1. Priorities for addressing substance use disorder in humanitarian settings

Populations affected by humanitarian emergencies are vulnerable to substance (alcohol and other drug) use disorders (SUD), yet treatment and prevention services are scarce. Delivering SUD treatment services in humanitarian settings is hampered by limited guidance around the preparation, implementation, and evaluation of SUD treatment programs. This study aimed to identify and prioritize key gaps and opportunities for addressing SUD in humanitarian settings.

UNODC convened a consultation meeting (n = 110) in coordination with UNHCR and WHO and administered an online survey (n = 34) to thirteen program administrators and policymakers, eleven service providers, nine researchers, and one person with lived experience to explore best practices and challenges to addressing SUD in diverse populations and contexts.

Participants agreed on key principles for delivering SUD treatment in humanitarian settings that centred on community engagement and building trust, integrated service delivery models, reducing stigma, considering culture and context in service delivery, and an ethical ‘do no harm’ approach. Specific gaps in knowledge that precluded the delivery of appropriate SUD include limited knowledge of the burden and patterns of substance use in humanitarian settings, the effectiveness of SUD treatment services in humanitarian settings, and strategies for adapting and implementing interventions for a given population and humanitarian context.

Results from this consultation process highlight existing gaps in knowledge related to the epidemiology and treatment of SUD in humanitarian emergencies. Epidemiological, intervention, and implementation research as well as operational guidance are needed to fill these gaps and improve access to substance use treatment services in humanitarian settings.