According to the 2022 UNODC World Drug Report 61 million people used opioids for non-medical reasons in 2020 and 128,000 people died due to opioid overdose, an increase of 45% since 2017. Most are preventable; respiratory support and administration of an opioid antagonist such as naloxone can reverse opioid overdoses, and take-home naloxone (THN) programs where likely overdose witnesses are trained in overdose response have been shown to be effective. In line with the WHO Community Management of Opioid Overdose (2014) and in response to Commission on Narcotic Drugs resolution on “Promoting measures to prevent drug overdose, especially opioid overdose” (2012), the UNODC-WHO Stop Overdose Safely (S-O-S) initiative was launched in 2017. It aims to save lives by training first responders in opioid overdose management and promoting access to THN. As part of the S-O-S initiative we trained 14 263 people likely to witness an overdose in Kazakhstan, Kyrgyzstan, Tajikistan and Ukraine in opioid overdose management. We followed up 1646 of these people in a prospective cohort study for 6 months and showed that naloxone was used at 90% of witnessed overdoses. Our findings demonstrated the feasibility of THN schemes also in low-and middle-income countries (LMIC) through a community-based approach.

The workshop will:

• describe the UNODC-WHO S-O-S Initiative and share the findings
• exchange with participants about their opioid overdose management work
• share experiences on THN schemes in S-O-S countries and other places

• Understand challenges and facilitators to implementation,
• Summarize study outcomes related to program and training effectiveness,
• Discuss qualitative outcomes related to experiences of program participants about overdose response suited for LMIC.

• Knowledge on how to respond to overdose in LMIC
• Feedback on feasible implementation and possible scale-up in LMIC
• Determination of key populations for future development of opioid overdose interventions