Impact of UNODC/WHO S-O-S (stop-overdose-safely) training on opioid overdose knowledge and attitudes among people at high or low risk of opioid overdose in Kazakhstan, Kyrgyzstan, Tajikistan and Ukraine

• DOI: 10.1186/s12954-025-01167-2
• Publication Date: 2025-02-20T12:00:03Z
• Authors: Paul Dietze; Samantha Colledge...; Gilberto Gerra; Vladimir Poznyak; Giovanna Campello; Wataru Kashino; Dzhonbek Dzhonbekov; Tetiana Kiriazova; Danil Nikitin; Assel Terlikbayeva; Kirsten Horsburgh; Anja Busse; Dzmitry Krupchanka
• Keywords: Opioid Overdose; Health psychology; Drug overdose

Opioid overdose education and naloxone distribution (OEND) is an evidence-based strategy to reduce opioid deaths in line with guidance provided by the World Health Organization (WHO) United Nations Office on Drugs Crime (UNODC). However, OEND effectiveness has rarely been examined low- middle-income countries (LMICs). The WHO/UNODC Stop Overdose Safely (S-O-S) project involved training of > 14,000 potential witnesses response (including administration naloxone) Kazakhstan, Kyrgyzstan, Tajikistan Ukraine. We impact using S-O-S package, developed within framework project, knowledge attitudes towards, as well effective amongst participants stratified high low personal risk overdose. A sample were recruited into a cohort study evaluate effects package. Of these participants, 1481 at or completed pre- post-S-O-S questionnaires that incorporated sections Brief Knowledge (BOOK) Attitudes Scale (OOAS) instruments. Outcomes included overall scale scores instrument sub-scales. Mean change scores, overdose, calculated compared repeated measures t-tests. Variation according select participant characteristics (e.g., age, sex) was also multivariable linear regression. After there increases BOOK OOAS mean similar pattern evident for all subscales. Observed changes larger (between 11% 112%, depending measure) those who 5% 33% measure), reflecting higher baseline observed few variations across other characteristics. no experience (β=-0.3; 95%CI=-0.5-0) not currently being drug treatment (β=-0.6; 95%CI=-0.4-0.8) associated score. Reporting having witnessed previously (β = 0.5; 95%CI 0.2-0.8). Not (β=-1.3; 95%CI=-0.1-2.4) score package resulted substantial improvements related responses four countries, most notable lower Widespread implementation could improve LMICs.