Enhancing Treatment Services for People who Use Substances [ENTRUST]

Implementing Organization
Organization of American States [OAS]

Considering that providing care for people facing drug use disorders imposes a heavy burden on public health systems and that there is a significant treatment gap worldwide, a specialized consultancy team will help countries design and implement a plan to carry out specific actions toward addressing the drug problem within the local dimension, based on the needs and opportunity areas identified through drug policy evaluation tools and resources like the Multilateral Evaluation Mechanism (MEM) that countries in the Americas utilize. 


International consensus in finding responses to the world drug use problem highlights the public health approach. Political guidelines and declarations, like the OAS Hemispheric Drug Strategy, underscore the need for treatment services to offer a range of evidence-based, comprehensive therapeutic intervention models that follow internationally validated quality standards oriented toward treatment completion and sustained recovery. Nevertheless, there is a significant gap between the need for care and services available to deal with the consequences of using drugs. Therefore, CICAD is working with countries to expand and strengthen their capacities to offer accessible, timely, and non-discriminatory demand reduction services, ensuring respect for human rights and fostering the highest standards of care. Improving treatment coverage and quality is a worldwide priority that requires national and local quality assurance mechanisms jointly established by authorities and stakeholders within countries’ treatment networks. Their participation in this initiative will provide an intersectoral approach to the input for developing tailored resources oriented to address synthetic drug threats, considering the findings from mechanisms to measure the implementation of strategic anti-drug actions. 

Accomplishments to Date

In November 2023, CICAD hosted a workshop for English-speaking Caribbean countries to develop individualized operational plans concentrated on dealing with the consequences of substance use disorders and walk along with them throughout the preparation, implementation, and evaluation processes. 

Project Activities
  1. Develop individualized proposals for each country based on the findings reported by the mechanisms to measure the strategic implementation of actions aligned with drug policies. 
    1. Gather information on implementing treatment of substance use disorders (guidelines, technical documents, manuals, etc.) at a national level. 
    2. Compile data to assess the availability of information on treatment indicators (coverage, effectiveness, relapse, and retention rates, etc.) and the social consequences of substance use disorders in the population. 
    3. Form working groups that will prepare draft operational plans for optimizing countries' capacity to address substance use disorders. 
    4. Identify potential funding mechanisms and sources for providers to deliver services, programs, and activities in the long term. 
  2. Plan the execution of demand reduction strategies and interventions, identified by countries as priority actions in multiple domains, such as training of health workforce, updating policies and recommendations, developing training specialized training, mentoring, materials and methodologies, carrying out assessments and evaluations, etc. 
  3. Along with countries' authorities, explore the possibilities for approval and implementation of the planned execution of demand reduction strategies and interventions.  
  4. Carry out compliance monitoring with the goals established in the draft Drug Demand Reduction operational plans in the following terms: one, three, six, and twelve months.
  5. Propose financial indicators to evaluate programs' and services' performance. 
  6. Provide technical assistance and manage a network of working groups dedicated to improving care delivery and services to people with substance use disorders, their families, and communities.
  7. Carry out missions to countries to support the implementation of supervision visits to Drug Demand Reduction services. By addressing a different scope level (system, strategy, programs, and services), these visits will supplement others corresponding to ongoing initiatives and programs for quality optimization.
  8. Identify and disseminate best practices implemented by countries. 
Global Level Outcomes
  1. An expanded global health workforce's capacity to deliver accessible, timely, and non-discriminatory services to people facing the health threats and consequences of substance use disorders. 
  2. Tailored operational programs oriented to deal with the consequences of substance use disorders, taking into account the findings coming from mechanisms to measure the implementation of strategic anti-drug actions. 
National Level Outcomes
  1. Enhanced national systems and programs that provide treatment services for people directly affected by drug use disorders, as well as their families, significant others, communities, etc. 
  2. The project will produce a structured network of information on the delivery of drug use disorder treatment programs and interventions. 
  3. Directory of treatment services that currently operate in countries. 
  4. Updated operational program geared toward managing the consequences of drug use disorders. 

Current State Participant 

This initiative is not currently being implemented. 


JoseLuis Vazquez-Martínez Senior Program Officer Demand Reduction Unit +Executive Secretariat of the Inter-American Drug Abuse Control Commission (CICAD) Organization of American States (OAS) E-mail: JVazquez [at] oas [dot] org (JVazquez[at]oas[dot]org)