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The devastating consequences of drug use know no geographic, economic, social, or ethnic boundaries. Each year hundreds of thousands of people around the globe – rich, poor, educated, illiterate, male, female, and even young children – die from substance use disorders, and many are victims of drug-fueled violence. Beyond the toll drugs take on health and welfare, substance use disorders undermine economic development, diminish social and political stability, and reduce security in countries and regions around the world. 

For over four decades INL has responded boldly to this global challenge with innovative, evidencebased drug demand reduction programs which have set the standard in many countries worldwideEfforts include drug prevention and drug treatment services that have had a tremendous impact and have saved countless lives. 

INL, through cross-border dialogues and joint projects with foreign partners, shares programming ideas and proven approaches that treat and prevent drug use. We conduct training that strengthens clinical skills; raise standards of treatment and care; and support long-term recovery. Equally important, INL also conducts long-term evaluations of programs as part of a process of continuous improvement and refinement. As a result, INL-sponsored programs have demonstrated increasingly effective reductions in use and drug related crime. 

The specific goals of INL’s International Demand Reduction Program are to: 

  • Decrease drug use; 
  • Delay the onset of drug use; 
  • Reduce the number of morbidity deaths caused by drug use; 
  • Reduce drug related violence and criminal behavior; 
  • Diminish the presence of drug-fueled gangs and gang membership; and 
  • Establish self-sustained drug prevention, education, treatment, rehabilitation, and aftercare programs in partner countries. 

INL works with government and partner government-supported NGOs to implement drug prevention and treatment programs. To-date INL has partnered with over 85 countries to share drug prevention and drug treatment best practices (see map below).  

In addition, INL collaborates with international organizations, such as the United Nations Office on Drugs and Crime (UNODC)  the Colombo Plan  Organization of American States Inter-American Drug Abuse Control Commission (CICAD)  and the African Union  , to advance regional cooperation and exchange best practices. 

INL drug demand reduction programs include: 

Regional Training  Prevention: The Universal Prevention Curriculum   (UPC) consists of two series, one for managers and supervisors of prevention programs, and one for prevention practitioners. The development of examinations and International Certified Prevention Specialist credentialing program are now underway in INL’s target regions of the Western Hemisphere, Africa, and in Southwest, South, Southeast, and Central Asia. 

Regional Training – Treatment: The Universal Treatment Curriculum   (UTC) is a basic and advanced series of core courses that trains substance use treatment specialists. The UTC is being trained in over 50 countries around the world. As a result of INL-funded training programs, several countries including Kenya, El Salvador, The Bahamas, and Indonesia have adopted national and international-level certification standards for addiction counselors. Through examination and existing working experience drug treatment professionals can earn a credential as an addiction professional. 

Drug-Free Community Coalition Program: INL assists civil society and grassroots organizations to form community anti-drug coalitions in Latin America, Asia, and Africa. Over 200 coalitions are now active in 20 countries (Albania, Argentina, Brazil, Cape Verde, Costa Rica, Dominican Republic, Ecuador, Indonesia, Kenya, Kyrgyzstan, Mauritius, Paraguay, Peru, Philippines, Senegal, South Africa, Tajikistan, Togo, Uganda, and Uruguay). 

Drug Demand Reduction in Afghanistan: Afghanistan’s narcotics industry is responsible for a public health crisis that threatens the country’s long-term development and stability. There are an estimated 2.9 to 3.6 million drug users in Afghanistan — one of the highest per capita rates in the world. 

As the largest supporter of demand reduction programs in Afghanistan, INL’s Drug Demand Reduction program aims to address this mounting challenge including through drug treatment and preventive drug education initiatives. INL works closely with the Ministry of Public Health to implement a comprehensive program that includes prevention, treatment, and aftercare; technical assistance; and capacity building. This includes anti-drug outreach programs targeting Afghan youth. 

Currently, INL supports 86 of the 102 drug treatment programs in Afghanistan. These provide treatment to over 30,000 individuals per year. These centers are operated by 10 Afghan NGOs and the Ministry of Public Health (MoPH), with training and monitoring by the Colombo Plan. Through a transition plan, INL is working closely with the government of Afghanistan to ensure there is sufficient capacity within MoPH to sustain the treatment centers without outside support. 

Promotion of an International Society of Prevention and Treatment Professionals: INL supports a consortium of international organizations in the formation of a new global association for drug treatment and prevention professionals. The International Society of Substance Use Prevention and Treatment Professionals (ISSUP)  , supports the transformation of research into practice by promoting evidence-based prevention and treatment interventions and the training and credentialing of a drug demand reduction workforce. The International Consortium of Universities for Drug Demand Reduction (ICUDDR)   facilitates networking among universities to promote high quality education and training in the field of addiction prevention, treatment and public health interventions. 

Research and Demonstration Programs: INL supports research-based prevention and treatment programs and then identifies and disseminates the most promising results, which are applied in our other demand reduction programs as they are rolled out worldwide. For example, INL research and demonstration programs have resulted in highly effective treatment initiatives targeting high-risk youth and other underserved drug using groups such as women with substance use disorders.  Past outcome evaluations in 10 countries over 20 years have demonstrated success in reducing drug use 31 to 75 percent six months post-treatment; reductions in crime and arrests between 40 to 93 percent; and reductions of gang drug use by 70 percent.   Moreover, INL conducted the first drug use survey that included toxicological testing in Afghanistan, the first survey of its kind to be completed anywhere in the world. The survey revealed that 31 percent of all households in Afghanistan, and 11 percent of the population as a whole tested positive for one or more drugs, with drug use three times greater in rural than urban areas of the country. As a result of the survey, INL has expanded treatment to rural areas and initiating a new prevention program that will mainstream prevention initiatives across government ministries. 

U.S. Department of State

The Lessons of 1989: Freedom and Our Future