OBJECTIVES: We aimed to develop a Service Capacity Index for Substance Use Disorders (SCI-SUD) that would reflect the capacity of national health systems to provide treatment for alcohol and drug use disorders, in terms of the proportion of available service elements in a given country from a theoretical maximum. METHODS: Data were collected through the WHO Global Survey on Progress with Sustainable Development Goals (SDG) Health Target 3.5, conducted between December 2019 and July 2020 to produce the SCI-SUD, based on 378 variables overall. RESULTS: The SCI-SUD was directly derived for 145 countries. We used multiple imputation to produce comparable SCI-SUD estimates for countries that did not submit data (40 countries) or had very high level of missingness (9 countries). The final SCI-SUD demonstrates considerable consistency and internal stability and is strongly associated with the macro-level economic, healthcare-related and epidemiologic (such as prevalence rates) variables. CONCLUSION: The presented methodology represents a step forward in monitoring the global situation in regard to the development of treatment systems for SU disorders, however, further work is warranted to improve the external validity of the measure (e.g., in-depth data generation in countries) and ensure its feasibility for regular reporting (e.g., reducing the number of variables).

Department of Epidemiology and Data Science Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam Public Health Research Institute Amsterdam Netherlands

Department of Mental Health and Substance Use Alcohol Drugs and Addictive Behaviours Unit World Health Organization Geneva Switzerland

Department of Psychiatry University of Cambridge Cambridge UK

Department of Public Mental Health National Institute of Mental Health Klecany Czech Republic

Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health Toronto Ontario Canada

Management and Evaluation; and Department of Psychiatry Dalla Lana School of Public Health Institute of Health Policy University of Toronto Toronto Ontario Canada

National Drug and Alcohol Research Centre University of New South Wales Sydney Australia

National Rehabilitation Centre Abu Dhabi United Arab Emirates

PAHO WHO Collaborating Centre at CAMH Toronto Ontario Canada

Psychiatry Department Faculty of Medicine Cairo University Giza Egypt

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