Care in Crises: Addressing substance use disorders in humanitarian emergencies and among displaced populations

Implementing Organization
UNODC in coordination with partner agencies - UNHCR, WHO, IASC and others
Description

The numbers of people in need of humanitarian assistance and the numbers of displaced populations have reached a new record high in 2023. Considering the limited availability of information on substance use in humanitarian emergencies and the limited access to substance use disorder (SUD) treatment and care services in humanitarian contexts, UNODC is promoting the provision of treatment and care to people with SUDs in humanitarian emergencies as an essential component humanitarian assistance. For that purpose, UNODC is building partnerships with humanitarian actors, conducting rapid assessments, working on the development and piloting of practical technical tools including training materials on addressing SUDs in humanitarian settings. With a view to enhance information on substance use disorder treatment needs as well as the development of feasible and effective strategies to provide live-saving care in acute and protracted humanitarian emergencies, UNODC supports humanitarian actors, host countries and vulnerable communities through technical guidance and services for affected populations. 

Background
  1. UNODC World Drug Report 2023 – Special Points of Interest: Substance use disorders in humanitarian settings 
  2. International Standards for the Treatment of Drug Use Disorders   
  3. Rapid Assessment of Substance Use and Associated Health and Social Services in Selected Relief and Humanitarian (Refugee) Settings and Situations 
  4. Mapping of substance use disorder care facilities in French-speaking countries of West Africa (only FR version available).  
  5. Caring for your child in crisis situations 
  6. INCB, UNODC and WHO Joint Statement on Access to Controlled Medicines in Emergencies 
    Scientific articles and posters: 
  7. Testing a Screening, Brief Intervention, and Referral to Treatment Intervention Approach for Addressing Unhealthy Alcohol and Other Drug Use in Humanitarian Settings: Protocol of the Ukuundapwa Chapamo Randomised Controlled Trial 
  8. Moving from feasible to essential: Progress and future directions for promoting the implementation of substance use services for forcibly displaced populations in humanitarian settings  
  9. Priorities for addressing substance use disorder in humanitarian settings 
  10. Testing a Screening, Brief Intervention, and Referral to Treatment Intervention Approach for Addressing Unhealthy Alcohol and Other Drug Use in Humanitarian Settings: Protocol of the Ukuundapwa Chapamo Randomised Controlled Trial 
  11. Upcoming handbook on addressing substance use disorders in humanitarian settings – access to services for displaced populations and host communities in acute and protracted emergencies 
  12. Substance Use Disorders in Humanitarian Settings  
  13. A Multi-Level Parenting Skills Package for Families Living in Challenged Settings (including refugees, internally displaced, etc…)
  14. Care in Crises: Strengthening treatment and care for substance use disorders in Latin America 
  15. Substance use disorders in humanitarian settings can and need to be addressed: Here’s how.
Accomplishments to Date
  • UNODC conducted rapid assessments on substance use among displaced populations in selected relief and humanitarian settings in several countries, including Pakistan, Peru, Uganda, and an assessment is ongoing in Ecuador. 
  • In 2020, UNODC — in coordination with WHO and UNHCR, and with support from the US State Department and the Bureau of International Narcotics and Law Enforcement Affairs— brought together 110 experts for a three-day online consultation aimed at gathering the latest information and expertise on addressing substance use disorders in humanitarian settings. Comprising practitioners as well as people with lived experience, the multidisciplinary team was composed of members from 32 UN Member States, regional and international organizations, academia, and civil society. 
  • Throughout 2023, UNODC has been supporting substance use disorder treatment in Afghanistan, through capacity building of health professionals on elements of psychological and pharmacological treatment for SUDs, as well as SUDs treatment for populations with specific treatment needs. In addition, a workshop on the International Standards for the Treatment of Drug Use Disorders has been facilitated for implementing partner NGOs and other professionals from SUDs treatment centres. 
  • UNODC has conducted a mapping of SUDs treatment facilities available in a range of countries in West Africa, come of which affected by humanitarian emergencies. A total of eight countries have taken part in this mapping exercise: Benin, Burkina Faso, Cote d’Ivoire, Mali, Mauretania, Niger, Senegal and Togo. 
  • In June 2023, UNODC organized a Stop-Overdose-Safely (SOS) Level II training in Ukraine for practitioners from five NGOs engaging in social and health care services. The aim of this capacity building activity was to ensure continued training for potential witnesses of overdose in the community, even in times of conflict and war. 
  • In September 2023, UNODC carried out a training at the Northern frontier of Ecuador on the provision of substance use disorder treatment and care in humanitarian settings to 28 health professionals working with people in human mobility in the northern border of Ecuador. 
  • In 2024, UNODC – in coordination with a local university and NGO – will proceed with data collection in the province of Esmeraldas (Ecuador) on the patterns of substance use among populations in human mobility living in the region and their host community. 
  • UNODC, together with UNHCR and in coordination with the WHO, is developing a Handbook on “Addressing substance use and substance use disorders in humanitarian emergencies and displacement”. The purpose of this handbook is to present resources and key considerations relating to substance use and SUDs prevention, treatment and care for populations in humanitarian emergencies, including populations who have been forcibly displaced. The handbook will be published in 2024. 
  • UNODC has been co-facilitating and co-chairing the Thematic Group on Addressing Substance Use and Substance Use Disorders in Humanitarian Settings of the IASC (Interagency Standing Committee) Reference Group for Mental Health and Psychosocial Support in Humanitarian Settings. Under the framework of this Thematic Group, UNODC, together with WHO and UNHCR, has been developing a set of training materials on substance use for humanitarian practitioners from different levels of expertise. 
Project Activities

