• Skip to main content
  • Skip to secondary menu
  • Skip to primary sidebar
  • Skip to footer
  • Drug Policy and Law
  • Harm Reduction
  • Activism

Drugreporter

News and Films from the Frontline of the War on Drugs

  • News
  • Café
  • Videos
  • About Us
  • EN
    • HU
    • RU

Preventing avoidable deaths: what steps to take to mitigate opioid overdose? 

August 31, 2016 | Author: Péter Sárosi

Tweet

Today is the Inernational Overdose Awareness Day. On this occasion, please read an article about how to prevent opioid overdoses, written by our partners from APDES, Portugal!

In Europe, drug overdose continues to be the leading cause of death among people who use drugs (PUD) [1]. In 2014, it was estimated that overdose caused 18.3 deaths per million population aged 15-64, and rates of more than 40 deaths per million were reported in eight European countries1 [2]. Overdose accounts for more than 3.5% of overall deaths in males under 40 years of age, with 78% of overdose victims being male [2, 3]. Older opioid users were shown to be particularly vulnerable, although a recent slight increase in drug-induced deaths among users aged under 25 has been reported in some countries [2].

In spite of a promising European trend between 2009 and 2013 – when reported overdose deaths declined, thanks to the scaling-up of treatment and harm reduction interventions – the 2016 analysis showed a rise in drug-induced deaths related to heroin and other opioids [2]. This is of particular concern in the most recent data from countries with fairly robust reporting systems (Germany, Sweden and the UK). Moreover, synthetic opioids and medical purposed drugs are acquiring a substantial role in overdose deaths in some European countries (e.g. UK, France, Ireland, Finland), with fentanyl, methadone, buprenorphine and tramadol being more frequently mentioned in toxicology reports [4].

This brief snapshot suggests new challenges in the realm of ‘old’ problems. The increasing complexity of Europe’s drugs situation is now challenging practioners, policy makers and researchers to formulate effective responses for the mitigation of these avoidable deaths.

The Euro HRN Project II – Overdose prevention in Europe: collating lifesaving practices
As a contribution to this challenge, the European Harm Reduction Network developed a project2 with the general purpose of identifying and sharing best practice in overdose prevention. APDES (Portugal) and Akzept (Germany) contributed to the project by providing an overview of existing programmes and devices for reducing drug-induced deaths in Europe; by conducting a review of the effectiveness of measures for preventing opioid overdoses and identifying constraints on the most promising measures; and by formulating recommendations for the prevention of opioid overdose, regarding research, policy, and practice.

On this year’s International Overdose Awareness Day, under the slogan, ‘Time to remember. Time to act’, we describe some of the gaps in overdose prevention strategies revealed during the project, as well as a selection of 10 recommendations designed to overcome them. For the complete work please click here.

1.    Nationally-adapted guidelines for the development and strengthening of overdose prevention interventions should be created, under the concerted responsibility of policy-makers, researchers, practioners and people who use drugs. In Europe, only a small number of countries have guidelines for overdose prevention.

2.    Drug prevention policies should include socio-economic dimensions, such as resources developed to decrease economic inequalities, poverty and unemployment rates. Poverty status appears to predict 69% of the variance in drug overdose mortality rates [5].

3.    It is vital to promote access to drug treatment through multiple entry-points, as well as a timely response to those requesting treatment, in order to prevent drop-outs. Each day of opioid substitution treatment was associated with a reduction of 1% (in a one year period) in overdose risk [6].

4.    Governments need to seriously discuss the implementation of Drug Consumption Rooms (DCRs) with a multi-disciplinary team holding training in overdose prevention and appropriate emergency equipment (e.g. oxygen tanks, naloxone). DCRs must adopt a pragmatic harm reduction approach, by providing access to all persons who use drugs (e.g. OST clients, poly-consumption users).

5.    It is crucial that the professionals who work in drug services, as well as other professionals who have close contact with PUD (e.g. pharmacists, prison staff, police officers, and emergency staff) receive training in overdose prevention, recognition and response.

6.    It is necessary to extend the provision and regularity of individual overdose risk-assessment with PUD. Almost half of European countries don’t have, or have rare to limited coverage of overdose risk assessment, while PUD tend to be greatly unaware of, or underestimate, their overdose risk.

7.    There is an urgent need to scale up the provision of training programs on overdose prevention and response for people who use drugs (giving priority to those with a history of previous overdoses) and their families/social network. Current encouraging evidence on take-home naloxone programs must also be considered in training offers.

8.    Emergency services must be adequately prepared to deal with overdoses, and ‘opportunistic interventions’ need to be extended: deliver overdose information, promote links to health services, and schedule a subsequent heath check-up to screen for morbidities.

9.    It is necessary to refine record systems on drug-related deaths across Europe, by improving the standardisation of data collection and report procedures. This should allow an improved and timely surveillance of the phenomena, in order to provide inputs for drug prevention strategies as well as to conduct reliable inter-country comparisons.

