This article reviews an emergency department-based clinical vignette of a trafficked patient with co-occurring pregnancy-related, mental health, and substance use disorder issues. The authors, including a survivor of human trafficking, draw on their backgrounds in addiction care, human trafficking, emergency medicine, and psychiatry to review the literature on relevant general health and mental health consequences of trafficking and propose an approach to the clinical complexities this case presents. In their discussion, the authors explicate the deleterious role of implicit bias and diagnostic overshadowing in trafficked patients with co-occurring addiction and mental illness. Finally, the authors propose a trauma-informed, multidisciplinary response to potentially trafficked patients. © 2017 American Medical Association. All rights reserved.

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emergency medicine pregnancy complication complication Pregnancy Complications human ethics Ethics, Medical medical ethics Substance-Related Disorders Physicians Crime Victims Mental Disorders Humans psychology case report female pregnancy human trafficking physician hospital emergency service Emergency Service, Hospital crime victim psychiatry Delivery of Health Care health care delivery