Table 1 Characteristics of substance misuse interventions in conflict-affected populations
Author, year | Country | Population | Objective (design) | Intervention | Implementation challenges |
|---|---|---|---|---|---|
Abatemarco, 2004; West, 2008 | Croatia | Middle school students (49% female, 10–14 years) | Delay alcohol initiation and reduce use (cluster RCT) | School-based educational intervention | Human resources, community buy-in, competing priorities, government turnover |
Agani, 2010 | Kosovo | Family and community members | Strengthen community resilience and resources to address substance misuse (no evaluation) | Linking Human Systems Community Resilience Model (LINC) | None reported |
Armstrong, 2010; Kumar, 2009 | India | People who inject drugs; mean age, 30–31 years; mostly male | Reduce opioid use and related harm (Armstrong, 2010: prospective; Kumar, 2009: cross-sectional) | Sublingual buprenorphine | Sustainable funding |
Bolton, 2014 | Thailand | Adult Burmese refugees | Reduce alcohol and co-occurring mental health problems (RCT) | Transdiagnostic psychotherapy including brief motivational interviewing | Supervision, communication |
DARE, 2014; Lai, 2014 | Thailand | Refugees (male and female, adult and adolescent) | Treat and prevent substance use disorder (pre-, post-test) | Drug and Alcohol Recovery Education (DARE) and rehabilitation | None reported |
Ezard, 2010 | Thailand | Adult male Burmese refugees | Detect hazardous alcohol use and motivate reduction in risky drinking (cross-sectional) | Screening and brief intervention | Stigma, mistrust |
Todd, 2009; Todd, 2015 | Afghanistan | Males who inject drugs; 95% refugees; mean age, 32 years | Reduce injection-related harms (qualitative) | Harm reduction and needle exchange program | Insufficient services, logistics, organization |
UNODC, 2003; UNODC, 2004 | Afghanistan, Pakistan refugee camps | Adults (mostly refugees) with substance use problems | Prevent and reduce substance misuse and promote reintegration (no evaluation) | Capacity building, community awareness, rehabilitation | None reported |
Widmann, 2017 | Kenya | Male (50% refugees); mean age, 27 years | Reduce khat use (RCT) | ASSIST-linked brief intervention | Criminality, political tension |