Beyond the Anglo-American World: Advice for Researchers from Developing and Non–English-Speaking Countries

Today, more than 81% of the world’s population lives in nations categorized as lowand middle-income countries (LMICs) (World Bank, 2014). However, there are still few addiction journals published outside Europe, the United States, and Australia (see Table 3.2, Chapter 3), despite the growing need for specialized knowledge in many countries where addiction problems are prevalent. Presently, between 5% and 9% of the world’s population grows up with English as their first language. The dominance of English within scientific communication is, however, overwhelming. It is estimated that 80% of the world’s scientific articles are published in English-language journals (Montgomery, 2004; Van Weijen, 2012). The dominance is particularly strong in the physical and life sciences, whereas local languages may still have important roles in social sciences, law, and humanities. In the addiction field, we estimate that at least three fourths of the known addiction journals communicate in English. This chapter deals with the challenges encountered by addiction scientists who work in countries with few resources as well as those whose first language is not English. The aims of the chapter are to discuss (a) the practical and


Introduction
Today, more than 81% of the world's population lives in nations categorized as low-and middle-income countries (LMICs) (World Bank, 2014). However, there are still few addiction journals published outside Europe, the United States, and Australia (see Table 3.2, Chapter 3), despite the growing need for specialized knowledge in many countries where addiction problems are prevalent.
Presently, between 5% and 9% of the world's population grows up with English as their first language. The dominance of English within scientific communication is, however, overwhelming. It is estimated that 80% of the world's scientific articles are published in English-language journals (Montgomery, 2004;Van Weijen, 2012). The dominance is particularly strong in the physical and life sciences, whereas local languages may still have important roles in social sciences, law, and humanities. In the addiction field, we estimate that at least three fourths of the known addiction journals communicate in English.
This chapter deals with the challenges encountered by addiction scientists who work in countries with few resources as well as those whose first language is not English. The aims of the chapter are to discuss (a) the practical and professional issues that are faced by these scientists, (b) how authors who come from these countries can improve their chances of publishing in English-language journals, (c) the possibilities for authors to publish in both English and an additional language so they can communicate to different audiences, and (d) how to decide whether an article serves the public best by being published in the author's mother tongue and/or a local or regional journal.

The Skewed Distribution of Scholarly Communications
There is a fundamental imbalance between available resources and resource needs in the addiction field. On the one hand, there is as noted above a disproportionate concentration of addiction science and addiction publishing in the richer and English-speaking areas (North America, Europe, and Australia). On the other hand, the majority of the world's population and an increasing share of the addiction problems can be found in LMICs and countries where the native language is not English (Room et al., 2002). For example, Russia, Mexico, and many South American countries have high rates of alcohol-related disease and disability (World Health Organization [WHO], 2011), but few addiction journals can be found in these countries. This imbalance between prevalence of problems on the one hand and scientific and publishing possibilities on the other presents a serious challenge to those interested in the most effective and efficient use of resources in the interests of public health on an international level.
In November 2003, the WHO arranged a meeting called "Mental Health Research in Developing Countries: Role of Scientific Journals. " The joint statement by participating journal editors and the WHO (2004) describes the barriers to scientific publishing experienced by researchers from LMICs in the mental health research field.
The document states that the accumulation of scientific knowledge is dependent on free and accessible communication across the world. The promotion of good research increasingly requires not only the ability to access research from other parts of the world, which in many LMICs still is a problem, but also the opportunity to communicate research results. Researchers from LMICs often have difficulties in publishing their findings in scientific journals. The reasons include limited access to information, lack of advice on research design and statistics, and the difficulty of writing in a foreign language as well as material, financial, policy, and infrastructural constraints. Limited global appreciation of the research needs of LMICs and the comparative anonymity of their researchers may constitute additional barriers. According to the WHO (2004) report, many researchers from LMICs "are daunted by the seemingly insurmountable chasm between their research effort and its publication in international journals" (p. 226).
In a subsequent WHO mapping of research capacity for mental health in 114 LMICs (WHO, 2007), 66 countries had produced fewer than five articles between 1992 and 2003 that were indexed in MEDLINE or PsycINFO. On the other hand, a number of countries-Argentina, Brazil, China, India, the Republic of Korea, and South Africa-at this time all had substantive and increasing scientific production. More than half of the journals that published most of the indexed mental health research articles from LMICs were also edited in these countries.
