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Background and Aims: Low and middle-income countries (LMIC) have a disproportionately higher alcohol-attributable disease burden, in conjunction with a minimal focus on primary prevention. Screening and brief interventions can be a promising approach to address this problem. This systematic review aimed to perform a qualitative and quantitative synthesis of studies of brief interventions for harmful and hazardous alcohol use in LMIC. Methods: Systematic review of randomized controlled trials of brief interventions for harmful and hazardous alcohol identified from four electronic databases, conducted in any country identified as LMIC as per the World Bank. We measured differences in intervention and control groups on risk-scores using standard screening instruments, the frequency of heavy drinking, the drinking risk-level, or quality of life and other mental health-related outcomes. Results: A total of 14 studies were included, seven of them from South Africa. On standardized screening instruments, the brief intervention (BI) group had significantly lower scores than controls at 3 months (Hedges' g = - 0.34, P = 0.04), but the effects did not persist at 6- and 12-month follow-up (g = - 0.06, P = 0.68 and g = 0.15, P = 0.41, respectively). There was little evidence to suggest that BIs led to changes in the frequency of heavy drinking or change in the risk level of alcohol use. Surprisingly, a single session (g = -0.55, P < 0.001) fared better than multiple sessions (g = -0.03, P = 0.85). A nurse delivered brief intervention (g = -0.44, P = 0.02) showed better results than BIs delivered by others (g = -0.14, P = 0.66), whereas the outcomes were similar for young adults and middle-age people. Conclusion: Brief interventions for alcohol use show some promise in low- and middleincome countries. Specifically, a single session, nurse-delivered brief intervention for harmful and hazardous alcohol use appears to show a small but significant positive effect in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Background and Aims: Sexual dysfunction is often associated with substance use disorders. This study aimed to synthesize Indian literature on sexual dysfunction among patients with substance use disorders. Materials and Methods: Electronic search engines were used to identify studies of the last 20 years that reported sexual dysfunction with different substance use disorders. Information was extracted using a predefined template. Quality appraisal of the included studies was carried out using Joanna Briggs Institute checklist. Results: Twenty-seven relevant papers were identified that pertained to 24 distinct studies. Most of them were in patients with alcohol dependence, and fewer were in patients with opioid dependence. The study designs were primarily single-group cross-sectional, though many case--control, cross-sectional studies were also identified. The proportion of participants with sexual dysfunction ranged from 22.2% to 76% for studies related to alcohol dependence and 40% to 90% for studies pertaining to opioid dependence. Varied types of sexual dysfunctions were identified, including poor satisfaction, lack of desire, premature ejaculation, and erectile dysfunction. Efforts to address bias and confounders were not reported in most studies. Conclusion: Sexual dysfunction affects a substantial proportion of patients with substance use disorders. Clinicians can make an effort to ascertain and address sexual dysfunction in their routine clinical practice while dealing with patients with substance use disorders. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and its containment strategies have presented unique challenges to India's healthcare infrastructure. While a national lockdown initially resulted in the closure of all licensed liquor shops, it also made healthcare facilities dedicated to the treatment of substance use disorders challenging to access. Addiction treatment services have been functioning at limited capacity with a lack of consensus on operating procedures. In this article, we present actual case scenarios where lockdown affected substance use and the treatment process, and discuss the policy implications and considerations for both. [ABSTRACT FROM AUTHOR]