Family-centered interventions for people with substance use disorders in low-and middle-income country settings: a scoping review.

BACKGROUND

Substance use disorders (SUD) present a significant global health challenge, impacting people who use drugs (PWUD) and their families. While family-centered interventions have shown positive outcomes in high-income countries, their application in low-and middle-income countries (LMICs) remains unexplored. This scoping review sought to synthesize existing research evaluating family-centered interventions for PWUD in LMICs.

METHODS

A comprehensive search was conducted across 6 databases. From 4838 titles and abstracts initially screened, 101 full texts were examined for eligibility. Data was extracted from 20 studies (14 quantitative, 3 qualitative, and 3 mixed method). For qualitative studies, a codebook was developed, and two coders applied thematic analysis principles to identify key themes.

RESULTS

Family-centered interventions were heterogenous in treatment approaches, interventionist training, and duration. Findings revealed improvements in SUD knowledge and outcomes (e.g., increased smoking abstinence, decreased alcohol use and relapse rates). Psychosocial outcomes included improved quality of life, stronger family support, improved communication, and problem-solving skills, as well as reduced depressive symptoms, contributing to PWUD emotional well-being. Qualitative studies corroborated these findings and highlighted multi-level implementation barriers including logistical challenges (transport barriers, competing responsibilities), financial insecurity, mistrust in services, and limited provider capacity.

CONCLUSIONS

Family-centered interventions show promise in improving substance use and psychosocial outcomes among PWUD in LMICs. However, further research is needed to address challenges in effective implementation including ameliorating barriers to sustained engagement and support for long-term recovery to ensure durable effectiveness.