The impact of the WHO/UNODC S-O-S training package on opioid overdose response knowledge and attitudes

Background: Opioid overdose is a significant public health issue, but most work on overdose response has been undertaken in high income countries. As part of the WHO/UNODC Stop-Overdose-Safely (S-O-S) initiative a take-home naloxone training package was developed and tested in a project conducted in Kazakhstan, Kyrgyzstan, Tajikistan and Ukraine. We expected the S-O-S training package to improve knowledge of how to respond to overdose and attitudes towards overdose response. >

Methods: Pre and post measures of overdose response knowledge and attitudes were obtained by administering modified versions of the Brief Opioid Overdose Knowledge (BOOK) and Opioid Overdose Attitudes (OOAS) scales to 1646 participants in the S-O-S cohort study. Change in overall and subscale scores was determined by comparing post-training scores with pre-training scores using paired-sample t-tests, stratified by participants who identified as having a history of drug use (group 1) and those who did not (group 2). >

Results: Pre-training BOOK (M= 8.5 & 6.1 for group 1 and group 2 respectively) scores were high, but improved significantly after training (M= 10.6 & 10.9 for group 1 and group 2 respectively, p<0.01) with the effect consistent across all subscales (p’s<0.01). Pre-training OOAS (M= 95 & 91 for group 1 and group 2 respectively) scores were also high, and improved significantly after training (M= 105 & 105 for group 1 and group 2 respectively, p<0.01), with improvement noted for both the competence and confidence subscales (p’s<0.01). There was no change in the readiness subscale for group 1, reflecting pre-training scores at ceiling and a small decline evident in the readiness subscale for group 2 (mean change =-1, p<0.01). >

Conclusion: The S-O-S training package produced significant improvements in opioid overdose knowledge and attitudes. Findings suggest S-O-S materials are suitable for wide-spread rollout in low- to middle-income countries. >