Most of the problems in research production and indexing could be applied to the addiction field. Many countries with few resources are striving to develop scientific research capabilities in general. Efforts to strengthen addiction research do not always have sufficient political support. Politicians and decision makers in these countries-as in many others-are not necessarily interested in whether certain alcohol or other drug treatment and prevention measures are evidence based or not. Public support may be more important. Also, research results can be difficult to translate into policy. For these reasons, research and scientific publishing on addiction-specific questions may not be high on the list of political priorities. Turci et al. (2010) analyzed for instance the trends of epidemiological production in Brazil from 2001 to 2006. The authors observed that the main themes were public health nutrition, maternal and infant health, and infectious diseases; in short, there was a lack of epidemiological research on alcohol in Brazil.
Career scientists and professionally trained clinicians are needed, but except in the instance of government-sponsored university programs, there is little support for clinical, epidemiological, and policy research. Few LMIC countries have specialist addiction societies in which locally relevant and topical problems can be discussed and solutions developed. Training opportunities are lacking. In some countries, the number of master's and doctoral students has grown, as have specialization courses at the universities (see Chapter 3). But many addiction professionals entering the work force are clinicians in private practice who may do academic work voluntarily or for a small salary. Under the circumstances, the development of addiction research will be slow.
Further, communication with researchers in other countries is often restricted by lack of resources. Many libraries have run out of journal subscription funds, and addiction journals are seldom a priority. In some countries, influential research-funding agencies are now supporting programs that give most universities free access to online periodicals. These programs have improved the availability of international research. For example, the HINARI project was launched in 2002 by the WHO in collaboration with scientific publishers to make health research available in LMICs. Today it covers 13,000 journals and 30,000 e-books in many different languages (see www.who.int/hinari).
The formal communication of locally relevant addiction research is encountering other challenges. Local journals are necessary to deal with sociocultural peculiarities and the priorities of different societies. Presently there is a strong movement in several countries to publish good-quality articles, preferably in English. Because competition in the scientific field is intensifying, publication in indexed journals is a priority for researchers who need scientific credit for their work. Alcohol and other drug science is, however, a young and relatively small field. Local and non-English-language addiction journals have difficulties meeting the criteria for inclusion in U.S. and international indexing systems, such as Web of Science and MEDLINE.
A sign of how problematic the situation still can be is that no addiction journal from the Latin American region has been able to establish itself. As a consequence, many addiction scientists publish in indexed public health or mental health journals when writing for the local or regional audience in this part of the world. Only a small number of these articles are published in English. Publishing in these journals is, of course, in itself not a bad thing. But for the development of the addiction field in a particular country or region, a specialized journal can play an important role. In India, addiction researchers have since 2010 had the possibility to publish addiction research in the Indian Journal of Psychiatry (Murthy et al., 2010), but also the Journal of Mental Health and Human Behavior has articles on addiction. Researchers in African countries have the option of publishing in the African Journal of Drug and Alcohol Studies. In relation to the population and problems, the local publishing availability is anyhow extremely restricted. In many other countries the only option if you want to publish in an indexed addiction journal is to seek for one from outside your own country.
However important national or local journals are, it sometimes can be hard for a researcher from a country with few resources to rely on them. These journals often have limited funds, may be published irregularly, or may have long delays between submission and publication of an article. Not infrequently, these journals will find themselves in a vicious circle: They are not regarded as prestigious enough, which means that they will not get enough good articles, which in turn means that they will not get enough resources and not enough good articles.
Even if there are still relatively few addiction specialty journals outside of North America and Europe, and even fewer that are well indexed, there are some signs that the inequality in access to scientific publication, and in journals' relative status, may be leveling out. For instance, the indexing of non-English-language journals, including addiction journals, with Englishlanguage abstracts in Scopus has increased. Open-access developments and the possibilities to have online-only publications have improved the possibilities to publish without printing costs and also to add non-Englishlanguage versions of English-language articles as online-only supporting material (Meneghini & Packer, 2007). This is not yet an established practice in addiction journals but may be a model for the future. World Psychiatry, the journal of the World Psychiatric Association, is for instance now published not only in English but also in Arabic, Spanish, Chinese, Russian, French, and Turkish, with the aim to improve dissemination of research to clinical psychiatrists in different parts of the world (Maj, 2010).