The overall goal of the “Care in Crises” programme is to develop a modular set of materials and interventions that can be easily implemented as part of an essential response in humanitarian emergencies, thus saving lives and ensuring the inclusion of people with substance use disorders in other humanitarian responses. 

It is envisaged is to field-test, adapt and disseminate the upcoming handbook on “Addressing substance use and substance use disorders in humanitarian emergencies and displacement” and the IASC training materials in a context of humanitarian emergencies and situations of displacement. 

In order to understand the gaps, strengths and impact of these materials, UNODC will conduct rapid assessments on the availability of, accessibility to and quality of evidence-based SUDs treatment and care in selected humanitarian emergencies or situations of displacement. The results of the assessments will guide implementation of activities at local level and be part of the field testing of the above mentioned handbook and training materials: UNODC will seek to address any gaps identified and adapt the tools to better serve practitioners and people with SUDs in humanitarian settings and in displacement. 

Ongoing and integrated data collection beyond rapid assessments in field-testing sites, with a view to better understand substance use patterns and substance use disorder treatment and care needs in different phases of different humanitarian emergencies and among displaced populations and host communities, will be of additional relevance, also as there have been initial reports on the use of methamphetamine or other synthetic drugs also in humanitarian settings, so as to get a broader overview and understanding of synthetic drugs use in such contexts. 

UNODC proposes the following actions/activities, under the framework of the “Care in Crises” programme: 

  1. Carry out a rapid assessment on the availability and accessibility of substance use disorder treatment in selected contexts of protracted and acute emergencies to ensure the inclusion of substance use services as part of an essential humanitarian response, while evaluating feasibility, usefulness, effectiveness and safety.
  2. Mainstream the inclusion of data collection on substance use and substance use disorders in humanitarian settings and among displaced populations, as part of the development of overall health monitoring and surveillance of vulnerable populations. 
  3. Facilitate context-specific and adapted trainings on the upcoming handbook on “Addressing substance use in humanitarian emergencies” and the IASC training materials for a group of humanitarian practitioners and health/social practitioners in humanitarian settings, and/or working with refugees and displaced populations in specific regions/sites 
  4. Provide follow-up technical assistance to the trained practitioners in their efforts to provide adequate care to people with SUDs living in humanitarian settings and displaced populations 
  5. Include a monitoring and evaluation component in trainings and service provision to identify good practices, assess feasibility and safety of trainings and contribute to the global evidence base on effective interventions to address substance use in humanitarian settings. 
    Global advocacy strategy to ensure that addressing substance use disorders and the inclusion of people with substance use disorders becomes part of an essential response in humanitarian emergencies and among displaced populations 
Global Level Outcomes
  • Enhanced technical guidance on how to address substance use in humanitarian emergencies and among displaced populations: Lessons learnt on ways to improve the availability, accessibility and quality of evidence-based SUDs treatment and care in humanitarian contexts and among displaced populations 
  • Field-tested training materials on addressing SUDs in humanitarian settings, with a view to strengthening the capacities and skills of practitioners working with people in contexts of humanitarian emergencies. 
  • “Leave no one behind” by promoting that evidence-based SUDs treatment and care is available and accessible for all, without any stigma or discrimination, seeking to ensure that people living with SUDs in such settings or situations receive adequate care. 
  • Increase awareness at the international policy level, among humanitarian actors and UN Member States on the importance of evidence-based substance use disorder treatment and care as part of an essential response in humanitarian emergencies and among displaced populations 
National Level Outcomes
  • Enhanced capacity and nationally relevant technical guidance on addressing SUDs in humanitarian settings as well as among displaced populations and affected host population 
  • Enhanced access, availability and quality of evidence-based SUDs treatment and care in the selected implementation regions/sites 

Current State Participation (Organisation): 
UNHCR
WHO

Contact

Anja Busse Programme Officer, Prevention, Treatment and Rehabilitation Section (PTRS), United Nations Office on Drugs and Crime (UNODC) anja [dot] busse [at] un [dot] org (anja[dot]busse[at]un[dot]org)

Current State Participants
Afghanistan
Ecuador
Ukraine