Case Studies

Examples of successful advocacy efforts in different settings around the world

Facing reality – Overdose prevention in drug treatment

Naberezhnye Chelny, a mid-sized city in Russia’s Volga region, was built around the Kamaz truck manufacturing plant. The Timur Islamov Charitable Fund (TIF) was established in 2005 to respond to drug use in the area through needle exchange, case management, counseling, and other harm reduction activities. Overdose prevention and naloxone distribution are among the services they offer.

The organization provides naloxone to drug users through trainings at the drop-in center, and by street outreach. They also encourage secondary distribution through trusted peers. With a large Muslim population in the area, TIF distributes naloxone with a discreet leather holder that looks similar to the pouches many local Muslims wear around their necks to hold prayer scrolls.

Why overdose education in drug treatment and rehabilitation centers?

Acknowledging that many people overdose after a break from drug use, the staff at TIF thought it was important to have overdose education in local detoxification and rehabilitation centers. Getting into the detox centers to do overdose trainings didn’t pose much of a problem. The staff there understood that many people go through detox not to quit using drugs, but in order to lower their tolerancethereby reducing the money they need to spend on drugs – and that this puts people at increased overdose risk. However, getting overdose trainings into rehabilitation centers proved to be harder; rehabilitation staff were concerned it would give people a mixed message about drug use.

Julia, an overdose prevention expert at TIF recalls how she convinced the rehabilitation staff that overdose training was vital: “I framed it in terms of first aid. I also pointed out that after leaving rehab, people might be in a situation where a friend overdoses, and this will give them the skills they need to save a friend’s life.” 

A desomorphine user shows off the naloxone he keeps close at hand, in a pouch around his neck. He has used naloxone six times to revive fellow users.

“I framed it in terms of first aid. I also pointed out that after leaving rehab, people might be in a situation where a friend overdoses, and this will give them the skills they need to save a friend’s life.”

- Julia, Timur Islamov Charitable Fund, Russia

 

Every participant is equipped to save a life

TIF staff now does trainings in the rehabilitation center every three months, in order to ensure that all patients have a chance to participate during their stay in the center. The training consists of three sections: 1) an introduction to TIF and how to access the services they provide; 2) information about what overdose is, including the factors that might increase overdose risk and how to recognize an overdose and respond to it; 3) role-playing overdose response using a rescue breathing dummy. Participants are referred to the drop-in center to get naloxone after they leave the rehabilitation center.

Today the staff are supportive of the training. The chief psychologist at the center attends all trainings, including overdose prevention, and recognizes the importance of the information for the patients. Rehabilitation patients appreciate the training as well: “Today is the first time in my life that I attended a training. I was interested to go – [I wondered] ‘how will things be there?’ When I entered, my first impression was so-so. … Then, they started talking about the training and its subject. And I was really, really touched. I am very grateful to the organizers. I wish there were more training sessions like this.”

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