Enhancing Capacity for Comprehensive Drug Use Response in Humanitarian Settings

Background: 

Following the multilayered crises that hit Lebanon since 2019, people living in Lebanon have been facing an increase in vulnerabilities, from the economic crisis, to the Beirut blast to the COVID-19 pandemic. This increase in vulnerability reflects an increase in risk factors of addiction. With only 15 substance use treatment facilities in Lebanon, and 8 out of 15 of them located  in Mount Lebanon and Beirut (MOPH, 2017), there has been an increased need for mental health professionals, case workers, and  frontliners being able to manage cases of substance use (SU) adequately. This case study aims to understand the previous knowledge of frontliners and mental health profwessionals on substance use and their knowledge after a training course with Skoun. 

Methods:

Skoun developed a training of trainers (TOT) for mental health professionals, case workers, and frontliners.These trainings tackled awareness, prevention, adequate methods to suggest SU treatment, and management of substance use disorders. These training sessions were preceded with pre-tests and followed by post-tests. They were administered to 153 participants in 5 locations - Beqaa, Beirut, Tripoli, Saida, and Tyre- through 10 TOTs. This case study aims to understand the base knowledge of these professionals on substance use, and the increase in knowledge following the context relevant training offered. 

Results: after analyzing the pre and post test results of the TOTs, we found that there was a significant improvement in the participants’ perception of substance use. With a 70% decrease in the conception that using is similar to dependance (70.9% pre vs 20% post). As well as an improvement in perception of prevention and treatment, with a 60.53% decrease in the perception that addiction treatment is purely detoxification. An overwhelming 92.73% (versus 69% pre) now understand that strict rules and severe punishment are not a good preventive tool. Moreover, the analysis showed that 80% of the participants showed an increase of knowledge in risk and protective factors, treatment options and interventions, legal framework of SU and treatment in Lebanon; with the average percentage increase in knowledge being 40%. 

Conclusion  

In conclusion, training of this kind significantly improved the perspective of frontliners, case workers, and mental health providers on substance use and people who use drugs. Moreover, it lead to better identification of cases of SUD and adequate referral to diverse treatment options in a timely manner. Finally,  integrating such TOTs into national strategies, emergency humanitarian programing and response will have a major positive impact on treatment, prevention, and identification, as well as a decrease in risks associated with SU.