iii
The global burden of disease attributable to alcohol and illicit drug use is signifi cant
by any measure; it amounts to 5.4% of the total burden of disease, according
to the latest WHO estimates (WHO, 2009a). Another 3.7% of the global burden
of disease is attributable to tobacco use. And disorders due to psychoactive
substance use – including alcohol, drug and tobacco dependence – are the main underlying
conditions ultimately responsible for the largest proportion of the global burden of disease
attributable to substance use.
Effective strategies and interventions exist to prevent and treat substance use disorders.
However, effective implementation of such strategies and interventions relies on several
health system levels, including policy frameworks, the organization of prevention and
treatment systems, and provision of prevention and treatment interventions in health
care and other settings.
WHO’s key functions include monitoring health situations and assessing trends. In recent
years the WHO Department of Mental Health and Substance Abuse has produced a series
of ATLAS reports on global resources for mental health and neurological conditions. The
WHO project ATLAS-SU used a similar methodology to collect, compile and disseminate
information from countries on resources that are available for the prevention and
treatment of substance use disorders. This report has been developed on the basis of
that information and provides a general overview of the availability and organization of
prevention and treatment services for substance use disorders around the world, with
particular focus on low- and middle-income countries.
The data presented in this report indicate that mental health services are the main
providers of treatment for substance use disorders in less-resourced countries. In highincome
countries, specialized services play a signifi cant role in service provision for
substance use disorders through a broad range of providers. Specialized services are
important for consolidating and developing expertise and human resources, but improving
the health and well-being of persons with substance use disorders – and their families
– requires easily accessible and affordable services for those in need. Besides, in many
less-resourced countries, specialization for health professionals in substance use disorders
or addiction medicine is not available, or is available on only a very limited scale. In view
of this situation, the most feasible way to improve coverage of treatment is to integrate
prevention and treatment services for substance use disorders into health and social
welfare systems, to make them available and implement them routinely in primary health
care and other non-specialized settings as well as in the criminal justice system, and to
ensure an appropriate provision of treatment or referral to treatment at different points
of entry into the health and social care systems.
Recent initiatives and programmes of WHO, such as the mhGAP programme (WHO,
2008) and the development of the mhGAP intervention guide for mental, neurological
and substance use disorders in non-specialized health settings (WHO, 2010), or the Joint
UNODC-WHO programme on drug dependence treatment and care (UNODC/WHO, 2009),
are expected to improve the coverage and quality of prevention and treatment interventions
for substance use disorders in low- and middle-income countries. They are also expected
to contribute to bridging the gap between population needs and available services,
particularly in health care systems.
Improving the coverage and quality of prevention and treatment interventions for substance
use disorders requires well-developed and well-governed health care systems, properly
educated and trained human resources, fi nancial resources that are commensurate with
population needs, supportive policy and legislative frameworks, and the availability of
appropriate essential medicines. This publication is WHO’s fi rst attempt to cover all these
areas at global level with information collected from 147 countries from around the world,
representing 88% of the world population.
The data presented is this report are based on results of the questionnaire survey of
focal points identifi ed in WHO Member States, and on the efforts of WHO staff to
ensure validity of data. There are many challenges in collecting and presenting this type
of information, from the boundaries of prevention and treatment systems in different
countries to ensuring a common understanding of the terms and concepts used in the
data collection tools. It is acknowledged that these challenges result in limitations to the
presented data. However, the focus of the report is on presenting an overall picture of
available resources for treatment and prevention of substance use disorders globally, in
WHO regions, and in groups of countries with different levels of economic development.
In each subsequent round of data collection, all efforts will be made to improve the validity
and comparability of the data so that trends can be monitored in the development of
prevention and treatment resources for substance use disorders around the world. We
hope that this report will be useful to a wide range of stakeholders, particularly those
engaged in international efforts to improve the prevention and treatment of substance
use disorders in low- and middle-income countries.
http://filedefend.com/qt1c7gf9zd7q/9789241500616_eng.pdf
or
http://adf.ly/FfWiX
The global burden of disease attributable to alcohol and illicit drug use is signifi cant
by any measure; it amounts to 5.4% of the total burden of disease, according
to the latest WHO estimates (WHO, 2009a). Another 3.7% of the global burden
of disease is attributable to tobacco use. And disorders due to psychoactive
substance use – including alcohol, drug and tobacco dependence – are the main underlying
conditions ultimately responsible for the largest proportion of the global burden of disease
attributable to substance use.
