Trauma led us to substance use: an interpretative phenomenological analysis of refugee youth experiences with substance use during the COVID-19 pandemic in Uganda
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Date
2026-02-05
Authors
Akello, Sarah Racheal
Epuitai, Joshua
Ayiasi, Richard Mangwi
Kakyo, Tracy Alexis
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ Publishing
Abstract
Introduction: Refugee populations experience significant psychological stress in host countries. The COVID-19 pandemic worsened pre-existing vulnerabilities and also presented new vulnerabilities for substance use. The study was conducted to examine the pattern of substance use during and after the COVID-19 pandemic among youth residing in a rural refugee settlement camp in north-western Uganda.
Methods: The study was conducted in a refugee settlement camp in north-western Uganda. We used an interpretative phenomenological analysis framework to explore substance use among young people. We conducted eight in-depth interviews and four focus group discussions among youths between the ages of 18–30 years.
Results: We identified two master themes: (1) trauma led us to substance use and (2) desire for belonging and identity kept us in substance use. Young people recounted stories of trauma which served to initiate and promote substance use among them. COVID-19 restrictions on social isolation, social distancing and military enforcement of the restrictions exacerbated previous experiences of trauma resulting in substance use. Refugees, who were already separated from their families in the host country, engaged in substance use following further parental and social isolation, loneliness and reduced support systems in refugee camps. The reduced financial support, unemployment, closure of businesses and schools provided additional motivation to engage in substance use among young people. Surviving the refugee camp heightened the need for belonging to a group. The desire to belong in, to fit in and to stand out in the group altogether served to provide further avenues for substance use among young refugee populations.
Conclusion: Interventions for substance use among refugee youth, particularly during a pandemic, ought to consider the complex landscapes for refugees and their multiple layers of vulnerabilities. Peer pressures and group influence should be given special considerations while planning mitigation measures.
Description
This study explores how young refugees in north-western Uganda turned to alcohol and other substances during and after the COVID-19 pandemic as a way to cope with trauma, isolation, loss of support, and economic hardship. The findings reveal the profound impact of disrupted lives and social stress on the well-being of vulnerable youth, highlighting the human side of substance use as a coping strategy in challenging environments. By centering the voices and lived experiences of young refugees, the research underscores unmet mental health needs and the importance of accessible support systems. The study advances Sustainable Development Goals by addressing mental health and substance use (SDG 3: Good Health and Well-Being), reducing inequalities (SDG 10), and linking economic hardship to risky behaviors (SDG 1). It also contributes to SDG 16 (Peace, Justice, and Strong Institutions) by examining the effects of conflict-related trauma. In alignment with Uganda’s National Development Plan IV, the findings inform strategies for strengthening public health, expanding psychosocial services, and fostering resilience and social inclusion among refugee youth.
Keywords
Refugee youth, Trauma and substance use, COVID 19 pandemic, Lived experiences, Uganda
Citation
Akello, S. R., Epuitai, J., Ayiasi, R. M., & Kakyo, T. A. (2026). Trauma led us to substance use: an interpretative phenomenological analysis of refugee youth experiences with substance use during the COVID-19 pandemic in Uganda. BMJ Public Health, 4(1).