Mental health and substance use disorders (SUDs) are the world’s leading cause of years lived with disability; in low-and-middle income countries (LIMCs), the treatment gap for SUDs is at least 75%. LMICs face significant structural, resource, political, and sociocultural barriers to scale-up SUD services in community settings. This article aims to identify and describe the different types and characteristics of psychosocial community-based SUD interventions in LMICs, and describe what context-specific factors (policy, resource, sociocultural) may influence such interventions in their design, implementation, and/or outcomes. A narrative literature review was conducted to identify and discuss community-based SUD intervention studies from LMICs. Articles were identified via a search for abstracts on the MEDLINE, Academic Search Complete, and PsycINFO databases. A preliminary synthesis of findings was developed, which included a description of the study characteristics (such as setting, intervention, population, target SUD, etc.); thereafter, a thematic analysis was conducted to describe the themes related to the aims of this review. Fifteen intervention studies were included out of 908 abstracts screened. The characteristics of the included interventions varied considerably. Most of the psychosocial interventions were brief interventions. Approximately two thirds of the interventions were delivered by trained lay healthcare workers. Nearly half of the interventions targeted SUDs in addition to other health priorities (HIV, tuberculosis, intimate partner violence). All of the interventions were implemented in middle income countries (i.e. none in low-income countries). The political, resource, and/or sociocultural factors that influenced the interventions are discussed, although findings were significantly limited across studies. Despite this review’s limitations, its findings present relevant considerations for future SUD intervention developers, researchers, and decision-makers with regards to planning, implementing and adapting community-based SUD interventions.

中文翻译：

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低收入和中等收入国家基于社区的社会心理药物使用障碍干预措施：叙述性文献综述

心理健康和药物滥用障碍 (SUD) 是世界上导致残疾的主要原因；在中低收入国家 (LIMC)，SUD 的治疗差距至少为 75%。中低收入国家在扩大社区环境中的 SUD 服务方面面临着重大的结构、资源、政治和社会文化障碍。本文旨在识别和描述中低收入国家基于社会心理社区的 SUD 干预措施的不同类型和特征，并描述哪些特定背景因素（政策、资源、社会文化）可能会影响此类干预措施的设计、实施和/或结果。我们进行了叙述性文献综述，以识别和讨论中低收入国家基于社区的 SUD 干预研究。文章是通过在 MEDLINE、Academic Search Complete 和 PsycINFO 数据库中搜索摘要来确定的。初步综合研究结果，其中包括研究特征的描述（例如背景、干预措施、人群、目标 SUD 等）；随后进行了主题分析，以描述与本次审查的目标相关的主题。筛选的 908 份摘要中纳入了 15 项干预研究。所包含的干预措施的特点差异很大。大多数社会心理干预都是简短的干预。大约三分之二的干预措施是由经过培训的非专业医护人员提供的。除了其他健康优先事项（艾滋病毒、结核病、亲密伴侣暴力）之外，近一半的干预措施还针对 SUD。所有干预措施均在中等收入国家实施（即低收入国家没有实施）。讨论了影响干预措施的政治、资源和/或社会文化因素，尽管各项研究的结果显着有限。尽管本次审查存在局限性，但其研究结果为未来 SUD 干预开发人员、研究人员和决策者在规划、实施和调整基于社区的 SUD 干预措施方面提供了相关考虑因素。