An observational prospective cohort study of naloxone use at witnessed overdoses, Kazakhstan, Kyrgyzstan, Tajikistan, Ukraine
Étude de cohorte prospective observationnelle sur lusage de naloxone en cas doverdose au Kazakhstan, au Kirghizistan, au Tadjikistan et en Ukraine
Un estudio de cohortes prospectivo y observacional sobre el uso de naloxona en sobredosis presenciadas en Kazajistán, Kirguistán, Tayikistán y Ucrania
Dietze P. Gerra G. Poznyak V. Campello G. Kashino W. Dzhonbekov D. Kiriazova T. Nikitin D. Terlikbayeva A. Krupchanka D. Busse A.
1 March 2022World Health Organization
Bulletin of the World Health Organization
2022#100Issue 3187 - 195 pp.
Objective To determine whether participation in the United Nations Office on Drugs and Crime (UNODC) and the World Health Organization’s (WHO) Stop Overdose Safely (S-O-S) take-home naloxone training project in Kazakhstan, Kyrgyzstan, Tajikistan and Ukraine resulted in naloxone use at witnessed opioid overdoses. Methods An observational prospective cohort study was performed by recruiting participants in the implementation of the S-O-S project, which was developed as part of the broader S-O-S initiative. Training included instruction on overdose responses and naloxone use. Study participants were followed for 6 months after completing training. The primary study outcome was participants’ naloxone use at witnessed overdoses, reported at follow-up. Findings Between 400 and 417 S-O-S project participants were recruited in each country. Overall, 84% (1388/1646) of participants were interviewed at 6-month follow-up. The percentage who reported witnessing an overdose between baseline and follow-up was 20% (71/356) in Tajikistan, 33% (113/349) in Kyrgyzstan, 37% (125/342) in Ukraine and 50% (170/341) in Kazakhstan. The percentage who reported using naloxone at their most recently witnessed overdose was 82% (103/125) in Ukraine, 89% (152/170) in Kazakhstan, 89% (101/113) in Kyrgyzstan and 100% (71/71) in Tajikistan. Conclusion Implementation of the UNODC–WHO S-O-S training project in four low-to middle-income countries resulted in the reported use of take-home naloxone at around 90% of witnessed opioid overdoses. The percentage varied between countries but was generally higher than found in previous studies. Take-home naloxone is particularly important in countries where emergency medical responses to opioid overdoses may be limited.
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Behaviours and Health Risks Program, Burnet Institute, 85 Commercial Rd, Melbourne, 3004, VIC, Australia
Mental Health Department, AUSL of Parma, Parma, Italy
Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
Drug Prevention and Health Branch, United Nations Office on Drugs and Crime, Vienna, Austria
Public Organization Prisma, Dushanbe, Tajikistan
Ukrainian Institute on Public Health Policy, Kyiv, Ukraine
Global Research Institute Foundation, Bishkek, Kyrgyzstan
Global Health Research Center of Central Asia, Columbia School of Social Work, Almaty, Kazakhstan
Behaviours and Health Risks Program
Mental Health Department
Department of Mental Health and Substance Use
Drug Prevention and Health Branch
Public Organization Prisma
Ukrainian Institute on Public Health Policy
Global Research Institute Foundation
Global Health Research Center of Central Asia
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