illegal drugsA report by the World Health Organisation has highlighted the need to address a broad spectrum of mental health issues, including substance use disorder (SUD), in order to achieve global public health objectives.

Substance addiction is a large and growing problem for developing societies and, as part of their new study, researchers have evaluated reports on modalities for treating addiction and their effectiveness in the developing world. The study encourages looking at ways to adapt the Alcoholics Anonymous (AA) model to fit cultural norms in different countries.

Resources to address SUD in the developing world are severely limited, however, and some 34% of low-and middle-income nations have not yet developed a substance use policy.

Study lead Dr Craig Katz, of the Icahn School of Medicine in New York, said: "It is difficult to assess the extent of SUD. This is, in part, because of the limited capacity of these countries' governments to conduct national surveys, but it is also due to underinvestment in mental health care in these countries and to underutilization of mental health services in resource-poor settings.

"The poorest nations allocate the smallest portion of their already strained public budgets to mental health."

Although comprehensive overviews of treatment models were markedly absent from the literature surveyed according to, the studies highlight specific areas of need within developing countries, building on existing awareness of general barriers to treatment in those countries.

"Policymakers can use this information to design programs that meet known population needs and avoid providing extraneous services," added Katz.

To watch an exclusive interview with PHE's Mark Gilman at Drugs & Alcohol Today 2014 visit: 

The investigators recommend that future research should blend inquiry with practice. The authors suggest further evaluation of the AA model. There were mixed results in the literature regarding implementation of the AA model in developing countries that invite further exploration, ideally in more systematic and comprehensive ways.

Dr Katz concluded: "Although there is reason to question whether a model that relies so heavily on self-revelation and sharing will work in all places due to cultural and privacy concerns, the AA model has great appeal for developing countries that lack financial resources to create more comprehensive substance use treatment programs.

"Finding successful ways to adapt the AA model in different settings therefore may not only be a cost-effective way to scale up services, but also help foster a culture of awareness of substance use issues that can in turn spark greater investment in medicalized resources beyond what AA can offer."