Abstract
New scientific knowledge and effective, evidence-based interventions have provided health leaders and policymakers a remarkable paradigm to guide the development of addiction treatment services around the world. The definition of addiction as a brain disease, validated screening and assessment tools, medication-assisted treatment, and effective behavioral treatments have served as vehicles for both the United States and other countries to guide the transformation of their substance abuse treatment systems. Seeking to expand international research and infrastructure, the National Institute on Drug Abuse (NIDA)'s International Program has engaged international investigators and institutions in addiction research to promote dissemination of addiction science globally. This paper presents three mixed-methods case studies to exemplify the use of advancements in evidence-based practice in addiction treatment as guides and tools for the creation or further development of treatment systems in three countries, Vietnam, Lebanon, and Abu Dhabi. Results indicate that a framework of evidence-based medicine and empirical science creates a necessary platform from which objective conversations about addictions may begin. Other facilitative factors that help create treatment programs internationally include: a receptive and supportive government, support from international donors and technical experts, networking and interest from other international organizations, and often a synergistic and concerted effort by multiple entities and partners. Despite substantial differences in the circumstances that generated these initiatives and the varying scope of the services, common themes across these efforts have been the implementation of science-based approaches to systems transformation and support for a public health approach to addressing drug abuse and addiction.
Highlights
The development of treatment services for individuals with substance use disorders has been driven by a diverse set of forces and considerations
Drug abuse and addiction treatment began as part of the criminal justice system, social service system, community-based self-help efforts, or some combination of all three
The resulting guidelines were grounded in scientific evidence, and an extensive training program was implemented by local and international clinical experts to promote development of a methadone treatment system based on best practices
Summary
The development of treatment services for individuals with substance use disorders has been driven by a diverse set of forces and considerations. Many of the early “talk therapies” for drug abuse and addiction were based on peer-support approaches or some form of modified confrontational therapeutic community approach.[44] In the 1980s and 1990s, a variety of new behavioral therapies that were backed by scientific evidence supporting their efficacy and application began to emerge.[44,45,46,47,48] Two of these widely disseminated approaches, motivational interviewing and the Matrix Model, have contributed to the development of addiction services internationally.
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