Very little evidence has been reported in literature regarding the misuse of substances in rural areas. Despite the common perception of rural communities as a protective and risk-mitigating environment, the scientific literature demonstrated the existence of many risk factors in rural communities. The Drug Prevention and Health Branch (DHB) of the United Nations Office on Drugs and Crime (UNODC), and the World Health Organization (WHO), in June 2016, organized a meeting of experts in treatment and prevention of SUDs in rural settings. The content presented during the meeting and the related discussion have provided materials for the preparation of an outline document, which is the basis to create a technical tool on SUDs prevention and treatment in rural settings. The UNODC framework for interventions in rural settings is a technical tool aimed to assist policy makers and managers at the national level. This paper is a report on UNODC/WHO efforts to improve the clinical conditions of people affected by SUDs and living in rural areas. The purpose of this article is to draw attention on a severe clinical and social problem in a reality forgotten by everyone.

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The present study examined the impact of a novel intervention for children at risk for substance use or actively using substances that was provided to 783 children between 4 and 18 years of age in Afghanistan. They received the Child Intervention for Living Drug-free (CHILD) protocol while in outpatient or residential treatment. CHILD included age-appropriate literacy and numeracy, drug education, basic living safety, and communication and trauma coping skills. A battery of measures examined multiple child health domains at treatment's start and end and 12 weeks later. For younger children, there were no significant Gender or Gender X Time effects (all p's > .16 and .35, resp.). The time main effect was significant for all outcomes (all p's < .00192, the prespecified per-comparison error rate). Post hoc testing showed significant improvements from residential treatment entry to completion for all scales. For older children, a time main effect was significant for (all p's < .00192, the prespecified per-comparison error rate) all but one outcome. Community follow-up means were significantly lower than residential treatment entry means. CHILD had a positive impact on children, and treatment impact endured from posttreatment to follow-up assessment.

Abstract. Substance use among Nigerian adolescents has increased significantly in the past decade, highlighting the need to implement evidence-based, effective prevention programs as one strategy to help reverse this trend. This study aimed to identify profiles of adolescent substance use and parenting and school correlates of these profiles to inform preventive interventions. Latent class analysis identified four distinct use patterns in 2,004 adolescents (46% male; M = 14.8 years) attending public and private schools in Lagos. Low levels of use distinguished the Low Use class (92.1% of the sample), while use of alcohol, cigarettes, and codeine defined the Alcohol Use class (2.9%). Moderate to high use of tramadol and codeine without a prescription differentiated the Nonmedical Use class (2.8%), and high use of most substances defined the High Use class (2.1%). Males, older youth, and private school students engaged in the riskiest substance use. Students in the Low Use class compared to students in the High Use class were more likely to attend public schools and had parents who solicited less information from them but were more disapproving of substance use. Students in the Low Use class relative to students in the Alcohol Use class also were more likely to attend public schools and had parents who solicited less information but knew more about their child’s activities. These findings suggest that tailored preventive interventions with parents and adolescents could be useful and that more research is needed to understand how the private school context confers risk for substance use.

The United Nations Office on Drugs and Crime—World Health Organization International Standards on Drug Use Prevention—reflects the value of safe, nurturing and supportive social institutions around the lives of youths to benefit from the prevention of risky behavior extending beyond individually-developed resilience for healthy adolescent development. Schools are valuable social institutions to this effect and school safety and adolescent health outcomes can be threatened by drug use and violence. As such, collaborative, multi-level, evidence-based, developmentally sensitive, substance use prevention programs are imperative. The International Standards, in their latest version, did not reflect specific evidence of law enforcement officer-based programs with effect on drug use prevention, including in school settings. Nevertheless, the collaboration between law enforcement agencies and school-based substance use prevention programs continue to be the focus of research and policy. In this project, we aim to explore in more detail the role of law enforcement in preventing substance use in schools. We use mixed methods, including three phases: (i) scoping review on the best practices for effective law enforcement in school-based drug and crime prevention; (ii) interviews with experts, using the Delphi method, in substance use prevention and training law enforcement in school-based drug prevention; and iii) developing guidelines for law enforcement based on the findings. Initially, we identified a total of 17 papers that were categorized in four categories based on their results (negative or null effect n = 11 studies, positive effect n = 1 study, mixed effects n = 4 studies and indefinite conclusion n = 1 study). However, the authors of the studies with negative or null effect did recommend being cautious about these results due to the respective studies’ methodological limitations. The actual and perceived roles of police are largely unclear and/or variable. Therefore, clear outlines regarding law enforcement’s role within schools are crucial as one study showed that an officer’s role influences how they respond to student conduct. A secondary emergent theme from this review indicates that there is potential for positively impacting a youth’s perceptions of police through collaborative and engaging school-based programs. Currently the project is gradually moving to Phase II, where we are identifying the key experts based on scientifically published peer reviewed and grey literature/guidelines to investigate elements that make the role of law enforcement officers in school-based prevention more effective. Given the frequency with which policy makers around the world request information about the role of law enforcement in effective prevention efforts, guidelines on their roles within schools is a gap that needs to be filled. Such efforts would improve drug prevention in schools and better orient law enforcement’s role in drug prevention within educational settings.

Afghanistan is one of only four countries in the world with the highest proportion of the population under the age of 15 years (48%). By comparison, adults in Afghanistan, ages 65 and older, represent only 3.7% of the population [1]. With a total fertility rate of 5.3 per woman [2], Having a 'youth bulge' creates an opportunity for economic development when youth are provided with an education and skills training; however, this 'bulge' can also be a threat as an insurgent group can readily attract uneducated youth for their purposes. Each year, 400,000 youth enter the Afghanistan

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