Theme: Social Science and Policy Research Year: 2021
Background Injection drug use prevalence in Eastern Europe and Central Asia is among the highest worldwide. Opioids are the most common drugs injected, with people who inject drugs a key risk group for opioid overdose death. The UNODC/WHO “Stop Overdose Safely” (S-O-S) initiative, which was informed by WHO recommendations/guidelines, is a multi-country project aiming to prevent opioid overdose deaths. The project was implemented in Kazakhstan, Kyrgyzstan, Tajikistan and Ukraine between 2019-2020, and involved overdose recognition/response training of more than 14,000 potential overdose witnesses and distributing more than 16,000 take-home naloxone (THN) kits across the participating countries. Methods To understand the views and experiences of S-O-S project participants, research teams in participating countries conducted focus groups with 287 participants, including people who use and inject drugs and people likely to witness an overdose. Forty-five individual interviews were also conducted with policy makers, public health administrators and other drug use disorder specialists, who participated in the initiative. Data were analysed thematically. Results Findings revealed previous experiences of trauma and loss, as a result of witnessing an overdose death, were common in the communities where the initiative was implemented. Narratives point to the significance of THN programs as a mechanism for saving lives, but also for addressing widespread discrimination/marginalisation for people who use drugs, with many participants describing feeling valued and cared about, not only by families and friends, but also by health and emergency care providers, as a result of the initiative. Conclusion Our findings highlight how broad access to THN programs can enhance the health and wellbeing of people who use drugs and their communities and have an important role to play in the prevention of overdose deaths. Findings have important implications for policy/practice responses that focus on the issues/needs of people who use drugs in low to middle income countries. Disclosure of Interest Statement Paul Dietze has received an untied educational grant from Indivior for work related to the introduction of buprenorphine/naloxone into Australia, and he has also served as an unpaid member of an Advisory Board for an intranasal naloxone product. Vladimir Poznyak and Dzmitry Krupchanka are staff members of the World Health Organization (WHO) and Anja Busse, Wataru Kashino and Giovanna Campello are staff members of the United Nations Office on Drugs and Crime (UNODC). The authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions or policies of the WHO or UNODC. The S-O-S project was funded by the Bureau of International Narcotics and Law Enforcement Affairs at the US State Department through a contribution to the UNODC-WHO Programme on Drug Dependence Treatment and Care. Paul Dietze is funded by a National Health and Medical Research Council Senior Research Fellowship (1136908).
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