Estimate of the extent of opiate overdose in Ukraine

Abstract

BACKGROUND: Overdose is known to be among leading causes of death in injection drug users (IDUs). However, there is no official statistics in Ukraine with regard to both fatal and nonfatal overdose. We aimed to estimate the scope of the problem and level of provided help to those who have suffered overdose.
METHODS: Data from bio-behavioral survey conducted among IDUs in 2007 (N=8575) with general questions about having experienced overdose and specialized survey among participants of overdose prevention and response program conducted in 2010 (N=2821) were considered. The specialized survey inquired personal experience of overdose and received help, witnessing overdose in others and providing help. Data triangulation was used to estimate the scope of the problem.
RESULTS: Among the participants of the specialized survey, 1918 witnessed overdoses and 550 of them said that help was delivered late. Thus, up to 29% of overdoses could be fatal. According to the results of the bio-behavioral survey, 35-37% of self-prepared opiates users have ever experienced overdose, while among all IDUs current opiate users constitute 53% and 80% are ever users. Among the participants of the specialized survey, a larger proportion are current opiate users (73%), and 70% have ever suffered overdose with 19% within the last six months. Of 1201 opiate overdoses reported by the participants of the specialized survey, 179 have reported to have received specific treatment with naloxone which constitutes 15%. With estimated number of IDUs in Ukraine around 300 thousand, this makes 159 thousand opiate users, 57 thousand those who have ever suffered overdose and 15 thousand those who suffered overdose within last six months. Of these, 4 thousand could have died and 2 thousand could have received specific treatment with naloxone.
CONCLUSION: We estimate that 30 thousand nonfatal and 8 thousand fatal overdoses may happen in Ukraine per year.
KEYWORDS: injection drug use, opiates, overdose, naloxone, fatal overdose, nonfatal overdose, Ukraine.