Is substance use of any substance? Study on substance use and mental health on Russian, Somali and Kurdish origin populations in Finland

To date, our knowledge on substance use in migrated populations in their host countries is scarce. In addition, associations between discrimination and substance use have been rarely investigated in the European context. The Finnish Migrant Health and Wellbeing Study (Maamu) collected information in 2010–2012 from Russian (n=526–688), Somali (n=338–472) and Kurdish (n=506–612) origin adults living in Finland using interviews and health examinations. For comparison, general population data were obtained from the national Health 2011 Survey (n=1,165). Alcohol use (AUDIT-C), daily tobacco smoking, lifetime cannabis use were used as outcomes. Substance use was examined in relation to contextual factors, including socio-demographic factors, migrationrelated factors, depressive and anxiety symptoms, potentially traumatic experiences, and perceived discrimination. Statistical analyses were performed using logistic regression and best-fitting models (Akaike’s Information Criteria, AIC). Compared with the general population, binge drinking was less prevalent among all migrant origin groups, while daily tobacco smoking was more prevalent among Russian and Kurdish origin men. Substance use associated with depressive and anxiety symptoms and suicidal ideation among the Kurdish origin population. Potentially traumatic experiences were associated with binge drinking among the Kurdish, and with lifetime cannabis use among Russian origin population. Perceived discrimination was associated with alcohol use and cannabis use only among the Kurdish origin population. In conclusion, substance use occurred in all the studied migrant origin groups but the patterns of substance use and associations to contextual factors were unique to each group. The findings of this thesis draw attention to mental health problems and traumatic experiences associating with substance use to which particularly forced migrants might be exposed. Perceived discrimination associating with substance use highlights its importance as a determinant of wellbeing among migrant origin populations.Päihteiden käyttö ja mielenterveys Suomessa asuvien venäläis-, somali- ja kurditaustaisten keskuudessa Päihteiden käytöstä maahan muuttaneiden keskuudessa on rajoitetusti tutkimustietoa jopa Euroopan laajuudella. Erityisen vähän tiedetään päihteidenkäytön ja syrjinnän välisistä yhteyksistä maahanmuuttajataustaisen väestön keskuudessa. Vuosina 2010–2012 toteutetussa Maahanmuuttajien terveys- ja hyvinvointitutkimuksessa (Maamu) kerättiin tietoa Suomessa asuvista venäläis- (n=526–688), somali- (n=338–472) ja kurditaustaisista (n=506–612) aikuisista haastattelujen ja terveystarkastusten avulla. Suomessa asuvasta yleisväestöstä koostuvan verrokkiryhmän tiedot on poimittu Terveys 2011 tutkimuksen aineistosta (n=1,165). Alkoholin käyttö (AUDIT-C), päivittäinen tupakointi ja elinaikainen kannabiksen käyttö olivat tutkimuksen päätemuuttujia. Päihteidenkäyttöön liittyvinä selittävinä tekijöinä tarkasteltiin sosiodemografisia muuttujia, maahanmuuttotaustaan liittyviä muuttujia, masennus- ja ahdistusoireita, traumakokemuksia ja koettua syrjintää. Tilastolliset analyysit tehtiin logistista regressiota käyttäen ja malleja tarkasteltiin Akaiken informaatiokriteeriä käyttäen. Yleisväestöön verrattuna humalahakuinen alkoholinkäyttö oli harvinaisempaa kaikissa tutkituissa maahanmuuttajataustaisissa ryhmissä. Päivittäinen tupakointi oli venäläis- ja kurditaustaisilla miehillä yleisempää kuin yleisväestössä. Päihteidenkäyttö oli yhteydessä masennus- ja ahdistuneisuusoireisiin sekä itsetuhoisiin ajatuksiin kurditaustaisten keskuudessa. Traumakokemukset olivat yhteydessä humalahakuiseen alkoholinkäyttöön kurditaustaisilla ja elinaikaiseen kannabiksen käyttöön venäläistaustaisilla. Koettu syrjintä oli yhteydessä alkoholinkäyttöön ja elinaikaiseen kannabiksen käyttöön vain kurditaustaisten keskuudessa. Tutkimustulokset korostavat päihteidenkäytön yhteyksiä mielenterveyden ongelmiin ja traumaattisiin kokemuksiin, joita erityisesti humanitäärisistä syistä maahan muuttaneet saattavat kokea. Koetun syrjinnän ja päihteidenkäytön yhteys osoittaa, että syrjintä on merkittävä terveyteen ja hyvinvointiin vaikuttava tekijä maahan muuttaneiden väestönosien keskuudessa

Päihteiden käyttö ja mielenterveys Suomessa asuvien venäläis-, somali- ja kurditaustaisten keskuudessa

