Social learning and peer education in responding to opiate overdose among injection drug users in Ukraine

Anna Tokar, Tatiana I Andreeva, Liudmyla Shulga


BACKGROUND: Opiate overdoses (OD) constitute one of the leading causes of avoidable deaths among people aged 20-40 years old. As peer-administered help in cases of overdose was found to be effective, we aimed to explore how much the subjects of the intervention are able to learn from one another and from their own experience.
METHODS: Secondary data analysis was performed with the 2008 dataset of peer-driven intervention among IDUs who were not involved in harm reduction programs earlier; recruiting was performed with respondent driven sampling methodology combined with peer education covering overdose response. Subsample of 6667 opiate users was considered. Data on overdose response strategies experienced by respondents were considered predictors and data on intended response strategies as outcomes. To reveal relationships between the experienced and intended responses, binary logistic regression analysis was performed.
RESULTS: With recommended strategies including calling ambulance, putting a person in recovery position, fixing the tongue, applying mouth-to-mouth resuscitation and cardiac massage, percentages of those planning to apply them was considerably higher (on average, 2.3 times higher) than the percentage of those having experienced them.
With other strategies including applying cold, pain, ammonia, percentages of those who experienced the strategy and those who planned to practice it were rather close and on average differed just by 1.1.
With all the strategies, the intention to apply a particular response in future was strongly associated with personal experience of having had this applied when having an overdose episode. Peer-education to larger extent determines the intentions of those who have not experienced particular overdose responses themselves. On the other hand, social learning contributes to persisting of those experienced strategies which cannot be recommended.
CONCLUSIONS: Social learning can impact intended overdose responses, its competing interaction with peer-education needs to be taken into account in harm reduction programs.


overdose (OD); injection drug users (IDUs); overdose prevention and response; overdose response communication; opiate drugs

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