Reflecting on International Overdose Awareness Day

Tuesday 31 August is International Overdose Awareness Day.

Rhonda Robertson, Principal advisor lived experience and peer project lead (addiction) reflects on the importance of this day and why it matters here in Aotearoa.

It’s only recently that I’d stopped to consider what it must be like to lose a son, daughter, parent or partner to overdose, I’d never really thought about it in that way.

Given my lived experience of opioids and injecting drug use, this may seem a little odd. My perspective on overdose was an occupational hazard. I’ve been reflecting on this quite a bit lately mainly due to International Overdose Awareness Day, held annually on August 31^st.

Overdose awareness day has its origins dating back to 2001 and was initiated by Sally J Finn at the Salvation Army needle and syringe program in St. Kilda Melbourne.^[1] This had been precipitated by a heroin glut and contributed to reported increases in fatal and non-fatal overdose in the late 1990s.^[2] What is now a global campaign, started off as a local community event for friends and family to come together to commemorate loved ones who had died from an overdose. Loved ones were often left with considerably shame and sorrow, due to the stigma surrounding people who use substances. The aim was to raise awareness of overdose and reduce substance-related death, especially for those mourning the loss of family and friends.

The goals of the International Overdose Awareness Day are:

• To provide an opportunity for people to publicly mourn loved ones in a safe environment, some for the first time without feeling guilt or shame.
• To include the greatest number of people in International Overdose Awareness Day events, and encourage non-denominational involvement.
• To give community members information about the issue of fatal and non-fatal overdose.
• To send a strong message to current and former people who use drugs that they are valued.
  
• To stimulate discussion about overdose prevention and drug policy.
• To provide basic information on the range of support services that are available.
• To prevent and reduce drug-related harm by supporting evidence-based policy and practice.
• To inform people around the world about the risk of overdose.

International Overdose Awareness Day is coordinated by not-for-profit public health organisation, Penington Institute.^[3]

Perhaps the most publicised example in recent history is what is often referred to as the opioid epidemic in the United States. The 12 Month-ending Provisional Counts and Percent Change of Drug Overdose Deaths in the United States are predicting over 95,000 in 2021.^[4]

Why does this matter here in Aotearoa?

When most people think of overdose, they may think of Trainspotting or lying unconscious with a needle hanging out of their arm. Public perception of overdose tends to centre around opioids i.e. heroin, fentanyl, morphine etc. however, in Aotearoa the reality is quite different. While we do have deaths related to opioids we have more deaths related to the use of synthetic cannabinoids and methamphetamine. Alcohol is also significantly involved in many overdose deaths as are benzos i.e. diazepam, clonazepam etc. Alcohol poisoning is occasionally reported in the media but the legality of alcohol means that it doesn’t grab the attention that other substances do i.e. methamphetamine or synthetic cannabinoids, so availability of alcohol products ensures quality and production control and accurate harm reduction lower-risk drinking guidance.

The overdose rates relating to the use of synthetic cannabinoids 70-75 deaths between 2017 – 2019^[5] resulted in an across government and wider community response to the Acute Drug Harms Initiative. This includes High Alert which provides current information on risks associated with particular substances and particular communities. The recent sanctioning of drug checking is also a pragmatic response to the risks associated with black market to access substances.^[6] The recent approval and scheduling of naxolone for opioid overdose is an example of harm reduction in practice.

While there’s currently no coordinated national response to International Overdose Awareness Day, a number of services such as needle exchange and addiction services acknowledge the 31^st of August every year.

Find out more about International Overdose Day here.

References

[1] https://www.overdoseday.com/about-the-campaign/

[2] Dietze P et al. 2004. The course and consequences of the heroin shortage in Victoria. NDLERF monograph no. 6. Canberra: Australian Institute of Criminology. https://www.aic.gov.au/publications/ndlerfmonograph/ndlerfmonograph6

[3] https://www.penington.org.au/

[4] Ahmad FB, Rossen LM, Sutton P. Provisional drug overdose death counts. National Center for Health Statistics. 2021. https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm#dashboard

[5] https://www.rnz.co.nz/news/nat...

[6] https://knowyourstuff.nz