BackgroundKabul has over 12,000 people who inject drugs (PWID), most of them heroin users, and opioid substitution therapy has recently been introduced as an effective method to reduce opioid use. We aimed to evaluate a pilot Opioid Substitution Therapy Pilot Program (OSTPP) in Kabul, Afghanistan, particularly to (1) describe characteristics of the participants enrolled in the program and (2) identify factors associated with client retention in the OSTPP.FindingsTwo cross-sectional surveys evaluated participants attending the OSTPP at baseline (n = 83) and 18 months after (n = 57). Questionnaires assessed socio-demographic, drug use behavior, and general and mental health factors. After 18 months, 57 participants remained in the OSTPP. Participants lost to follow-up were younger (p < 0.01) and married (p < 0.01) and had no family contact (p < 0.01). Participants at 18 months reported no criminal activity in the last month and only two (3.5 %) reported heroin use in the last month, constituting significant decreases from baseline.ConclusionsWhile preliminary results are promising, further evaluation is needed to determine the feasibility of implementing OSTPP in this setting and effectiveness in reducing injection risk behaviors in Afghanistan.

Originally published at: Grünblatt, Edna; Tschakarjan, Senop; Brezinka, Veronika; Walitza, Susanne (2014). Extraordinarily fast response to low-dose sertraline in a child with severe obsessive-compulsive disorder and high functioning serotonin transporter genotype.

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One in four people in the world have a mental or neurological disorder at some point in their lives. People affected by conflict and other situations of violence are particularly vulnerable. Furthermore, conflict situations also strain healthcare systems with already scarce or inadequate resources. The International Committee of the Red Cross (ICRC) works to ensure that the people affected have access to basic healthcare -including mental healthcarethat meets universally recognised standards. The ICRC aims to address psychological and psychosocial needs in a holistic manner, assessing and responding to the various needs, and regularly consulting the individuals and communities concerned. It also takes a multidisciplinary approach. The ICRC has developed a set of activities that seek to respond to different mental health and psychosocial needs and that can be adapted to the different populations the ICRC serves. There is still a large gap between mental health and psychosocial needs and the actual care provided worldwide. The ICRC works to address and reduce this gap.