31 August 2012
The annual International Overdose Awareness Day, founded by The Salvation Army, occurs on Friday, 31 August.
This day aims to educate Australians and people overseas about drug overdoses (ODs); related to licit (prescribed) substances and illicit drugs such as heroin. We also want to raise awareness of warning signs of ODs; to respect and acknowledge people's grief; to honour the memory of those who have been lost; and to support those who are doing the grieving.
Every year the International Overdose Awareness Day presents stories of loss and hope; of grace and pain and grief and insight. Memories are honoured and information is shared. Brave loved ones share their lives, and the general public is exposed to education on harm minimisation, and some signs and treatment of overdoses. People of good will want to stop overdoses and to prevent them, when they do occur, from having fatal consequences for all concerned.
One emphasis this year is raising awareness that irregular sleeping patterns characterised by loud, erratic snoring and gurgling may potentially be an indicator of overdose, as the respiratory system is shut down by chemical reactions to the substances concerned. This is not a readily recognised indicator of overdose for people in everyday circumstances.
Another aspect to this year's IOAD is the continuing public conversation about the prospects and possible impact of a real time monitoring system being introduced for prescribed drugs. Such a system would allow general practitioners and pharmacists instant access to a database that allows them to see if scripts had already been requested, written up and filled out for individual patients.
'A real time monitoring system is part of the answer to prevent the abuse of prescription drugs, but it's not a magic solution,' explains John Ryan of Anex.*.
'We need further education about drug use and the risks associated with both prescribed and illicit drug use. We need better information to be available relating to prescription drugs, and we need doctors and pharmacists to be more proactive and engaged with clients who come to them in pain. We also need more funding for pharmacotherapy treatment â€“ in other words, medically assisted addiction treatments such as methadone and buprenorphine that assist people through withdrawal and maintenance programs.'
Royal Abbott, from Anex* says doctors need to educate their patients about the potentially fatal impact the substances can have, particularly combined with other Central Nervous System (CNS) depressants such as alcohol, benzodiazapines or medications used for insomnia .
'Overdose is a preventable tragedy,' adds John, 'which leaves people behind to pick up the pieces. There are just not enough doctors who understand the issues, or who take the time to deal with a patient's issues. It's often about the stigma attached to a patient.
'The approach to minimising harm in people's lives has to improve in this country. We can no longer allow the stigmatising of family and friends of those who lose their lives or their health to overdoses.'
Using drugs such as alcohol, and legal and illegal opiates, etc., is an exercise as long as human history. As well as the reality of physical addiction to some substances, drug use can be a form of self-medication for people in extremis: drug users often take the substances to mask emotional, physical, psychological and spiritual pain and distress.
'Drug use is a medical issue; not a moral failure,' John emphasises. 'It touches people from all demographic groups and all walks of life.'
'It's too easy for people to demonise drug overdoses as some dramatic, sordid adventure with heroin in a back alley. The reality is that many people in Australia 'slip away' accidentally with normal prescription drugs and a few alcoholic drinks,' adds Royal Abbott. 'The combination is toxic.'
'More often than not, overdoses are accidental,' says Belinda McNair from The Salvation Army Australia Southern Territory's alcohol and other drugs (AOD) unit. 'Often, assumptions are made of people's intentions and purposes, and states of mind, that are without foundation.
'Also,' she adds, 'the reality is that when people do manage to reduce their drug use, or get off them completely, their bodies' tolerance levels drop as usage diminishes. This puts them at increased risk and means that the likelihood of overdosing increases as people make progress with their recoveries. If they use again, after periods of decreased use or abstinence, it can send their bodies into an overdose.
'People especially at risk of an overdose include those who have been abstaining voluntarily as part of a treatment regimen, or have been removed from access to drugs while serving a custodial sentence in prison.
Belinda explains that, in Victoria alone, approximately 80% of overdoses occur as a result of polydrug use (that is, a mixture of substances such as heroin, alcohol and prescription drugs) or lowered tolerance.
'The misuse of legally-obtained pharmaceutical products and alcohol is a growth area in overdoses,' Belinda says, 'and that's especially true in rural areas.'
This article resulted from a conversation with Belinda McNair, a service development officer in the Salvation Army's Australia Southern Territory's alcohol and other drugs unit, and John Ryan and Royal Abbott, respectively the CEO and the communications officer of Anex.* For more information contact Barry Gittins, territorial social policy and programme consultant (researcher/writer), firstname.lastname@example.org.
* Anex is an independent, not-for-profit health organisation that is 'dedicated to reducing the harms associated with drug use, including, injecting drug use, alcohol misuse, and pharmaceutical substance misuse. Anex upholds the Australian government's commitment to harm reduction as an essential element of its harm minimisation strategy on drugs.'
Read Shane story, a victim of OD in the latest issue of our Warcry magazine.