Drug overdose remains a leading cause of accidental death in Europe and the Americas. On August 31st, Dianova International remembers all lives lost and calls for expanded Naloxone access
According to the European Monitoring Center on Drugs and Drug Addiction (EMCDDA), it is estimated that over 70,000 lives were lost to drug overdoses in Europe in the first decade of the 21st century. In the US, fatal heroin overdoses have almost tripled in three years with more than 8,000 fatalities per year, while at the same time roughly that number die from prescription opioid painkillers.
Whereas the number of overdose deaths is much lower than of yore, when the heroin epidemics spread across the countries, Drug overdose continues to be a major cause of death, especially among young opioid users in Europe and the Americas. In Europe, recent data show that overdoses account for more than 3.4% of all deaths among Europeans between the ages of 15 and 39 (Eurostat 2013).
The International Overdose Awareness Day was created in Australia in 2001 to raise awareness and commemorate those who have been lost to drug overdose. Since that time, many community organizations and NGOs such as hospitals, community health centers and user groups in the US, UK and Australia have held events aiming to reduce the stigma of drug-related deaths and provide basic information on how to reduce the risks of overdose and on the support services that exist in their local communities.
Overdose Prevention & Responses
Preventing overdose deaths can be addressed at two levels: implementing a set of interventions geared towards a full-blown prevention or reducing the fatal outcomes after overdoses have occurred. At both levels, strategies used include the scaling-up of protective factors and the reduction of risks. Below, some of the most important strategies used:
Increasing awareness of overdose risks – as many drug users are unaware of, or underestimate overdose risks, effective communication can help reduce such risks (risks are increased: in case of reduced tolerance following detoxification, cessation of treatment or release from incarceration; when using opioids in combination with other sedating drugs; and when users have certain medical conditions, such as HIV and liver or lung disease).
Providing effective treatment – evidence suggests that opioid substitution treatment substantially reduce the risk of mortality as long as continuity of treatment is maintained.
Improving continuity of care (throughcare) between prison and community – As there are high numbers of overdose deaths among former inmates shortly after their release, a number of interventions are recommended including education on overdose risks and prevention and/or initiation or continuation of substitution treatment.
Implementing supervised drug consumption rooms –"Injection rooms" provide a safer drug use environment, advice on safer injection practices as well as medical supervision. All of them are equipped to face drug overdoses and reduce related mortality. As of 2015, a total of 74 facilities operate in Europe (5 countries and Norway); millions of injections have been supervised and no overdose fatalities have occurred within these facilities.
Improving first responder response – As most drug users have witnessed or experienced overdoses, they are likely to be potential first responders in emergency overdose situations, as well as their friends and family. Bystander responses must be improved through information and training in overdose prevention, recognition and response. In addition, as recommended by WHO, people likely to witness an opioid overdose should have access to Naloxone (Narcan®), an effective antidote which can reverse the effects of intoxication
It is estimated that globally there were 183,000 (range: 95,000-226,000) drug-related deaths (mostly overdoses) in 2012, with opioid overdose the largest category.
Drug overdose was responsible for 41,340 deaths in the US in 2011. US overdose deaths have increased for 12 successive years. In 2011, and for the fourth year in a row, the number of US citizens whose deaths were drug-related exceeded the number of fatalities in road traffic accidents (33,561).
In 2012, overdoses in the UK (3,256) exceeded the number of deaths in road accidents (1,832).
In Ontario, Canada, there was a 242% increase in fatal opioid overdoses between 1991 and 2010; from 12.2 deaths per million people to 41.6 deaths per million in 2010.
It is estimated that more than 70,000 lives were lost to drug overdoses in European Union countries in the first decade of the 21st Century. European Union nations reported 6,100 overdose deaths in 2012.
Countries in South America, the Caribbean and Central America reported between 4000 and 7300 drug-related deaths, with a mortality rate well below the global average
In Asia, it is estimated that there were between 11,400 and 99,600 deaths in 2012
Nearly four Australians die every day from overdose. Overdoses out-numbered road fatalities in Australia in 2012 (1,427 vs 1,338)
Sources available on the web site of the International Overdose Awareness Day