MENTE CLINICAL INSTITUTE · PUBLICATION

In Brief

The Caribbean carries a substantial burden of substance-related harm and remains among the least represented regions in the international addiction literature. This review brings together what is currently known across 18 jurisdictions and documents where the data simply does not exist.

We examined four domains:

Epidemiology

Alcohol dominates: consumption varies widely across the region and alcohol use disorder rates exceed global averages in every jurisdiction examined. The opioid crisis driving North American figures is not mirrored here but with most islands lacking any national drug use survey, much of what exists is modelled estimate rather than measurement, and the true burden is likely underestimated.

Societal impact

Tourism contributes an estimated 11.4% of regional GDP, and the alcohol infrastructure built for visitors operates year-round for residents. Hospitality workers are a documented high-risk group internationally: 3.5 times more likely to drink than low-risk comparison groups. Yet no study of this exists anywhere in the Caribbean.

Policy

Policy has strengthened over three decades, but drink-driving limits sit above WHO recommendations and enforcement lags well behind the law on paper. Mental health receives roughly 2.4% of health budgets in the Americas while accounting for 19% of the region’s disease burden.

Research, prevention and treatment

Substance use data is collected across the region but sits in national drug council repositories unconnected to the institutions able to analyse and publish it. Jamaica is the exception and the model: its drug council partnered with the University of the West Indies, and is one of only four Caribbean SIDS to have published in the regional literature index since 1982.

What this means for Aruba

Aruba sits outside most of this reporting altogether. It is not a UN-designated small island developing state which places it outside several of the data calls and reporting frameworks that determine how the Caribbean gets counted. Aruba has no recent national substance use survey, and has never published in the regional health sciences literature index.

At the same time, Aruba’s economy is among the most tourism-dependent in the region. The one occupational group the international literature identifies as highest-risk for alcohol and substance problems, hospitality workers, makes up a substantial share of the workforce here, and has never been studied anywhere in the Caribbean.

The practical consequence is that services on this island are planned without a measurement of the problem they exist to address. Prevalence is unknown, treatment need is unquantified, and funding decisions are made in that vacuum. Closing that gap does not require new institutions. It requires linking data that is already being collected to people able to analyse and publish it. That is what Mente Clinical Institute was established to do.