Marginalisation of LMIC Research in the International Discourse
In academia, faculty are often evaluated by the number of their publications and the impact of the journals in which their articles are published. Publishing in high-impact journals has become the principal aim for many because grants, positions, and funding go to scientists, faculty, and departments that succeed in this respect (e.g., see Linardi et al., 1996). When research funds are in short supply, resources are concentrated in the hands of a few investigators, and the dominance of impact factors contributes to this concentration.
Thomson Reuters, which publishes the most commonly used impact factors, does not provide complete coverage of the world's scientific journals. Englishlanguage journals and especially U.S. journals are better represented. This means that, in general, research conducted in LMICs and reported in languages other than English is under-represented. However, the situation is improving in several regions. SciELO is a bibliographic database and electronic library focusing on the developing world. In 2014, it covered more than 1,000 selected journals from South America, Spain, Portugal, the Caribbean, and South Africa. The topics include health sciences and social sciences, and every article can be downloaded free. In 2013 SciELO reached an agreement with Thomson Reuters Web of Knowledge that will increase the visibility of Latin American and Portuguese language research. This development was possibly facilitated by strong efforts to increase the English language publication of Brazilian research. In Brazil, English language scientific articles now are more common than Portuguese, and there are systematic attempts to improve the quality of the published texts (Science for Brazil, 2013). The African Journals Online (AJOL), a database with nearly 500 journals, has been launched to promote access to African research. About 160 of the journals are devoted to health fields, but only one addiction journal (see above) is listed among them. The European Reference Index for the Humanities and Social Sciences (ERIH PLUS) (which expanded in 2014 to include both humanities and social sciences) is established with the aim to "enhance global visibility of high quality research in the humanities published in academic journals in various European languages all over Europe" (NSD, 2014). In Iran, several electronic databases for scientific publishing were established in 2004. Amin-Esmaili and colleagues (2009) showed that the international databases have a low coverage of Iranian addiction research but argue that, by combining the bilingual (Iranian and English) Iranian databases with big international ones such as MEDLINE, PsycINFO, and Embase, it was possible to cover as much as 80% of the Iranian addiction research publications. Similar efforts are seen in Turkey.
The problems for LMIC researchers who seek to publish internationally may be compounded by structural factors associated with the management of the English-language scientific journals. Around 2000, a survey of the editorial and advisory boards of leading international journals in the field of mental health (e.g., Archives of General Psychiatry, American Journal of Psychiatry, Schizophrenia Bulletin, British Journal of Psychiatry, Adolescent Psychiatry) found only 4 representatives from LMICs among 530 board members (Saxena et al., 2003). The absence of LMIC representation on the editorial boards of the major journals may explain why authors from developing countries often feel that their articles do not receive sympathetic treatment. Thus, research from LMICs is likely to be regarded as less relevant in the international discourse. This is supported by a study of articles published in Addiction (West & McIlwaine, 2002), which found that articles from LMICs were cited significantly less often than those ranked by independent peer reviewers to be of the same quality as those from the developed world. Other studies have shown that an increase in the number of articles published from LMICs is not paralleled by a similar increase in citation of these articles (Holmgren & Schnitzer, 2004;Volpato & Freitas, 2003).
Additional factors that may account for the relatively limited number of publications from these countries include poor research methods, inadequate sample sizes, less-sophisticated statistical analyses, lack of national or regional journals, and limited English-language competence ( see for instance Gosden, 1992)

The Language and Culture Trap
English is the lingua franca of scientific research today and will be in the foreseeable future. However, as Montgomery (2004) points out, to call it "the universal language of science" is ahistorical and possibly inattentive to the complex linguistic developments taking place in the world. In the future, more and more people will be bilingual, and languages other than English will grow in importance. For the present, however, the English language has a dominant position in addiction science.