10.    The gap frequently found between drug policy design and implementation should be reduced through continuing investment and funding and via systematic assessment of interventions.

Final Remark
Fluctuations in the levels of fatal and non-fatal overdoses are a result of multiple factors, ranging from the individual to the broader environmental context. Thus, the demand for an effective overdose prevention strategy requires a multi-level approach.

References
[1] United Nations Office on Drugs and Crime (UNODC) (2013). Opioid overdose: preventing and reducing opioid overdose mortality. Discussion paper UNODC/WHO 2013. Vienna: UNODC. Retrieved from http://www.unodc.org/docs/treatment/overdose.pdf
[2] European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). (2016). Annual report 2016: The state of the drugs problem in Europe. Luxembourg: Publications Office of the European Union.
[3] Data retrieved from:http://epp.eurostat.ec.europa.eu/statistics_explained/index.php/Causes_of_death_statistics#Further_Eurostat_information
[4] European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). (2015). Annual report 2015: The state of the drugs problem in Europe. Luxembourg: Publications Office of the European Union.
[5] Marzuk, P. M., Tardiff, K., Leon, A. C., Hirsch, C. S., Stajic, M., Portera, L., & Hartwell, N. (1997). Poverty and fatal accidental drug overdoses of cocaine and opiates in New York City: An ecological study. American Journal of Drug Alcohol and Abuse, 23(2), 221–228. doi:10.3109/00952999709040943
[6] Darke, S., Williamson, A., Ross, J., & Teesson, M. (2005). Non-fatal heroin overdose, treatment exposure and client characteristics: Findings from the Australian treatment outcome study (ATOS). Drug and Alcohol Review, 24(5), 425–432. doi:10.1080/09595230500286005.

By the APDES Research Department

Filed Under: Articles Topics: Drug Consumption Rooms, Drug Policy and Law, European Drug Policy, Harm Reduction, Overdose Prevention

Access to this article is free - but to produce articles and videos is not. Drugreporter is a non-profit website that needs your support to provide you with high quality contents.

Become a supporter and make a donation of 5 $ today!

Kapcsolódó cikkek:

40 Years in the Frontlines of Harm Reduction in Ireland – Interview with Tony Duffin

December 20, 2022 - Péter Sárosi

Decriminalisation in Portugal: Through the Lens of People who Use Drugs

December 5, 2022 - István Gábor Takács

Drugreporter News | 2022 November

November 24, 2022 - István Gábor Takács

Kapcsolódó videók:

Decriminalisation in Portugal: Through the Lens of People who Use Drugs

December 5, 2022 - István Gábor Takács

Drugreporter News | 2022 November

November 24, 2022 - István Gábor Takács

Harm Reduction in Athens – With the Eye of an Outsider

November 23, 2022 - Péter Sárosi

You can browse our topics here:

Activism COVID-19 Criminalisation Dose of Science Drug Consumption Rooms Drug Policy and Law European Drug Policy Harm Reduction Hepatitis HIV/AIDS Marijuana Policies Medical Marijuana Needle and syringe programs New Psychoactive Substances Opiate Substitution Overdose Prevention Psychedelic Medicines Regulation and Control Russian Drug Policy Sex Work United Nations Drug Policy US Drug Policy

Primary Sidebar

BECOME A SUPPORTER OF DRUGREPORTER! INVEST THE PRICE OF A COFFEE MONTHLY AND MAKE SURE DRUGREPORTER KEEPS RUNNING!
Subscribe to the Newsletter!

"*" indicates required fields

This field is for validation purposes and should be left unchanged.
  • Facebook
  • Twitter
  • YouTube

Search

Drugreporter Video Database

Hundreds of videos on drug policy, harm reduction and human rights for streaming and download, also on a world map!

DRUGREPORTER NEWS

Monthly drug policy news from around the world

Drugreporter café

In our new online video show, we regularly discuss new developments in the world of drug policy with professionals, activists and decision makers. You can also listen to the Drugreporter Café in Podcast format on Spotify or Apple Podcasts!

COVID-19 Harm Reduction Update

On this info page Drugreporter provides regular updates about resources and news on how harm reduction service providers respond to the COVID-19 Epidemic.

Drugreporter Video Advocacy Network

Browse videos produced by members of our Drugreporter Video Advocacy Network, from all around the world!

DRUG USERS NEWS

Russian language videos on drug policy, harm reduction and human rights.

Our award winning animated documentary movie is based on the original audio recording of Kostya Proletarsky, a drug user and HIV activist who died as a result of mistreatment and torture at a Russian prison. Festival appearances, news and resources are available here!

Footer

Rights Reporter Foundation
Hungary, 1032 Budapest
San Marco Street 70.
Email: rightsreporter@rightsreporter.net

Search

Our other websites:

The Rights Reporter Foundation

The Autocracy Analyst

Room for Change Campaign

Room in the 8th District Campaign

A Day in the Life movie website

Drugreporter