{"id":6384,"date":"2016-08-31T09:12:30","date_gmt":"2016-08-31T09:12:30","guid":{"rendered":"https:\/\/drogriporter.hu\/preventing-avoidable-deaths-what-steps-to-take-to-mitigate-opioid-overdose\/"},"modified":"2022-07-04T14:11:25","modified_gmt":"2022-07-04T12:11:25","slug":"preventing-avoidable-deaths-what-steps-to-take-to-mitigate-opioid-overdose","status":"publish","type":"post","link":"https:\/\/drogriporter.hu\/en\/preventing-avoidable-deaths-what-steps-to-take-to-mitigate-opioid-overdose\/","title":{"rendered":"Preventing avoidable deaths: what steps to take to mitigate opioid overdose?\u00a0"},"content":{"rendered":"

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

<\/p>\n

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].<\/p>\n

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 \u2013 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].<\/p>\n

This brief snapshot suggests new challenges in the realm of \u2018old\u2019 problems. The increasing complexity of Europe\u2019s drugs situation is now challenging practioners, policy makers and researchers to formulate effective responses for the mitigation of these avoidable deaths.<\/p>\n

The Euro HRN Project II – Overdose prevention in Europe: collating lifesaving practices
\nAs 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.<\/p>\n

On this year’s International Overdose Awareness Day, under the slogan, \u2018Time to remember. Time to act\u2019, 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<\/a>.<\/p>\n

1.\u00a0\u00a0 \u00a0Nationally-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.<\/p>\n

2.\u00a0\u00a0 \u00a0Drug 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].<\/p>\n

3.\u00a0\u00a0 \u00a0It 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].<\/p>\n

4.\u00a0\u00a0 \u00a0Governments 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).<\/p>\n

5.\u00a0\u00a0 \u00a0It 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.<\/p>\n

6.\u00a0\u00a0 \u00a0It is necessary to extend the provision and regularity of individual overdose risk-assessment with PUD. Almost half of European countries don\u2019t have, or have rare to limited coverage of overdose risk assessment, while PUD tend to be greatly unaware of, or underestimate, their overdose risk.<\/p>\n

7.\u00a0\u00a0 \u00a0There 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.<\/p>\n

8.\u00a0\u00a0 \u00a0Emergency services must be adequately prepared to deal with overdoses, and \u2018opportunistic interventions\u2019 need to be extended: deliver overdose information, promote links to health services, and schedule a subsequent heath check-up to screen for morbidities.<\/p>\n

9.\u00a0\u00a0 \u00a0It 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.<\/p>\n

10.\u00a0\u00a0 \u00a0The gap frequently found between drug policy design and implementation should be reduced through continuing investment and funding and via systematic assessment of interventions.<\/p>\n

Final Remark
\nFluctuations 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.<\/p>\n

References
\n[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 https:\/\/www.unodc.org\/docs\/treatment\/overdose.pdf
\n[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.
\n[3] Data retrieved from:https:\/\/epp.eurostat.ec.europa.eu\/statistics_explained\/index.php\/Causes_of_death_statistics#Further_Eurostat_information
\n[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.
\n[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\u2013228. doi:10.3109\/00952999709040943
\n[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\u2013432. doi:10.1080\/09595230500286005.<\/p>\n

By the APDES Research Department<\/p>\n","protected":false},"excerpt":{"rendered":"

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He is a human rights activist and drug policy expert, the founder and editor of the Drugreporter website since 2004, the author of countless articles, co-author of books and director of films about harm reduction and drug policy reform. He was the Director of the Drug Policy Program at the Hungarian Civil Liberties Union between 2004 and 2015. He is experienced in working at international drug policy forums such as the Commission on Narcotic Drugs. He was twice elected to the Core Group of the EU Civil Society Forum on Drugs. He is the co-chair of the Eurasian Harm Reduction Network. He has been representing the Hungarian Harm Reduction Network at the government\u2019s drug advisory body in Hungary since 2007. Peter also contributed to building a network of advocacy NGOs in Europe: the European Drug Policy Initiative. He provided technical assistance to several NGOs, and launched several campaigns on drug policy reform. As a member of the Drugreporter video advocacy team, he has produced videos about drug policy issues in a number of countries. These videos are now part of a unique online drug policy video library.","url":"https:\/\/drogriporter.hu\/en\/author\/sarosip-2\/"}]}},"featured_image_src_square":"https:\/\/drogriporter.hu\/wp-content\/uploads\/sites\/8\/2016\/08\/od_day.jpg","_links":{"self":[{"href":"https:\/\/drogriporter.hu\/en\/wp-json\/wp\/v2\/posts\/6384","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drogriporter.hu\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drogriporter.hu\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drogriporter.hu\/en\/wp-json\/wp\/v2\/users\/1005"}],"replies":[{"embeddable":true,"href":"https:\/\/drogriporter.hu\/en\/wp-json\/wp\/v2\/comments?post=6384"}],"version-history":[{"count":0,"href":"https:\/\/drogriporter.hu\/en\/wp-json\/wp\/v2\/posts\/6384\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drogriporter.hu\/en\/wp-json\/wp\/v2\/media\/6325"}],"wp:attachment":[{"href":"https:\/\/drogriporter.hu\/en\/wp-json\/wp\/v2\/media?parent=6384"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drogriporter.hu\/en\/wp-json\/wp\/v2\/categories?post=6384"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drogriporter.hu\/en\/wp-json\/wp\/v2\/tags?post=6384"},{"taxonomy":"countries","embeddable":true,"href":"https:\/\/drogriporter.hu\/en\/wp-json\/wp\/v2\/countries?post=6384"},{"taxonomy":"section","embeddable":true,"href":"https:\/\/drogriporter.hu\/en\/wp-json\/wp\/v2\/section?post=6384"},{"taxonomy":"video-author","embeddable":true,"href":"https:\/\/drogriporter.hu\/en\/wp-json\/wp\/v2\/video-author?post=6384"},{"taxonomy":"drug","embeddable":true,"href":"https:\/\/drogriporter.hu\/en\/wp-json\/wp\/v2\/drug?post=6384"},{"taxonomy":"archive","embeddable":true,"href":"https:\/\/drogriporter.hu\/en\/wp-json\/wp\/v2\/archive?post=6384"},{"taxonomy":"video-series","embeddable":true,"href":"https:\/\/drogriporter.hu\/en\/wp-json\/wp\/v2\/video-series?post=6384"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}