Jagadisha Thirthalli1, Prabhat K Chand. 1. Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India. jaga@nimhans.kar.nic.in
Abstract
PURPOSE OF REVIEW: To enquire as to how applicable are the latest developments in pharmacotherapy of substance use disorders (SUDs) to patients in developing countries. We review the latest literature regarding the magnitude of the problem in developing countries. We then present a review of recent developments in pharmacotherapy of SUDs, especially from developing countries. Finally, we discuss the barriers that prevent patients in developing countries from benefiting from these developments. RECENT FINDINGS: The problem of SUDs is increasing in developing countries and there is a severe shortage of manpower to manage it. Disulfiram, naltrexone and acamprosate are useful in treating alcohol dependence, and likewise methadone and buprenorphine in treating opioid dependence. Strategies of matching patients to medications and combining the medications have shown promise. There is a parallel benefit of reduction in the risk of HIV spread among injecting drug users. However, many barriers prevent an average patient with SUD from benefiting from these developments. CONCLUSION: Medication treatment can improve the outcome of SUDs. Research in this field is catching up in developing countries. However, due to issues of availability, affordability, manpower and governmental policies, a large number of patients in these countries are unable to benefit from recent developments. Urgent efforts are required to fill this gap between research and practice.
PURPOSE OF REVIEW: To enquire as to how applicable are the latest developments in pharmacotherapy of substance use disorders (SUDs) to patients in developing countries. We review the latest literature regarding the magnitude of the problem in developing countries. We then present a review of recent developments in pharmacotherapy of SUDs, especially from developing countries. Finally, we discuss the barriers that prevent patients in developing countries from benefiting from these developments. RECENT FINDINGS: The problem of SUDs is increasing in developing countries and there is a severe shortage of manpower to manage it. Disulfiram, naltrexone and acamprosate are useful in treating alcohol dependence, and likewise methadone and buprenorphine in treating opioid dependence. Strategies of matching patients to medications and combining the medications have shown promise. There is a parallel benefit of reduction in the risk of HIV spread among injecting drug users. However, many barriers prevent an average patient with SUD from benefiting from these developments. CONCLUSION: Medication treatment can improve the outcome of SUDs. Research in this field is catching up in developing countries. However, due to issues of availability, affordability, manpower and governmental policies, a large number of patients in these countries are unable to benefit from recent developments. Urgent efforts are required to fill this gap between research and practice.
Authors: Julia Dickson-Gomez; Gloria Bodnar; Carmen Eugenia Guevara; Karla Rodriguez; Lorena Rivas De Mendoza; A Michelle Corbett Journal: Subst Use Misuse Date: 2010-08-24 Impact factor: 2.164
Authors: Frederick L Altice; Adeeba Kamarulzaman; Vincent V Soriano; Mauro Schechter; Gerald H Friedland Journal: Lancet Date: 2010-07-31 Impact factor: 79.321
Authors: Knowlton W Johnson; Stephen R Shamblen; Matthew W Courser; Linda Young; Melissa H Abadi; Thom Browne Journal: Subst Abuse Treat Prev Policy Date: 2013-06-04