Effective strategies and interventions exist to prevent and treat substance use disorders.
However, effective implementation of such strategies and interventions relies on several
health system levels, including policy frameworks, the organization of prevention and
treatment systems, and provision of prevention and treatment interventions in health
care and other settings.
WHO’s key functions include monitoring health situations and assessing trends. In recent
years the WHO Department of Mental Health and Substance Abuse has produced a series
of ATLAS reports on global resources for mental health and neurological conditions. The
WHO project ATLAS-SU used a similar methodology to collect, compile and disseminate
information from countries on resources that are available for the prevention and
treatment of substance use disorders. This report has been developed on the basis of
that information and provides a general overview of the availability and organization of
prevention and treatment services for substance use disorders around the world, with
particular focus on low- and middle-income countries.
The data presented in this report indicate that mental health services are the main
providers of treatment for substance use disorders in less-resourced countries. In highincome
countries, specialized services play a signifi cant role in service provision for
substance use disorders through a broad range of providers. Specialized services are
important for consolidating and developing expertise and human resources, but improving
the health and well-being of persons with substance use disorders – and their families
– requires easily accessible and affordable services for those in need. Besides, in many
less-resourced countries, specialization for health professionals in substance use disorders
or addiction medicine is not available, or is available on only a very limited scale. In view
of this situation, the most feasible way to improve coverage of treatment is to integrate
prevention and treatment services for substance use disorders into health and social
welfare systems, to make them available and implement them routinely in primary health
care and other non-specialized settings as well as in the criminal justice system, and to
ensure an appropriate provision of treatment or referral to treatment at different points
of entry into the health and social care systems.
Recent initiatives and programmes of WHO, such as the mhGAP programme (WHO,
2008) and the development of the mhGAP intervention guide for mental, neurological
and substance use disorders in non-specialized health settings (WHO, 2010), or the Joint
UNODC-WHO programme on drug dependence treatment and care (UNODC/WHO, 2009),
are expected to improve the coverage and quality of prevention and treatment interventions
for substance use disorders in low- and middle-income countries. They are also expected
to contribute to bridging the gap between population needs and available services,
particularly in health care systems.
Improving the coverage and quality of prevention and treatment interventions for substance
use disorders requires well-developed and well-governed health care systems, properly
educated and trained human resources, fi nancial resources that are commensurate with
population needs, supportive policy and legislative frameworks, and the availability of
appropriate essential medicines. This publication is WHO’s fi rst attempt to cover all these
areas at global level with information collected from 147 countries from around the world,
representing 88% of the world population.
The data presented is this report are based on results of the questionnaire survey of
focal points identifi ed in WHO Member States, and on the efforts of WHO staff to
ensure validity of data. There are many challenges in collecting and presenting this type
of information, from the boundaries of prevention and treatment systems in different
countries to ensuring a common understanding of the terms and concepts used in the
data collection tools. It is acknowledged that these challenges result in limitations to the
presented data. However, the focus of the report is on presenting an overall picture of
available resources for treatment and prevention of substance use disorders globally, in
WHO regions, and in groups of countries with different levels of economic development.
In each subsequent round of data collection, all efforts will be made to improve the validity
and comparability of the data so that trends can be monitored in the development of
prevention and treatment resources for substance use disorders around the world. We
hope that this report will be useful to a wide range of stakeholders, particularly those
engaged in international efforts to improve the prevention and treatment of substance
use disorders in low- and middle-income countries.
http://filedefend.com/qt1c7gf9zd7q/9789241500616_eng.pdf
or
http://adf.ly/FfWiX