use of
Substances................................................................................................................. 322 18.3.7 Complex Dynamics .................................................................................................. 323
18.3.7.1 National Survey on Drug Use and Health Shows Increase in Use among Hurricane Katrina and Rita Evacuees Compared to Those Who Remained ............................................................................... 323
18.3.7.2 Changes in Drug Distribution Networks Postdisaster ............................... 323 18.3.7.3 Localized versus Regional Devastation ..................................................... 323
18.4 Disaster Impact on Substance Abuse and Prevention Treatment Infrastructure .................. 323 18.4.1 Impact of 9/11 Attack on Lower Manhattan Opioid Treatment Providers ............... 324
18.4.1.1 Impact of Hurricane Katrina on Methadone Provision in the South ......... 324 18.4.2 Impact of 2005 Hurricanes on Gulf Coast Substance Abuse Prevention and
Treatment Providers ..................................................................................................324 18.4.3 Loss or Disruption of Recovery Networks ............................................................... 325
18.5 At-Risk Populations .............................................................................................................. 325 18.5.1 Disaster Survivors Who Are in Early Recovery....................................................... 325 18.5.2 Survivors Experiencing Disaster-Related Mental Health Symptoms ....................... 325 18.5.3 First Responders ....................................................................................................... 325 18.5.4 Adolescent Youth ...................................................................................................... 326
18.6 Case Studies .......................................................................................................................... 326 18.6.1 Iowa Disaster Response ............................................................................................ 327
18.6.1.1 2008: Catastrophic Floods ......................................................................... 327 18.6.2 Colorado Disaster Response ..................................................................................... 329
18.6.2.1 2008: Severe Storms and Tornadoes .......................................................... 329 18.6.2.2 2005: Hurricane Katrina ............................................................................ 329 18.6.2.3 2002: Wildœres .......................................................................................... 330
18.6.3 Massachusetts Disaster Response ............................................................................. 331 18.6.3.1 2008: Hurricane Katrina Evacuees and Response ..................................... 331
This chapter will use a multifaceted approach to bring the reader up to date with recent research on the effects of disaster on survivors with substance use problems. The subject of substance abuse has been the focus of relatively few empirical studies in comparison to other areas of disaster research, including disaster mental health, which is also a burgeoning field of study. Much of the serious research on substance use postdisaster occurred within the past decade, since the terrorist attacks of September 11, 2001 (9/11), and again after observing the devastating impacts of Hurricane Katrina on August 29, 2005, along the U.S. Gulf Coast. Some of these research findings are discussed within this chapter. Additionally, the field observations of three different states’ substance abuse responses to disasters are presented. Together, both the scholarly studies and the anecdotal state reports yield a number of considerations for disaster planners and responders. We will discuss some of these considerations and how they informed several important state and federal disaster substance abuse initiatives during the past several years. While the precise relationship between disasters and substance use is still not fully understood, the topic nevertheless merits more serious consideration and should be addressed in the local or state jurisdiction’s overall behavioral health planning and response to disasters.