The scientific world today is dominated by a small group of rich countries. The United States is in the lead, followed by the United Kingdom, Canada, Australia, and the European nations, which are oriented toward a similar scientific tradition and in which English-language training is well developed. The disproportionate influence of research from these countries extends to basic science, prevention, epidemiology, and treatment research. American researchers tend to cite American researchers (see further discussion in Chapter 7 and in Babor, 1993). The same applies to other countries, but with the dominance of journals from the United States and other English-language countries (and English-oriented countries such as Sweden), there is a citation bias across the research field as a whole. Research that is performed in the United States may represent a priori for many Anglo-American readers and some uncritical readers as well-that is, such results may appear to represent a more universal truth than results from a study conducted in a country such as India. Researchers in some Western nations (e.g., the Nordic countries) have adapted to the dominant research paradigms and seem to manage quite well, in terms of citation measurement (Ingwersen, 2002). The under-representation of non-Englishspeaking nations in indexed journals and in cited research extends to several developed countries, such as Spain, Germany, and France (Maisonneuve et al., 2003), suggesting that general linguistic and cultural influences may be at work. The present dominance of a few countries' science on an international level may imply a serious bias in the selection of research topics, questions asked, methods used, and types of research conducted, and a relative neglect of problems in the developing world. There are other problems inherent in this hierarchy within addiction research. Addiction science has at least two subdivisionsbasic and applied research. The former is more or less universal in its nature, and scientific knowledge from basic research can be applied everywhere in the world. The latter is contextual. Public health research, for instance, belongs to this category. Today, public health research in LMICs suffers from a double disadvantage: (a) the difficulty in getting published and quoted in the influential journals and (b) unfair competition at the national and international level with the much better funded neurobiological research (see Midanik, 2004). In short, this means that the world literature on substance misuse is rarely determined by the research priorities of the developing countries.
Commerce plays a role as well and may not favor the public health interests of the poorer parts of the world. Randomized clinical trials of new medicines, with potential markets in richer countries, have a greater probability of being published than brief interventions to treat alcohol and other drug users. Not all policymakers realize that alcohol and tobacco are more important issues than heroin and cocaine in the developing countries (Ezzati et al., 2002).
Again, we can see signs of an improvement in the situation. Warner et al. (2014) analyzed published contributions in the international journal Tobacco Control between 1992 and 2011. The proportion of original-article authors from LMICs during 2007-2011 compared with all the earlier years increased from 7.2% to 22.7% and LMIC lead authors increased from 4.0% to 13.7%. There was also a significant increase in articles covering LMIC issues. In another study (Zyoud et al., 2014), a considerable increase of tobacco articles with authors from Middle Eastern Arab countries was reported between 2003 and 2012.
For researchers from LMICs, some of the problems in getting published come from not being familiar with the codes of international scientific communication. In the above-mentioned survey of physics, chemistry, and biology journals (Gosden, 1992), the editors summarized the problems encountered by researchers who were not native English speakers. The most often mentioned problem was that research results and discussion were not well written: that is, an inability to communicate the importance and relevance of the research. Another important problem was that authors did not know the written and unwritten "rules of the publishing game" (pp. 132-133). For instance, they failed to cite sufficient references to earlier research and were not familiar with the argumentation style or scientific level of the journal (Gosden, 1992). Writing a good scientific article for an international audience demands not only technical skill, such as being able to carefully follow the instructions to authors, but also an acquired competence in social communication. The best way to gain this is by reading some of the journals mentioned in Chapter 3 and getting feedback on your writing from more experienced researchers. This is not always easy in an LMIC.

What Do We Know about Addiction Journals' Language and Cultural Policies?
Unfortunately, we have almost no research to show how addiction journals in general deal with articles from LMICs and only a small, and partly old, amount of information about their language policies. In two surveys conducted by the International Society of Addiction Journal Editors (ISAJE), Edwards andSavva (2002a, 2002b) mapped the language policies of 14 Englishlanguage journals and nine non-English-language journals. Half the editors of the English-language journals who responded had not mastered any language besides English. This is a handicap in a multilingual scientific world. Based on this ISAJE questionnaire, it seems that the English-language addiction journals outside the United States have greater international representation on their editorial boards. The composition of an editorial board can give an indication of the internationalism of a journal. We have no exact knowledge of how the LMICs are represented on the editorial boards, but representation is likely to be low. Among the responding English-language journals in the 2002 survey, the share of research articles from non-English-language countries varied from 0% to 57% at this point of time. In this sample, about one third of the journals had a policy to give special support to authors with mother tongues other than English. Only three of the 14 journals declared that they could not give any language-editing support. Of the non-English-language journals responding to the questionnaire, the majority published only in the language of the country of publication. Several published articles that had already been published in English. Several journals were regional or had international ambitions. All the editors knew English, and several were competent in more than one foreign language. All journals had English summaries. The editorial boards often had representatives from other countries.
