Human trafficking exists in at least 124 countries worldwide and in every state including New York.1 Traffickers use coercion and psychological abuse, deception and fraud, threats, physical and sexual violence, abusive work and living conditions, and coerced substance use to lure their victims. Additionally, international studies have found that traffickers force drug use as a form of coercion. Some reports suggest that US drug traffickers also control their victims with substance use and addiction. Additionally, preexisting substance use can be a risk factor for youth involvement in exchanging sex for money.2
Trafficked women and girls experience severe and potentially life-threatening physical and mental health consequences, which can be lifelong. Serious mental problems result, including anxiety, depression, self-injurious behavior, suicidal ideation and suicide, substance use disorder, PTSD, dissociative disorders, and complex PTSD. Physical consequences can include neurological issues, gastrointestinal disturbances, respiratory distress, chronic pain, sexually transmitted infections (including HIV), urogenital problems, dental problems, fractures, and traumatic brain injuries (TBI).3
Every day in the United States, human trafficking victims interact with health care providers, but these victims are rarely identified. Fear, shame, and trauma frequently prevent disclosure.4 Health care providers should employ a trauma-informed approach informed by a human rights-based framework when working with human trafficking survivors.5 Any patient/client encounter involves obtaining and analyzing subjective and objective data with varying degrees of uncertainty and using the information to formulate a care plan. However, in cases of potential human trafficking, the stakes are particularly high, underlining the need for a protocol, and a multidisciplinary approach that is survivor-centered, culturally relevant, evidence-based, gender-sensitive, and trauma-informed.6
Relationship-building tips for working with human trafficking survivors include the following:
- Create a safe space for private screening; meet the person’s physical needs;
- Adopt open, nonthreatening body positioning;
- Engage the patient/client;
- Adapt the screening process to accommodate the person’s individual needs;
- Avoid the temptation to probe for any unnecessary details;
- Use respectful and empathetic language; and
- Be prepared to respond to a potential trauma reaction.7
Task Force for Human Trafficking
OASAS participates on the state’s Interagency Task Force for Human Trafficking. We work in cooperation with the Governor’s Office and a number of state agencies to educate the public on how to identify the signs of human trafficking, train local government and law enforcement officials to identify individuals who may have been trafficked, propose legislation to crack down on traffickers, and develop strategies for referring survivors to local support services.
The New York State Office of Temporary and Disability Assistance funds providers in New York State that will help victims of human trafficking become secure, independent individuals. Anyone who suspects they may be a victim or a witness to human trafficking is encouraged to call the Human Trafficking Resource Center at 1-888-373-7888, which will help with locating resources within your community. You can also text “HELP” to 233733 (BeFree). If you are experiencing an emergency, please contact your local police department or dial 911.
If you are in need of treatment for substance use disorders, use the FindAddictionTreatment.ny.gov tool to locate a program with real time availability or call the New York State HOPEline at 1-877-8-HOPENY or text 467369.
1 Hanni Stoklosa, MD, MPH, et al. Medical Education: Medical Education on Human Trafficking, American Medical Association Journal of Ethics, October 2015, Volume 17, Number 10: 914-921.
2 American Psychological Association. Report of the Task Force on Trafficking of Women and Girls, 2014.
3 American Psychological Association. Report of the Task Force on Trafficking of Women and Girls, 2014.
4 The Human Trafficking Legal Center and HEAL Trafficking. Fact Sheet: Human Trafficking & Health Care Providers: Lessons Learned from Federal Criminal Indictments and Civil Trafficking Cases, 2017.
5 Hanni Stoklosa, MD, MPH, et al. Medical Education: Medical Education on Human Trafficking, American Medical Association Journal of Ethics, October 2015, Volume 17, Number 10: 914-921.
6 Hanni Stoklosa, MD, MPH, et al. Medical Education: Medical Education on Human Trafficking, American Medical Association Journal of Ethics, October 2015, Volume 17, Number 10: 914-921.
7 Administration for Children and Families Office on Trafficking in Persons and National Human Trafficking Training and Technical Assistance Center. Adult Human Trafficking Screening Tool and Guide, 2018.