ID: HR19-167

Presenting author: Thiha Lin

Presenting author biography:

I am currently working as a program coordinator in Asian Harm Reduction Network (AHRN) and lead the outreach with NSEP programs. I joined AHRN as a worker in 2005 and have 14 years experience in Harm Reduction work. I graduated from the Asian Institute of Management.

Naloxone Now! A call to prioritize peer-led overdose management in Myanmar

Thiha Lin, Thaung Hnin Nu, Thint Naing Lin

Issue
Overdose is among the leading causes of death amongst people who inject drugs (PWID), in shooting galleries far from health facilities. In a reality where users are in fear of arrest; avoid care or lack access to cost-effective life-saving antidote Naloxone, in Myanmar non-medical staff are not allowed to administer Naloxone. Peers witnessing OD willing to safe lives now resort to ineffective traditional practices such as ‘met-ka-laung’ (rubbing neck, back with metal or glass), beating and saltwater injection.
Setting
Myanmar is known for its opium production, mining and armed conflicts while poverty is rampant;all driving forces for widespread heroin use. It is estimated that there are 300,000 drug users with over 93,000 opioid injectors. AHRN operates 14 comprehensive one-stop-shop harm reduction services for drug users in hard-to-reach rural, conflict restricted, border and mining areas, where due to distance of shooting galleries and lack policies, community-based overdose treatment is not readily available.
Project
A desk search comprised of AHRN data, confirmed the global empirical evidence on the success of peers in OD management and focus-group-discussions with dealers and peers showed: 1. Gaps in OD responses; 2. Substantial number of fatal overdoses; 3. Substantial number peers and dealers identified willing to manage ODs; 4. Outreach workers, peers and dealers were trained in OD emergency aid responses and community-based Naloxone provision.
Outcomes
30 overdose prevention and management training for peers/ dealers were conducted and 61 dealers and 20 peers participated in this community-led overdose management program and 270 number of overdose HE sessions for PWID were conducted. In three years period (2015-2017), 793 number of overdose cases were reported out of which 771 were successfully managed with Naloxone injection by Peers or dealers. Recovered drug users showed increased linkage to care as well as health seeking behaviour and reduced risk behaviour.