Lectio Praecursoria</p

Substance use, affective symptoms, and suicidal ideation among Russian, Somali, and Kurdish migrants in Finland

Comorbidity of substance use with affective symptoms and suicidality has been well documented in the general population. However, population-based migrant studies about this association are scarce. We examined the association of affective symptoms and suicidal ideation with binge drinking, daily smoking, and lifetime cannabis use among Russian, Somali, and Kurdish migrants in comparison with the Finnish general population. Cross-sectional data from the Finnish Migrant Health and Wellbeing Study (Maamu, n?=?1307) and comparison group data of the general Finnish population (n?=?860) from the Health 2011 Survey were used. Substance use included self-reported current binge drinking, daily smoking, and lifetime cannabis use. Affective symptoms and suicidal ideation were measured using the Hopkins Symptom Checklist-25 (HSCL-25). We performed multivariate logistic regression analyses, including age, gender, and additional socio-demographic and migration-related factors. Suicidal ideation (OR 2.4 95% CI 1.3?4.3) was associated with binge drinking among Kurds and lifetime cannabis use among Russians (OR 5.6, 95% CI 1.9?17.0) and Kurds (OR 5.5, 95% CI 1.9?15.6). Affective symptoms were associated with daily smoking (OR 1.6, 95% CI 1.02?2.6) and lifetime cannabis use (OR 6.1, 95% CI 2.6?14.5) among Kurdish migrants. Our results draw attention to the co-occurrence of suicidal ideation, affective symptoms, and substance use, especially among Kurdish migrants. These results highlight the variation of comorbidity of substance use and affective symptoms between the different populations. This implies that screening for substance use in mental healthcare cannot be neglected based on presumed habits of substance use.Peer reviewe

The prevalence of substance use among Russian, Somali and Kurdish migrants in Finland: a population-based study

Background Substance use is a well-known public health problem, but population-based research on migrants’ substance use in Europe is limited. Factors related to the cultural background and current life situation might influence substance use among migrants. Here, the prevalence of substance use in Russian, Somali and Kurdish migrants in Finland is reported in comparison with the general population, and the associations between substance use and socio-economic and migration-related background factors among migrants are analysed.MethodsCross-sectional data from the Finnish Migrant Health and Wellbeing Study (Maamu) and comparison group data of the general Finnish population (n = 1165) from the Health 2011 Survey were used. The survey participants were of Russian (n = 702), Somali (n = 512), and Kurdish (n = 632) origin. Substance use included self-reported alcohol use within previous 12 months (AUDIT-C questionnaire), current and lifetime daily smoking and lifetime use of cannabis and intravenous drugs.ResultsBinge drinking was less prevalent among all migrant groups than in the general Finnish population (Russian men 65%, p p p p p p = 0.04) and Kurdish (29%, p ConclusionsBinge drinking is less common among migrants than in the Finnish general population. However, current daily smoking was more prevalent among Russian and Kurdish migrant men compared with the general population. Younger age, level of education, employment, duration of residence in Finland and language proficiency were associated with binge drinking and daily smoking with varying patterns of association depending on the migrant group and gender. These findings draw attention to the variation in substance use habits among migrant populations.</p

Use of benzodiazepine and related drugs in migrants and Finnish-born persons: a nationwide register-based study

Aims: Benzodiazepines and related drugs (BZDR) are often used longer than generally recommended. The aim is to study patterns of use among migrant and Finnish-born users of BZDR, and to identify factors that are associated with long-term use and BZDR polytherapy. Methods: This register-based study includes a nationwide sample of migrants (n=8729) and their Finnish-born controls (n=11 388) who had purchased BZDR in 2011-2014, but not in 2009-2010. Information on drug purchases was obtained from the National Prescription Register and the duration of drug use was estimated using PRE2DUP method. The main outcomes were long-term use of BZDR, polytherapy and time until discontinuation of BZDR use. Sociodemographic variables and information on preceding psychiatric diagnoses were included as covariates. Logistic and Cox regression analyses were the statistical methods used. Results: Only migrants from Sub-Saharan Africa were more likely to discontinue the medication once initiated than Finnish-born users. Migrants were significantly less likely to be long-term users (adjusted odds ratio 0.79, 95% CI 0.70-0.89) or polytherapy users (aOR 0.90, 95% CI 0.84-0.97) of BZDR compared with Finnish-born participants. Conclusions: Migrants had less long-term and concomitant use of several BZDR than Finnish-born participants. The pattern of use is more optimal among migrants, but it may also reflect poorer access to mental health treatment.</p

Migrants Are Underrepresented in Mental Health and Rehabilitation Services : Survey and Register-Based Findings of Russian, Somali, and Kurdish Origin Adults in Finland

