Prevention of deaths due to substance use

According to a recent report by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA, 2019) on deaths due to substance use in Europe, there were 8200 deaths in the EU in 2017 due to single or multiple substance use. Four out of five deceased were men and 8-9 out of 10 were deaths related to opioid use, such as heroin. The report highlights that most deaths involved young people, around 30-40 years of age.

In Cyprus, according to the Monitoring Department/National Documentation and Monitoring Centre for Drugs data, in 2017 there were 16 deaths due to overdose, a number which increased over the previous years. The deceased were in the age group of 25-29 years and 8 out of 10 are men.

Countermeasures

Measures being promoted in Europe to tackle drug-related deaths, focus primarily on overdose prevention, but also on the survival of overdose patients. In particular, the following measures are considered best practices (EMCDDA, 2017):

  • Integrate and keep opioid users in substitution therapy, as well as ensuring continuity of treatment in prisons and during reintegration into the community.
  • Promote overdose awareness, particularly about key risk factors, such as the combination of substances with alcohol and/or benzodiazepines.
  • Ensure the availability of naloxone (opioid antagonist) and educate frontline professionals on its use to reverse overdose.
  • Educate and train users, their peers, and family members in overdose recognition and naloxone administration until the ambulance arrives.
  • Establish supervised use sites, where use takes place in a safer and healthier environment, under the supervision of qualified health personnel.

Cyprus

In Cyprus, the Cyprus Addictions Authority coordinates a comprehensive intervention measure, which provides naloxone (in nasal spray form) to opioid users participating in substitution and harm reduction programs. The intervention mandates the education of users on issues such as identifying the risk factors that lead to overuse, identifying overuse, proper ways to deal with overuse, naloxone administration methods, the naloxone effective period and basic first aid techniques.

The harm reduction programs involved in the action are:

  • Substitution Program "GEFYRA", Mental Health Services of Ministry of Health (Athalassa Hospital, tel.: 22402194/22402130)
  • Substitution Program "SOSIVIO", Mental Health Services of Ministry of Health (Old Limassol Hospital, tel.: 25305111 Hospital Office / Mental Support Office 25305077
  • Larnaca Substitution Unit "DIAVASI", Mental Health Services of Ministry of Health (Old Larnaca Hospital, tel.: 24828795)
  • Paphos Substitutes Unit "STROFI", Mental Health Services of Ministry of Health (Pafos General Hospital, tel.: 26803144/26803174)
  • Famagusta Substitutes Unit "EPISTROFI", Mental Health Services of Ministry of Health (Famagusta Health Centre, tel..: 23815078/23815089
  • Direct Access and Harm Reduction Centre "STOHOS" - Cyprus Anti-Drug Association and Nursing Services of the Ministry of Health (Marias Sygklitikis 1, 1011 Nicosia, tel.: 22460077)

NAAC has also developed guidelines for the implementation of the action as well as a leaflet with naloxone administration instructions.

NAAC’s aim in the next step, is to educate users’ family members on naloxone administration.

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