In general, because ISAJE is an international organization with particular sensitivity to the language issue, it is possible that addiction journal editors are more conscious than editors in general of the importance of supporting research from non-English-language cultures.

What Can an Author Do?
In this section we turn to some practical suggestions that may help to correct the imbalance, level the playing field, and improve the diversity of addiction science.

Crossing the Cultural Border to the English-language Publications
As noted above, it may be particularly difficult for authors from LMICs and non-English-speaking countries to get an article accepted in an Englishlanguage journal. It is thus especially important for LMIC authors to show that they have mastered the rules of the game: to carefully follow the instructions to authors, checking that the structure, the language, and the presentation of the study and its results are clear and logical and that the references are correct. If the formalities are not followed, even a study containing strong and original findings might immediately be turned down. Cultural bias may put higher demands on research from countries where resources are few. The famous Chilean pharmacologist Jorge Mardones concluded in an interview (Edwards, 1991, p. 392) after a long career: I do not know why there is a generalized attitude of doubt concerning results reported in papers coming from Latin American laboratories. In order to overcome this situation, we need to be extremely certain about the accuracy and high significance of our results, before submitting a paper for publication. I feel that this is an advantage, because the worst thing a scientist can do is to pollute the scientific environment with data of poor value.
Before submitting a manuscript, an author would be wise to find a mentor or an experienced investigator who could read through the article and give advice on the presentation of the results. This may however be difficult in many countries where the addiction research milieu is very small. ISAJE is able in some cases to provide support to unexperienced authors through its mentoring program, in which experienced editors and researchers will help authors to produce publishable manuscripts (see ISAJE's website, www.isaje.net).
Collaborative studies should be encouraged. A survey of Nigerian articles published in a psychology journal showed that more than 75% of the articles were published by single authors, a figure that was much higher than that found in American journals at the time (I. Obot, personal communication, 2004). One suggestion is to try to work in a team that includes people with expertise in different areas, such as statistics and social science. This may help to improve the quality of the study and enhance its appeal to a greater number of readers. Another possibility is to work within a joint project with researchers from non-LMICs or within a large, international network. This is in most cases only possible if you have already published in an international English-language journal or work with other researchers who have international contacts and reputation. International conferences can provide possibilities for networking, but to attend them you need financial resources. In Brazil, it has been possible to document publishing success with this kind of cooperation and international exchange (Barata, 2010).
Technical requirements are relatively easy to identify and follow. A more difficult challenge is that conventions about how to write an article differ among countries. Burrough-Boenisch (2013), in a text on editing problems, gives some examples that show how culturally embedded our scientific writing endeavors are. For an Anglo-American, the author states, the German tradition of writing may seem both pretentious and less well organized. The traditional writing style of some Asian cultures, such as China, Japan, Korea, and Thailand, may give an incoherent impression. Further, when French scientists transfer the French convention of reporting science in the present tense to their English writing, they seem to be stating general truths, rather than describing their own procedures and findings.
In most cases it is not possible for an author to communicate with the readers of a journal if the author cannot talk to them in the "scientific dialect" of that particular publication. (This is of course also true when you choose a publication channel within one linguistic area.) This requires that the author is fairly well acquainted with the specific journal and knows what types of articles are published and in what format.
