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Injection drug users’ knowledge about overdose prevention and take home Naloxone in Ukraine. ICF 'International HIV/AIDS Alliance in Ukraine Liudmyla Shulga Anna Tokar. Presentation outline. Reasons for paying attention to OD – Ukrainian context Data available Challenges and solutions. - PowerPoint PPT Presentation
Citation preview
Injection drug users’ knowledge about overdose prevention and take home
Naloxone in Ukraine.ICF 'International HIV/AIDS Alliance in Ukraine
Liudmyla ShulgaAnna Tokar
Presentation outline
• Reasons for paying attention to OD – Ukrainian context
• Data available
• Challenges and solutions
Background2008• Literature review on OD scale and use of Naloxone.• First training on OD prevention and Naloxone use. No systemic work on
organizational level.
2009• Start of OD prevention programs with take home Naloxone in 37 NGOs
– Training on programme implementation for social workers– Evaluation of Naloxone use efficacy
• During 12 months 500 ampoules of Naloxone distributed.
2010• 81 Alliance-Ukraine supported organizations implement OD prevention• 57 of them buy Naloxone (15 948 ampoules).
Addressing concerns
• Behavioral surveys (2007, 2009): 11-14%
• Peer Driven Intervention: 30-33%
• Survey, 2010: 49 (F) - 53 (M)%
Survey, 2010• Location: 15 cities
• Sample size: 2821 IDUs (72% M, 28% F), aged 17 - 58 y.o.
• Recruited by word of mouth
• Interviewer-assisted questionnaires
Respondent Characteristics
17-24 25-30 31-35 36-580
5
10
15
20
25
30
35
15
29
24
30
17
34
20
27
malefemale
OD cases
1 time 2 times 3-5 times 6 times and more Do not remember0
10
20
30
40
50
60
70
80
OD cases ever during lifetime (N=1461)OD cases during last 6 months (N=391)
During Naloxone refill: which drugs did you use at last OD?
ATS+O
Benzo
s + O
+Methad
on
O+alcoh
ol O
ATS + aloh
ol
Bupren
orphin
e
alcoh
ol
benz
oATS
methad
onoth
er0
10
20
30
40
50
60
70
8079 78 77 77
1823
1814 12
2 2
Series1
Challenges “behind the curtains”
• Naloxone is a prescription drug which makes its distribution more expensive and not anonymous.
• Absence of official statistic on OD prevalence and prevalence of OD-induced deaths.
• Death certificates contain information about “poisoning” without specification. This happens due to lack of equipment the cost of which is not affordable for the state.
• Naloxone is used as a method of IDUs control.
Instruction for naloxone use from the Ministry of Health documents
Alarming Issues
• Although there is educational programme on OD, absence of naloxone makes it less effective.
When observing OD in someone what did you do?
calle
d ambu
lance
took t
o hos
pital
rescu
e brea
thing
recov
ery po
sition
phys
ical p
ain
tried t
o awak
e
injec
ted st
imula
nts
used
Nalo
xone
0
10
20
30
40
50
60
70
80
90
100
35
10
43
53
60 58
115
65
90
57
47
40 42
8995
Yes No
Alarming Issues: not calling ambulance
• 65% didn’t even try to cal an ambulance• Out of those who called the ambulance, it
arrived in 95% of cases
Common reasons:• fear of police: 35% - 67%• Fear of dealing with medical staff: 26% - 35%• Believed in being able to cope on their own: 42%
- 57%
Acknowledgement• Anna Tokar, MSc
• Maryna Varban, PhD
• Ukrainian organizations that took part in the survey with no extra funding.