One night in Almaty, Kazakhstan, George was found unconscious in his car by someone who knew all too well what was happening because he, too, was going through a program to overcome addiction: these were overdose symptoms. Quickly, George’s friend clapped his face and poured cold water on him. Then, he administered intramuscular Naloxone using a kit and knowledge he gained from a program called Project Renaissance.
Within seven to ten minutes, George regained conscious. Within 30 minutes, he recovered completely after a cup of hot tea.
Unfortunately, George’s story is not unique.
Project locations for Renaissance
According to the United Nations Office on Drugs and Crime, Central Asia and Eastern Europe are home to an estimated one-quarter of all people who inject drugs worldwide. The UN Reference Group on HIV and Injecting Drug Use estimates that there are around 3.7 million people who inject drugs in the region.
It was with this dire backdrop that a project began — the one that provided the expertise to help save George’s life — in the heart of Central Asia. Project Renaissance, a couple-based HIV and overdose prevention for people who inject drugs, was launched in 2009.
Read the publication, “Reducing opioid overdose in Kazakhstan: A randomized controlled trial of a couple-based integrated HIV/HCV and overdose prevention intervention ‘Renaissance’” in the International Journal of Drug Policy.
Renaissance is a part of the larger body of research completed here at the Social Intervention Group (SIG), and was adapted from a US-based SIG intervention, “Connect,” which was identified by the Center for Disease Control as a best practice. At the time of launch, there were almost no other couple-based interventions for people who inject drugs in Central Asia.
Couples-based intervention through Project Renaissance. Photo source: magazine.columbia.edu
A couples-based approach creates a safe environment for couples to disclose sensitive issues such as sexual coercion, extra dyadic relationships, gender power imbalances, and sexual risk.
A recent study about the outcomes of Project Renaissance published by The Global Health Research Center of Central Asia (GHRCCA) was the first to evaluate the efficacy of a couple-based HIV and overdose prevention intervention.
Clinical Coordinator for Project Renaissance, Elena
Findings: Project Renaissance
It is striking: 20% of the individuals who injected drugs experienced a non-fatal opioid overdose within six months of the study. Within a year, ten people died because of a fatal opioid overdose. This underscores an urgent need to redress overdose among people who inject drugs in Kazakhstan as a public health priority.
Both Renaissance and the comparison study conducted by GHRCCA — wellness promotion — significantly reduced risks for non-fatal overdose over the 12-month follow-up. However, Renaissance’s risk reduction has the added benefit of significantly reducing both overdose and HIV risk behaviors (as well as HCV incidence). Over one-year period, there was a 51% reduction in HIV incidence in the risk reduction arm when compared to the wellness promotion arm.
Integrating a low-threshold overdose prevention intervention like Renaissance into the continuum of HIV services may further build the trust and increase the engagement of people who use heroin and other opioids in HIV services to achieve the UNAIDS 90-90-90 goals by 2020, while preventing the substantial loss of lives to overdose.
2009 Renaissance Start-Up Training
Project participants, in addition to George’s friend, shared their own personal experiences with Project Renaissance:
“Being equipped with those knowledge and skills I got during the sessions, I learned to be more patient to my partner, we don’t have any “closed” themes regarding STI transmission or drug use.”
“We are very thankful to your project. We have learned a lot! My husband and I have dropped using drugs and other psychotropic drugs. We learned a lot about damage from drug abuse. Thank you to the project staff that helped us a lot to look at yourself and to the world with new eyes.”
“Indeed, there have been huge changes in my life because of your project, the most important – changes in mind. Finally, I put an end to my drug abuse and step by step return to my previous life, which was before I used drugs. The Renaissance project unassumingly but faithfully changes the mind of drug users; it indeed works! I love you so much, wishing you success and prosperity and expanding your activities!”
Read the publication, “Reducing opioid overdose in Kazakhstan: A randomized controlled trial of a couple-based integrated HIV/HCV and overdose prevention intervention ‘Renaissance’” in the International Journal of Drug Policy.
International Journal of Drug Policy
Note: George is not the individual’s actual name.
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