Some English-language journals are more sympathetic than others to articles from other countries and cultures. This is possible to find out by doing the following: • looking at the journal's mission statement to see if it has any policy regarding articles submitted from different countries or cultures; • checking whether the journal has previously published articles by non-English-language authors; • checking to what extent the editorial board is international, which may imply a greater understanding of cultural diversity and a more multicultural peer-reviewer pool; and • contacting the editor to find out if the journal may be interested in your work-pointing out its particular importance and the possible mitigating circumstances of being from an LMIC or non-English-speaking country. Montgomery (2004) points out that the linguistic future of the world will be one of diversity, bilingualism, or even multilingualism. An important goal in this world will therefore be "to increase tolerance towards variation in scientific English-to avoid the imperial attitude that one standard must be obeyed" (p. 1335). Until this tolerance is developed, however, authors of scientific articles have to take the language issue seriously. As noted above, the way in which authors present their results is often crucial to how the editor and reviewers will view the research report. The importance of good English-language usage cannot be over-emphasized. The presentation of the study and the results is particularly important when the topic or setting may seem new and exotic to the editor and reviewers. It is not just a matter of using the right terminology. Many English-speaking editors and reviewers (similar to many French-, German-, or Swedish-speaking editors) will have a rather strict idea of what constitutes good language.

Crossing the Language Border
Should one do a professional language check before sending in an article? Although it is expensive and time consuming, the answer is YES. If researchers are certain that they have a good case, a more experienced person has read the article and found it good, and the authors want to publish it in a journal with no resources to help with language editing, it will definitely increase the chances of acceptance. There is also the risk that if the article is considered to be a "borderline case, " it will be rejected if there are language problems. However, in rare cases, if the authors know that the journal and the editor have a policy of accepting articles by non-English-language authors and the journal has the resources to do a language check, it may not be necessary to have perfect English at the time of the first submission. But this is a case where contacting the editor beforehand is definitely worthwhile.
A few words about editing services: in most countries, there are English language manuscript editing services available for academic research papers written by non-native English speakers. These manuscript editors are generally native speakers of English with substantial experience in editing scholarly articles, and many of them are accomplished authors in the field. English editing services usually assure that the most important points, ideas, and opinions are communicated in the appropriate style of scientific writing and using the appropriate vocabulary for the context. The text is also checked for typographical and spelling errors, including punctuation.
Services range from a simple language check through to highly detailed copyediting. Additional options may include formatting according to the particular journal's standards, adjusting the word count to meet journal requirements, and writing a cover letter. Many services use an English language expert to complete a substantive edit first, then pass the text on to a professional English proofreader who makes sure the text flows well and the meaning is clear. Of course, all of the options also raise the price of the service, but even a basic language check can be very useful for teams of non-native English authors, when it can be difficult to maintain a consistent style throughout a document.

Killing Two Birds with One Stone: Dual-Language Publication
Where the topic of the article is such that it would be important to publish both at the national level and in an international journal, the author could consider trying to publish the same text in more than one language. In fact, if authors feel that their results should be considered in the development of local policy, publication of the results in an international journal may very well give the findings more prestige among the politicians of their country. Some addiction journals will agree to publish an article that has already been published in another language or to simultaneously publish the article in several languages.
These practices do not violate ethical codes regarding duplicate publication (see Chapter 14) as long as the editors agree and the simultaneous publication is mentioned along with the source of the original. If there is an interest in presenting the article to several audiences, the general rule for the author is to find out the policy of the journal(s). If the journal is published with open access or provides the option to publish additional material online only, there is a possibility that the same journal can publish an English-language and another language version of the same article. Check this with the editor.

Importance of National and Local Publications
As a researcher, one should not be blinded by the prestige of internationalism but instead try to protect the diversity and applicability of research. The diffusion of relevant research to a national audience fulfils important democratic, social, and health policy aims. Brazil has been prioritizing this as well, and there is good research available in Portuguese but not in English with relevance to policies. (Bastos & Bertoni, 2014;INPAD, 2012). The development of culturally specific research is also important for the global development of addiction research.
Nevertheless, some research may lack universal relevance. Research on specific treatment systems, on special treatment modalities, or on effects of nationally implemented policy measures in LMICs may sometimes be irrelevant outside their national or regional audience. In parallel, some of the research published in the big international journals, based on findings in North America or Europe, may not be relevant in other cultural circumstances or in developing countries.
As long as most of the important databases and indexing systems favor English-language journals and journals from the affluent countries, journals published in LMICs and non-English journals may be regarded as less-prestigious publication channels. However, in some countries, such as Nigeria, there has been a growing acceptance of locally published articles as important parts of a person's academic curriculum vitae The African Journal of Drug and Alcohol Studies was set up in response to the number of addiction researchers in Africa having grown and some of the issues of national importance not being of interest to international journals, the only channels for African researchers in earlier times.
