The global movement towards a public health approach to substance use disorders

Abstract

Drug misuse is a global problem. Markets that supply illegal drugs often span international borders. However, each country has different primary drugs of use, populations that are using and consequences of use. The policy approach of each country to addressing substance use disorders can be characterized along a continuum between purely public health approaches and purely law enforcement approaches. Historically, a law enforcement approach has been the primary strategy in much of the world. However, there is a growing movement towards use of a public health approach. This article provides four case examples, Ukraine, Philippines, Nigeria and Peru, where there is movement to develop addiction public health infrastructure. The work varies by country, but includes regulatory changes, workforce development and resource allocation all of which are supported by the United Nations Office on Drugs and Crime (UNODC) and multi-national organizations that provide training and technical assistance, funded primarily by the European Union and United States governments. All four countries highlighted have barriers to moving towards a more public health approach which may include popularity of the law enforcement approach, turbulent government environments, and economics of being a drug producing nation. However, whether starting from the top down with changed policies, such as Ukraine or from the bottom up with training community members as in the Philippines, each country provides an example of how donor resources can be applied to make the transition towards a more humane and evidence-based approach to addressing substance use disorders. Key Messages While the primary approach to addressing drug use has focussed resources on law enforcement for over 100 years, many countries are adopting elements of a public health approach including prevention and treatment of the harms of drug use including substance use disorders. There is a growing global movement to make policy towards drugs and drug users more humane and evidence-based. Donor nation resources can be applied in a variety of combinations to improve care and outcomes for people who use drugs in low- and middle-income countries.

Mental Health of Adolescents Exposed to the War in Ukraine

“…Even before the war, the population of Ukraine had substantial mental health needs. [33][34][35][36] For example, the population prevalence of major depressive disorder and alcohol use disorders has been reported to be higher in Ukraine than other areas in Eastern Europe. 34 In addition, the country's mental health care system has faced challenges: psychosocial interventions are not widely available in Ukraine; instead, Ukraine's psychiatry services rely on inpatient care and a medication-focused approach.…”

“…Even before the war, the population of Ukraine had substantial mental health needs . For example, the population prevalence of major depressive disorder and alcohol use disorders has been reported to be higher in Ukraine than other areas in Eastern Europe .…”

Prevalence of metastases in patients with head and neck tumors in a public radiotherapy service

“…Faz-se importante saber que o uso abusivo de SPA é considerado como um problema de saúde pública global que acompanha a história da humanidade (JOHNSON et al, 2022;NAWI et al, 2021).…”

“…O consumo de drogas é influenciado por diversos fatores de risco, que podem ser genéticos, pelo desenvolvimento, inserção cultural e fatores psicossociais (VOLKOW; MICHAELIDES; BALER, 2019;LO;YEUNG;TAM, 2020;NAWI et al, 2021). Frente a isso, cada país deve ter uma abordagem específica para a abordagem aos usuários e os transtornos decorrentes do uso, na qual a prevenção e o tratamento são as principais estratégias para o enfrentamento dessa problemática (JOHNSON et al, 2022;LO;YEUNG;TAM, 2020TAM, , 2020.…”

Equine-assisted therapy effectiveness in improving emotion regulation, self-efficacy, and perceived self-esteem of patients suffering from substance use disorders

“…Substance Use Disorders (SUD) is a term replacing the diagnoses of abuse and dependence adopted in DSM-4 and DSM-5 [ 1 ]. It is an overwhelming public health problem throughout the world, with increasing trends throughout the last few decades [ 2 ]. This could be attributed to many social determinants such as feeling of insecurity, trauma, severe distress, and repression [ 3 ].…”