SUD TREATMENTS IN DEVELOPING

COUNTRY: MONGOLIABY UYANGA BAYANDALAI

THIS PRESENTATION AIMS TO EXPLORE SUBSTANCE USE DISORDERS TREATMENTS IN DEVELOPING COUNTRY, MONGOLIA, AND WHAT RESOURCES ARE AVAILABLE TO INTEGRATE SUD TREATMENTS IN MONGOLIA.

VIDEO: MONGOLIA’S BATTLE WITH THE BOTTLE (2010)

• https://www.youtube.com/watch?v=HsgSO5_H2ho

• According to World Health Organization (2014), in Mongolia, alcohol per capita (15+) consumption (recorded) increased 2.8 during years of 2008 – 2010 with prevalence of heavy episodic drinking 27.0% in 2010. Even though, there are said to have written national policy and action plan for those who abuse and dependent, Mongolian Age-standardized death rates (Liver cirrhosis 78.8 per 100,000 males) and alcohol-attributable fractions (71.7% males) in 2012.

• In 2014, United Nations (UN) review of drug strategies stated that “the world drug problem remains a common and shared responsibility” (National Institute of Health, 2015),

• United Nations Office on Drugs and Crime (UNODC) and World Health Organization (WHO) working together to implement international standards to provide standardized manuals to help United Nations member countries to address SUD in their home states (Gerra, Koutsenok, Saenz, Busse, 2015).

• The global strategy to reduce the harmful use of alcohol, endorsed by the Sixty-third World Health Assembly in 2010, recognizes the close links between the harmful use of alcohol and socioeconomic development. • The level of risk associated with harmful use of alcohol in

developing countries is much higher than in high-income countries where people are increasingly protected by comprehensive laws and interventions (WHO, 2010).

THE GLOBAL STRATEGY TO REDUCE THE HARMFUL USE OF ALCOHOL. • Setting the scene:

• The harmful use of alcohol has a serious effect on public health and is considered to be one of the main risk factors of poor health globally.

• It is estimated that 2.5 million people worldwide died of alcohol-related causes in 2004.

• It is a major avoidable risk factor for neuropsychiatric disorders.

• The degree of risk for harmful use of alcohol varies with age, sex and other biological characteristics as well as setting and context.

• A substantial scientific knowledge base exists for policy-makers to make change.

WHO (2010)

THE GLOBAL STRATEGY TO REDUCE THE HARMFUL USE OF ALCOHOL CONTINUED..

• Challenges and opportunities:

• Increasing global action and international cooperation: it continues to be a global health issue.

• Ensuring intersectoral action: Not only health sector, but also sectors such as development, transport, justice, social welfare, fiscal policy, trade, agriculture, consumer policy, education and employment, civil society, and economic operators need to engage simultaneously.

• According appropriate attention: Policy and decision-makers often give a low priority to preventing and reducing the harm of alcohol use. Affordability and availability of alcohol.

• Balancing different interests: Even though production, distribution, marketing and sales of alcohol create employment, income, and tax revenue, balancing different interests is challenging to policymakers.

• Focusing on equity: Population-wide rates of drinking are lower in poorer societies; however, for a given amount of consumption, poorer populations may experience disproportionately higher levels of alcohol-attributable harm.

WHO (2010)

THE GLOBAL STRATEGY TO REDUCE THE HARMFUL USE OF ALCOHOL CONTINUED..

• Aims and objectives

• The purpose of the global strategy is to support and complement public health policies.

• The vision of the global strategy is improved health and social outcomes for individuals, families, and communities with reduced morbidity and mortality due to use of alcohol.

• It aims to give guidance for action.

WHO (2010)

THE GLOBAL STRATEGY TO REDUCE THE HARMFUL USE OF ALCOHOL CONTINUED..

10 target areas for policy options and interventions:

1. Leadership, awareness and commitment: Policy changes by decisionmakers.

2. Health services response: Health care providers deliver prevention, treatment, and care for alcohol use and alcohol induced disorders and co-morbid conditions.

3. Community action: develop and support community programs and policies.

4. Drink-driving policies and countermeasures: legal B.A.C, suspension of license, ignition interlock, driver education classes, treatments.

5. Availability of alcohol: appropriate licensing system, regulating liquor merchandises and retail sales.

6. Marketing of alcoholic beverages: regulating marketing

7. Pricing policies: taxation

8. Reducing the negative consequences of drinking and alcohol intoxication: policies such as responsible serving of beverage on premises.

9. Reducing the public health impact of illicit alcohol and informality produced alcohol: regulating sales.

10. Monitoring and surveillance: national survey on alcohol consumption. WHO (2010)

SUD TREATMENT BARRIERS IN MONGOLIA• Funding

According to WHO (2010), two-thirds of the WHO member states reported having a government unit responsible for alcohol and drug treatment services, only 45.8% of the countries have an annual budget appropriation for treatment programs. Low-income countries are less likely to have a government unit for treatment or dedicated budget. Tax funding is the most common.

- In Mongolia, client needs to pay out of pocket for the treatment program.

• Public Health model

Not enough researches are done as well as options for treatment facilities. Only one treatment facility in Mongolia. According to WHO (2010), only 100 beds were available.

• Human Resources

Health care professionals, trained counselors

IN CONCLUSION

• A lot of policy changes, education and trainings for professionals, etc. are needed for Mongolia to reduce the harmful use of alcohol and other drugs.

REFERENCES:• G. Gerra, I. Koutsenok, E. Saenz, A. Busse (2015). International Standards in the Treatment of Drug use Disorders. Drug Prevention and

Health Branch, United Nations Office on Drugs and Crime (UNODC), Austria. Retrieved from http://www.drugabuse.gov/international/abstracts/international-standards-in-treatment-drug-use-disorders

• National Institute on Drug Abuse (2012). Principles of Drug Addiction Treatment: A research-based guide. (3rd ed.), National Institutes of Health, U.S. Department of Health and Human Services. Retrieved from http://www.drugabuse.gov/sites/default/files/podat_1.pdf

• National Institute of Health (2015). International Research Collaboration on Drug Abuse and Addiction Research (R01). Department of Health and Human Services. Retrieved from http://grants.nih.gove/grants/guide/pa-files/PA-15-142.html

• United Nations Office on Drugs and Crime, World Drug Report 2015. United Nations publication. Retrieved from http://www.unodc.org/documents/wdr2015/World_Drug_Report_2015.pdf

• World Health Organization (1994). ICD-10 Symptom Glossary for Mental Disorders. Division of Mental Health. Retrieved from http://www.drugabuse.gov/sites/default/files/podat_1.pdf

• World Health Organization (2010). Global strategy to reduce the harmful use of alcohol. Retrieved from http://www.who.int/substance_abuse/msbalcstragegy.pdf

• World Health Organization (2010). ATLAS on substance use: resources for the prevention and treatment of substance use disorders. WHO Press: Geneva. Retrieved from http://www.who.int/substance_abuse/publications/treatment/en/

• World Health Organization (2014). Global Alcohol Report by country: Mongolia. Retrieved from http://www.who.int/substance_abuse/publications/global_alcohol_report/profiles/mng.pdf?ua=1

• Video: Mongolia’s battle with bottle by Aljazeera English. Retrieved from https://www.youtube.com/watch?v=HsgSO5_H2ho