Involved Agencies/ Sectors:
World Health Organization (WHO),
United Nations Office on Drugs and Crime (UNODC)
Collaboration Framework
Joint UNODC/WHO Programme on Drug Dependence Treatment and Care
Target (Country/ Group):
People likely to witness an opioid overdose in selected cities of Kazakhstan, Kyrgyzstan, Tajikistan, and Ukraine
The Stop Overdose Safely (S-O-S) initiative—developed in compliance with WHO guidelines on Community management of opioid overdose—aims to prevent opioid overdose deaths. Under the umbrella of this initiative a multi-country project was implemented in Kazakhstan, Kyrgyzstan, Tajikistan, and Ukraine, that involved overdose recognition and response training, including the provision of take-home naloxone (THN).
Prevent opioid overdose by promoting access to naloxone and the training of potential first responders in overdose management and evaluate its feasibility and impact. The ultimate goal is to contribute towards reducing deaths due to preventable opioid overdoses.
The project resulted in the rapid distribution of THN; 14,263 potential opioid overdose witnesses were trained within the eight-month implementation phase. The cohort study found that 90% of project participants reported using naloxone at witnessed overdoses across almost all countries (88.1% in Ukraine), in line with UNODC/WHO targets. In almost all instances it was recorded that the victim survived. Extrapolation of the naloxone use figures from the cohort study (31%) to the entire S-O-S project sample of 14,263 would suggest that the implementation may have resulted in naloxone administration by as many as 4,388 individuals, and many lives saved as a result.
Findings suggest that implementing an S-O-S training project in low- and middle-income countries is feasible and can lead to naloxone use at witnessed overdoses. However, project implementation required substantial advance research, consultation and programme development to overcome numerous challenges. Analyses of local policing practices, for example, showed that awareness of opioid overdoses was low in most countries. As a result, project implementers designed and conducted first aid training for police officers in Kyrgyzstan and specific training in overdose responses for some police officers in Ukraine. Concerns about the police’s attitude to naloxone carriage led to the inclusion of a note in naloxone kits indicating that the kits were endorsed by government authorities, even though no country had legislative barriers against the carriage of either naloxone or needles and syringes. In addition, the availability of naloxone in ambulance services varied across countries. These situational factors and other barriers to implementation need to be considered in future S-O-S training projects. Finally, plans for sustaining the project must be made before implementation. In the study countries, take-home naloxone programmes continue but resources have not been allocated to allow their expansion
Study showed that the implementation of a WHO–UNODC S-O-S training project can result in the successful use of take-home naloxone at around 90% of witnessed opioid overdoses in low- to middle income countries.
REPORT
https://apps.who.int/iris/bitstream/handle/10665/340497/9789240022454-eng.pdf?sequence=1&isAllowed=y
PAPER 1
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8886259/pdf/BLT.21.286459.pdf
PAPER 2
https://www.sciencedirect.com/science/article/pii/S095539592100387X?via%3Dihub
WHO Guidelines
https://apps.who.int/iris/handle/10665/137462
