1. Reporting to WHO Death certificate  National statistics  WHO International Classification of Disease (ICD) – All poisonings – Drug poisonings – Drug abuse/dependence Each country identifies deaths differently Just because a drug is present in a death, doesn’t mean it caused the death

2. Possible Overdose Deaths CountryYear(s)Deaths/year (average) Rate per 100,000 All Poisonings Drug Poisonings Drug Abuse Russia1999-20046,2504.3  Kazakhstan20044402.9  Tajikistan1981-20011172.2  Kyrgyzstan2000-2004450.92  Georgia1998-200150.11  All Poisonings (includes not from drugs) Russia1999-200466,90646.5  Ukraine1981-200412,00223.8  Kazakhstan20043,28521.9  Low Data Quality China1987-19996,190*  * Urban areas representing approximately 10% of the population

3. drug user surveys hospital data ambulance

4. Project Lazarus Wilkes County, North Carolina, USA source + more info at projectlazarus.org

10. Why Data Matters Collecting information on overdoses and overdose reversals can help your clients, your program and your country’s health policy. Applications of data: – Client feedback & starting dialogue – Program planning – Grant writing – Policy/advocacy – Program evaluation

11. What Data Tell Us What’s the problem? Is it different now than it was in the past? Is it different for different people? Is it different from my place to your place? What can we do now to intervene? Did we fix it?

12. Translating Street to Science 4. Information is provided to politicians, medical providers, law enforcement, funders [once per year] 1.Clients interviewed by outreach workers [every day] 2. Paper forms collected and data entered in computer [once or twice per month] 3. Data are analyzed and reports written [twice per year]

13. Putting Numbers into Words - 1 Alliance (Ukraine) Baseline Questionnaire Can be used to describe the problem “Our clients have experienced ____ [Q10a] overdoses in the past 6 months, and witnessed ____ [Q13a] overdoses. Overdose is a significant problem in our community.”

14. Putting Numbers into Words - 2 Alliance (Ukraine) Naloxone Refill Questionnaire Can be used to promote/evaluate the program “Our clients witnessed or gave naloxone ____ [Q12] times since [date]. In ____% [Q16] of the cases, the person lived. Our clients can effectively use naloxone to prevent overdose deaths.”