The wider acceptance of local publications also recognizes the reality that it is difficult for many researchers to get published in international journals. The number of scientists has increased but not the resources and support-such as libraries and translation services-that are needed to conduct the kind of research and produce the kind of articles that would be interesting for an international journal. This does not mean that the research is not valuable.
For researchers from LMICs, pragmatism in the choice of a publication channel seems essential. As noted above, it can sometimes be problematic to rely on only national or local journals, especially those with few resources, but the situation may be improving.

Conclusions
Addiction problems and their solutions have strong local, national, and cultural characteristics. Addiction research needs to communicate within these milieus. It is important to preserve linguistic and cultural diversity in the communication of scientific findings. Addiction problems are an unfortunate fact of life in many countries and are growing in Latin America, Africa, and Asia. International communication is clearly necessary for the spread of information and can be personally rewarding, as indicated in Box 4.1. The research communities in LMICs need support and encouragement. In a world of increasing globalization, the English-speaking developed world can easily become isolated, not recognizing that it has much to learn from experience in other parts of the world.
In this chapter we have noted some signs that the global balance in science is improving. We know that many international and English-language journals are sympathetic toward publishing research from other countries and linguistic areas (see Edwards & Savva, 2002a, 2002b. The activities within international organizations such as ISAJE will hopefully further increase the awareness of resource, language, and cultural issues among journal editors and the research community in general through fostering networks and striving to change the discriminative practices of the databases and indexing systems. This is the good The following quotation from an interview with Professor Mustapha Soueif, an Egyptian psychologist, cannabis researcher, and internationally recognized addiction expert, shows how exciting it can be to confront the challenges of publishing in multiple languages and different cultures (Edwards, 1991): I have to be "bilingual" if I care for international readership and acknowledgement. And bilingualism is not an easy job. You cannot reduce it to a pendular movement from Arabic to English and vice versa. Rather, you switch off a whole way of thinking, feeling and mode of expression; and tune yourself to a totally different wave length. At the start of your career you find that this exercise is really tough, and overloaded with frustrating moments. But you accept it the way it is, because you chose to have it this way. Gradually, you attain higher levels of relevant skills; your troubles decrease, yet they never disappear.
Another implication is that you have to accept a double load of responsibilities most of the time; I mean your local duties (the university, the private clinic, sharing in national meetings and writing in periodicals) and international requests (usually meetings and writings). Sometimes you have to turn down a request from one side or the other. But you have to be very careful if you intend to play the two roles with optimum smoothness. It takes creative effort to find points of convergence between both, and it is, therefore, highly rewarding.
A third implication is that gradually your role is redefined for you. You are no more just a local scientist with international resonance. You are transformed into a culture-transmitter or a bridging factor. You are expected to behave as a medium for communication between two cultures. Whenever you cross the fence you should do something useful and interesting to the people on the other side. Of course what you carry with you should always be relevant to scientific endeavour. But it is sometimes peripheral. Yet it proves to be quite instrumental in promoting mutual understanding between investigators trying to transcend national and/ or cultural barriers. This is all the more important when it comes to an area like research in drug abuse. (pp. 438-439) Box 4.1: Professor Mustapha Soueif on "Bilingualism" in addiction publishing. news for researchers from less-resourced countries and non-English-language cultures.
The bad news is that the competition within research is hardening, strengthening existing hierarchies in the world of science and putting increasing demands on researchers from LMICs. Researchers from these countries face special challenges. General advice and rules of conduct are of limited value. Hard work and a good dose of pragmatism are needed if you want to communicate your research to the appropriate audience and get scientific credit for it.
In this chapter we have pictured the unique challenges faced by addiction scientists who work outside the cultural and linguistic mainstream. It will take a great deal of skill, persistence, and courage to get to the top of your field. But the rewards awaiting you at the summit may be that much greater, because you will have acquired the skill to read the map and orient yourself both in your country of origin and in the world that lies beyond.
Please visit the website of the International Society of Addiction Journal Editors (ISAJE) at www.isaje.net to access supplementary materials related to this chapter. Materials include additional reading, exercises, examples, PowerPoint presentations, videos, and e-learning lessons.