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When victims of sex trafficking have SUDs, they are often not properly recognized as victims

• There are disparities and systemic racism in the perceptions and recognition of sex trafficking victims, particularly in marginalized communities.
• Sex trafficking victims with SUDs are often frequent users of emergency services and are seen as hostile and uncooperative by first responders because of their addiction and trauma.
• Not much is known about strategies for preventing sex trafficking.
• The co-occurrence of sex trafficking and other types of victimization makes it difficult to identify victims of trafficking.

Victims of sex trafficking who have SUDs often have restricted or limited access to services and quality treatment

• Without the ability to quickly access methadone or other medication-assisted treatment, victims may return to the trafficker for access to drugs or money for drugs.
• SUD relapse and re-trafficking are common among victims.

Victims with SUDs often receive unfavorable treatment within the criminal justice system

• Trafficking victims might not report the trafficking or other victimizations they have experienced to law enforcement because they do not trust criminal justice actors—particularly after an arrest.
• Victims with SUDs and complex trauma might not be seen as credible witnesses by prosecutors, judges, and juries.
• Particularly when SUDs are involved, sex trafficking victims might be unable to engage in traditional court or problem-solving courts.
• Trafficking victims often lack the stability for long-term participation in criminal justice cases, and traffickers use SUDs to manipulate victims and keep them from participating.

Substance use disorder (SUD) is common among victims of sex trafficking. Traffickers may exploit individuals' existing opioid use or other SUDs to coerce them into sex trafficking, or they may facilitate substance use to keep trafficking victims from exiting. Additionally, trafficking victims may use substances to cope with trauma.

The intersections of sex trafficking and SUD complicate both legal responses and victim advocate responses to sex trafficking cases. Victim SUD can lead to challenges for law enforcement and prosecutors in developing cases against traffickers. On the provider side, traditional victim services are often insufficient for victims of trafficking with SUDs, who face substantial barriers to accessing services. A better understanding of the nexus between sex trafficking and SUDs is critical for implementing victim-centered and trauma-informed responses to this vulnerable population.

In this report, the authors describe an online panel, convened in April 2021 by RTI International and the RAND Corporation on behalf of the National Institute of Justice, in which subject-matter experts and criminal justice practitioners discussed how SUDs and sex trafficking complicate the identification and screening of victims and victims' ability to access treatment and legal remedies. The panel participants identified 21 high-priority needs to support a better understanding of sex trafficking and SUDs and a variety of solutions for addressing these intertwined issues.

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