Addiction
Early View
Article first published online: 10 MAR 2015

Editorial
Why are we not doing more for alcohol use disorder among conflict-affected populations?
Bayard Roberts1,* and Nadine Ezard2,3
DOI: 10.1111/add.12869
Excerpt [Open Access]
Despite considerable risk of alcohol use disorder (AUD) among civilians affected by armed conflict, the humanitarian response and research on this issue are inadequate. There needs to be greater engagement with AUD among humanitarian, developmental, United Nations, governmental, donor and research agencies. There also needs to be more comprehensive guidance and tools on ways to address AUD.

There are currently more than 50 million people forcibly displaced from their homes as refugees and internally displaced persons (IDPs) due to armed conflict—the highest number since the Second World War. There are also many millions more who remain in areas affected by conflict or have recently returned to them after displacement. The vast majority are in low- and middle-income countries.

There are a number of reasons why we should be concerned about alcohol use disorder (AUD) among conflict-affected civilian populations in low- and middle-income countries. They are often exposed to high levels of violent and traumatic events which are strongly associated with mental disorders such as post-traumatic stress disorder (PTSD), depression and anxiety [1]. Both exposure to traumatic events and these mental disorders are, in turn, associated with AUD [2-6]. Conflict and forced displacement of refugees and IDPs also lead commonly to worse living conditions and impoverishment; the loss of family, friends and livelihoods; and erosion of social support, self-esteem and resilience. Alcohol may be used as a form of self-medication or a coping strategy. Poor living conditions and limited access to health care further increase the disease burden per unit of alcohol consumed [7]. The post-conflict environment may also witness a scaling-up of alcohol promotion as new markets open up and national and transnational alcohol companies expand their activities [8, 9]…