OPIOID OVERDOSAGE AND HARM REDUCTION STRATEGIES IN LOWER-INCOME COUNTRIES: A COMPREHENSIVE REVIEW

Zahra Zahid Piracha*, Umar Saeed, Amal Sohail Malik, Muhammad Nouman Tariq, Syed Shayan Gilani, Laiba Razaq, Manaal Amir Basra, Talha Abdul Waheed, Ayesha Israr, Seneen Noor and Elyeen Noor

ABSTRACT

Background: Opioid receptor agonists, encompassing substances like heroin and prescription opioids, pose a pronounced public health challenge globally. Non-fatal opioid overdoses, especially prevalent among prescription opioid users, exceed fatal cases. The effectiveness of Take-Home Naloxone (THN) programs, proven in higher-income nations, remains uncertain in lower-income countries. Objectives: This study aims to comprehensively analyze review articles addressing opioid overdose and harm reduction strategies, with a specific focus on resource-constrained settings. Objectives include identifying prevalent risk factors, evaluating the effectiveness of harm reduction measures, and formulating a practical change plan for implementing THN strategies in developing nations. Methods: A meticulous search across Medline/PubMed, Science Direct, PsycINFO, Google Scholar, and the Virginia Commonwealth University library facilitated the identification of relevant review articles. Keywords such as "Naloxone," "take-home naloxone," and "opioid overdose prevention" were strategically employed. Data extraction emphasized overdose prevalence, contributing factors, and harm reduction efficacy. Thematic analysis categorized data into interventions, socio-economic factors, risk factors, and harm reduction strategies. Results: Findings underscore the urgency of tailored harm reduction strategies in lower-income countries, recognizing regional disparities, cultural influences, and healthcare infrastructure variations. THN emerges as a critical intervention, but its implementation requires nuanced approaches. Challenges include limited healthcare resources, stigma, and cultural factors influencing opioid use patterns. Conclusion: This study provides insights into the socio-economic determinants of opioid overdose and existing harm reduction strategies, laying the groundwork for future efforts. Tailored interventions, encompassing drug safety testing, supply management, injectable opioid programs, pain management, policy solutions, and stigma reduction, are crucial in addressing opioid-related challenges in resource-limited contexts. The findings guide a practical change plan for THN implementation in developing nations.

Keywords: Keywords such as "Naloxone," "take-home naloxone," and "opioid overdose prevention" were strategically employed.