Need: In-kind contribution of opioid antagonist naloxone
The S-O-S Initiative: UNODC-WHO initiative and study on community management of opioid overdose, including emergency naloxone
Drug use and drug use disorders are a public health, developmental and security problem both in industrialized and developing countries. Drug disorders are associated with health problems, poverty, violence, criminal behaviour and social exclusion. Prevention and treatment of drug use disorders are essential demand reduction strategies of significant public health importance. Opioid use disorders and drug-related deaths, often from opioid overdose, are of concern in many parts of the world. With an estimated 207,400 drug-related deaths in 2014, corresponding to 43.5 deaths per million people aged 15-64, the number of drug related deaths worldwide is unacceptably high, yet has remained relatively stable, although with significant variations in some jurisdictions.
The S-O-S Initiative, promoting the expanded community management of opioid overdose, was launched by the United Nations Office on Drugs and Crime (UNODC) and the World Health Organization (WHO) at the Commission on Narcotic Drugs (CND) 2017. In line with the WHO (2014) guidelines on “Community Management of Opioid Overdose”, this initiative aims to save lives by promoting access to naloxone and training of potential first responders (including peers and family members) in overdose management. United Nations Member States and other stakeholders are encouraged to work towards universal coverage of opioid overdose management strategies including naloxone, as outlined in the following three targets:
90% of the relevant target groups will have received training in overdose risk and emergency management;
90% of those trained will have been given a supply of emergency naloxone;
90% of those who have been given a naloxone supply will be carrying the naloxone on them or have it close to hand.
This initiative aims to support Member States in their efforts to develop policy and legal frameworks to implement community management of overdose services. Moreover, it encourages broad partnerships between national governments, regional organizations, research institutes, civil society, interested funding agencies and other entities to work towards the 90-90-90 targets.
A further aim of this initiative is to mobilize and support people likely to witness an overdose in the community, with particular focus on people who use drugs, peers, as well as family members. The ultimate goal is to contribute towards reducing deaths due to preventable opioid overdose.
As part of the S-O-S Initiative and under the leadership of UNODC and WHO, a multi-country study is being developed to assess the feasibility of community-based naloxone provision, in line with the S-O-S Initiative targets, and to assess the impact on health-related outcomes. Four project countries, with a high prevalence of opioid use, located in Eastern Europe and Central Asia, have been included in the study, which is open for additional, interested countries to join with their own resources.
In the framework of the S-O-S Initiative, the UN is calling on companies producing the opioid antagonist naloxone, which rapidly reverses the effects of opioids, to consider providing this life-saving medication as an in-kind contribution to participating study countries (in Eastern Europe and Central Asia). This in-kind contribution would increase the access on a large scale to allow to demonstrate the feasibility and positive impact of community management of overdose approaches in low-and middle income countries.