"Drugs Can Be a Great Coercion": Service Providers' Perspectives on the Relationship between Substance Use and Trauma Bonding among Survivors of Sex Trafficking.

While research has demonstrated a complex relationship between sex trafficking and substance use, the relationship between substance use and trauma bonding is not well understood. A trauma bond refers to an emotional attachment that can develop between victims and their abusers. This study aims to explore the relationship between substance use and trauma bonding among survivors of sex trafficking from the perspective of service providers working directly with survivors of sex trafficking. This qualitative study involved in-depth interviews with 10 participants. Purposeful sampling was employed among licensed social workers or counselors working directly with survivors of sex trafficking. Audio recordings of interviews were transcribed and coded using aspects of a grounded theory approach. Three themes emerged from the data regarding the relationship between substance use and trauma bonding among survivors of sex trafficking: substance use as a tactic, substance use as a risk factor, and substance use as a potential trauma bond. These findings support the need to treat substance use and mental health concerns concurrently among sex trafficking survivors. Additionally, these findings can inform legislators and policymakers as they consider the needs of survivors.