Drug and alcohol services in middle-income countries.
OBJECTIVE
The present review summarizes current research in middle-income countries on drug and alcohol services for prevention, screening, treatment, care and rehabilitation between June 2006 and December 2007.


RESULTS
There is a dearth of scientific literature on prevention, treatment and rehabilitation in middle-income countries and no novel effective approaches reported during the review period. The Lancet Series on Global Mental Health showed only 0.7% of all papers reviewed were on low-income and middle-income countries. Several studies in these countries confirmed the effectiveness of brief interventions in treating alcohol use disorders at a primary care level. One study on alcohol screening in Brazil produced a promising screening tool. Other studies reported the availability of pharmacological and nonpharmacological treatments for alcohol and drug use disorders. Overall, poor accessibility to services and delayed onset of treatment persist. Political and cultural environments play a crucial role in providing services to fulfill treatment needs.


CONCLUSIONS
During the review period, reports from middle-income countries on alcohol and drug services were very limited. A few studies in some countries confirm the effectiveness of brief interventions in primary care settings. There is an obvious need for more research on alcohol and drug treatment services in middle-income countries.
Perngparn
Usaneya
U
Drug Dependence Research Center, WHO Collaborating Centre for Research and Training in Drug Dependence, College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand. pusaneya@chula.ac.th
Assanangkornchai
Sawitri
S
Pilley
Catherine
C
Aramrattana
Apinun
A
D000437:Alcoholism / Q000453:epidemiology* / Q000517:prevention & control / Q000534:rehabilitation; D001938:Brazil / Q000453:epidemiology; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008097:Lithuania / Q000453:epidemiology; D008403:Mass Screening; D008605:Mental Health Services / Q000706:statistics & numerical data; D002094:Republic of Belarus / Q000453:epidemiology; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000517:prevention & control / Q000534:rehabilitation; D013785:Thailand / Q000453:epidemiology