Mounting evidence suggests that migration background increases the risk of mental ill health, but that problems exist in accessing healthcare services in people of migrant origin. The present study uses a combination of register- and survey-based data to examine mental health-related health service use in three migrant origin populations as well as the correspondence between the need and use of services. The data are from the Finnish Migrant Health and Wellbeing Study (Maamu), a comprehensive cross-sectional interview and a health examination survey. A random sample consisted of 5909 working-aged adults of Russian, Somali, and Kurdish origin of which 3000 were invited to participate in the survey and the rest were drawn for a register-based approach. Some of the mental health services, based on registers, were more prevalent in the Kurdish origin group in comparison with the general population and less prevalent in the Russian and Somali origin groups. All the migrant origin groups were underrepresented in rehabilitation services. When affective symptoms were taken into account, all the migrant origin groups were underrepresented in all of the services. This calls for actions to promote mental health, diminish the barriers to access services, and improve the service paths for migrants

Pre-migration traumatic experiences, post-migration perceived discrimination and substance use among Russian and Kurdish migrants-a population-based study

Background and aimsThe associations between traumatic events, substance use and perceived discrimination have been rarely studied among migrants in host countries. We examined whether pre‐migration potentially traumatic experiences (PTEs) or perceived discrimination (PD) are associated with substance use among migrants with voluntary (Russians) and forced (Kurds) migration backgrounds.DesignCross‐sectional interview and health examination data from the Finnish Migrant Health and Wellbeing Study were used. The target sample (n = 1000 for each group) was drawn from the national population register using stratified random sampling by participants’ country of birth and native language.SettingPopulation‐based data were collected from six cities in Finland during 2010–12.ParticipantsThe participation rates were 68% (Russians) and 59% (Kurds). The analytical sample size varied (Russians n = 442–687, Kurds n = 459–613), as some participants completed only interview, health examination or short interview. The majority of Kurds had a refugee background (75%) while Russians had mainly migrated for other reasons (99%).MeasurementsThe three main outcomes were self‐reported binge drinking, daily smoking and life‐time cannabis use. PTEs and PD were self‐reported in the interview. Socio‐demographic background, migration‐related factors and current affective symptoms were adjusted for.FindingsAmong Kurds, PTEs were associated with binge drinking [adjusted odds ratio (aOR) = 2.65, 95% confidence interval (CI) = 1.30–5.42] and PD was associated with life‐time cannabis use (aOR = 3.89, 95% CI = 1.38–10.97) after adjusting for contextual factors. Among Russians, PTEs were associated with life‐time cannabis use adjusting for contextual factors (aOR = 2.17, 95% CI = 1.12–4.18).ConclusionsIn Finland, pre‐migration traumatic experiences appear to be associated with life‐time cannabis use among the Russian migrant population (voluntary migration) and binge drinking among the Kurdish migrant population (forced migration). Perceived discrimination in Finland appears to be associated with life‐time cannabis use among Kurdish migrants.</div

The prevalence of substance use among Russian, Somali and Kurdish migrants in Finland : a population-based study

Background: Substance use is a well-known public health problem, but population-based research on migrants' substance use in Europe is limited. Factors related to the cultural background and current life situation might influence substance use among migrants. Here, the prevalence of substance use in Russian, Somali and Kurdish migrants in Finland is reported in comparison with the general population, and the associations between substance use and socio-economic and migration-related background factors among migrants are analysed. Methods: Cross-sectional data from the Finnish Migrant Health and Wellbeing Study (Maamu) and comparison group data of the general Finnish population (n = 1165) from the Health 2011 Survey were used. The survey participants were of Russian (n = 702), Somali (n = 512), and Kurdish (n = 632) origin. Substance use included self-reported alcohol use within previous 12 months (AUDIT-C questionnaire), current and lifetime daily smoking and lifetime use of cannabis and intravenous drugs. Results: Binge drinking was less prevalent among all migrant groups than in the general Finnish population (Russian men 65%, p <0.01; Russian women 30%, p <0.01, Somali men 2%, p <0.01, Kurdish men 27%, p <0.01, Kurdish women 6%, p <0.01, general population men 87% and women 72%). Current daily smoking was more prevalent among Russian (28%, p = 0.04) and Kurdish (29%, p <0.01) migrant men compared with the reference group (20%). Younger age and employment were associated with binge drinking among migrants. Socio-economic disadvantage increased the odds for daily smoking in Russian, Somali and Kurdish migrant men. Several migration-related factors, such as age at migration and language proficiency, were associated with substance use. Conclusions: Binge drinking is less common among migrants than in the Finnish general population. However, current daily smoking was more prevalent among Russian and Kurdish migrant men compared with the general population. Younger age, level of education, employment, duration of residence in Finland and language proficiency were associated with binge drinking and daily smoking with varying patterns of association depending on the migrant group and gender. These findings draw attention to the variation in substance use habits among migrant populations.Peer reviewe