Substance Use Disorder in Afghanistan: The Situation and Needs to Address the Issue

INTRODUCTION: More than four decades of war and tragedy have destroyed most of the public infrastructure in Afghanistan. Currently, drug use is a major public health crisis in the country and drug treatment services have extremely limited coverage. This article is a review of substance use problem and treatment situation prior to the reinstatement of Taliban. The aim of this article is to provide evidence-based recommendations for policy makers to improve substance use treatment services and to integrate some components of this sector into primary health care and to ensure sustainability of services.

METHODS: A systematic search was conducted using key databases Medline, Embase, PsycINFO and Global Health. Manual search was also conducted to find further studies using Google Scholar, WHO, UNODC, relevant NGOs and Afghan government websites.

RESULTS: Substance use treatment programs have significant achievements over the last recent years in Afghanistan. However, many challenges need to be addressed. Current treatment programs are mainly donor dependent, and their sustainability is not ensured.

CONCLUSIONS: Substance use treatment sector has made significant progress in Afghanistan. But almost all programs have been in forms of shortterm projects funded by external donors. Community based approaches and expanding care to rural areas need to be prioritized as reasonable and cost-effective alternatives for the current resource-intensive programs. Further coordination mechanisms need to be established among different stakeholders to mobilize resources and engage community and local actors.