Overdose Awareness Involves More Than Just Thoughts and Prayers

Overdose Awareness Involves More Than Just Thoughts And Prayers

This week is International Overdose Awareness Week and it will take all of us to combat overdose deaths. Rahul Gupta, Director of the White House Office of National Drug Control Policy, recently highlighted the urgency of making the overdose reversal drug Naloxone more accessible across the U.S. to help stem the tide of the Fentanyl overdose epidemic. He highlighted the urgent need for consistent will, commitment to resources and action.

There has been some progress with overdose deaths slightly decreasing in 2023 and so far in 2024, but the CDC (Centers For Disease Control) stated that overdoses claimed the lives of almost 200,000 people in 2020 and 2021 alone with synthetic opioids like Fentanyl causing most of those deaths.

Short-term, improving access to overdose prevention drugs like naloxone will help those experiencing an overdose not die of it in the moment. However, it is not a good long-term solution to reducing overdose deaths since first responders and those that work in emergency rooms will tell you that those that experience overdoses sometimes will go right back out and continue their drug use, even in the face of the consequences of overdosing again due to the progressive and pervasive nature of those with SUD.

So, what can be done short-term and long-term to improve our efforts at reducing overdose deaths?

According to the U.S. Department of Health & Human Services (HHS) there are four main pillars in their overdose prevention strategy including:

Primary Prevention – preventing SUD (substance use disorder)
Harm Reduction – using strategies to reduce the harm of those engaged in active addiction.
Evidence Based Treatment – For those at a stage in their substance addiction where they are ready, having access to high-quality treatment for their SUD, including simultaneously addressing co-occurring mental health issues.
Recovery Support – Promoting connection and community through recovery support services, which can lead to better long-term outcomes.

While the overdose pandemic is a national issue it is brutally personal to anyone who has lost a loved one to a drug overdose death. The HHS goes on to state, “As the overdose crisis continues to change, we must take a pragmatic, evidence-based approach to saving lives, reducing risk, and removing barriers to effective interventions. This requires that we provide care and services that respect the health and dignity of people who use drugs.”

Prevention efforts, especially with adolescents in getting them the help they need early with mental health services, education about identifying risk factors and advocacy about the latest holistic substance addiction prevention facts and approaches is making a difference. The National Academy For State Health that provides detailed prevention strategies utilizing opioid settlement funding states, “Continued investment of evidence-based practices and strategies for reducing substance use, supporting early intervention, and reducing harms is critical to building a future addiction infrastructure.”

The NIH (National Institute Of Health) gives a good outline of how harm reduction efforts can help those in the early stages of substance addiction reduce the risks of overdose while they move towards recovery. While some of these strategies are controversial about whether they are helping or hurting those still in active drug use, the NIH states, “Decades of research have shown that some harm reduction strategies provide significant individual and public health benefits,^4,5,6 including preventing deaths from overdoses and preventing transmission of infectious diseases among people who use drugs and the larger community. Others reduce emergency department visits and costly healthcare services,^7,8 while in some cases offering people who use drugs opportunities to connect to substance use treatment ^9,10 and other healthcare¹⁰ services in settings relatively free of stigma.”

A research study listed in the NIH (National Institute of Health) in March 2024 looked at the spike in overdoses recently involving both stimulants (like Crack Cocaine and Methamphetamine) and opioids (like Fentanyl) which are often used in conjunction with one another for those in active addiction. Polysubstance use is on the rise, especially in large cities like Los Angeles and New York City, and is a well-documented risk factor for overdoses. This study looked at POINTS (Preventing Overdoses Involving Stimulants Study), which involved:

Looking at risk factors
Qualitative and quantitative evaluation of the drug supply of stimulants and opioids and use patterns
Collaborating with overdose prevention and response stakeholders to develop feasible, acceptable, and scalable multilevel strategies to prevent stimulant and opioid-involved overdoses in high-risk regions.

This study is ongoing but will provide valuable tools for those on the front lines to use to help reduce overdoses, as there is a lack of data about the current and evolving drug supply, how people use drugs in today’s more accessible illicit drug market, and community stakeholders have valuable insights into the feasibility and acceptability of intervention strategies in the evolving landscape.

Taking into account people in all stages of change of their SUD is vital to developing actionable strategies to reduce overdose deaths as not everyone is ready to get sober through a sustainable abstinence based recovery process until later in the progression of their substance addiction, and don’t deserve to die in the interim as they move through the evolution of their SUD progression involving active drug use and relapse.

Long-term, systemically treating the cause and not just the symptoms and signs of overdoses will holistically provide the best path to reducing overdoses in the U.S. The cause is SUD, and a 12-Step approach would say that means it is a threefold mind/body/spirit cause that requires a simultaneous and integrated threefold solution to attain sustainable recovery, that is not just surviving their SUD and co-occurring mental health issues, but living a life sober that is thriving.

To that end, another research study involving over 9,000 participants looked at core SUD recovery elements as a multifaceted process of ongoing personal development, aiming for sustained improvement in all areas of life, which is the eventual goal of recovery. It states, “Rather than imposing a top-down definition of recovery, this study considered the collective voices of individuals with lived recovery experience, aiming to forge an empirical, shared understanding of the term.” While those with long-term lived experience in recovery are interwoven into most strategies of SUD recovery, they are often under-valued in their effectiveness to help those seeking sustainable recovery attain it. Those devoting their lives to helping those with SUD, whether with a licensed clinical background and/or those without that background but that have valuable long-term lived experience in recovery need to do more to work together as a team and community and it will go a long way towards a holistic solution to the overdose pandemic.

Finding common ground about recovery is essential in helping people with SUD find a path to recovery that can be sustainable and lead to a happy, joyous and free life. Long-term, this is the best way to help holistically reduce overdose deaths and requires all of us to actively participate to bring it about. Until we systematically move to a more holistic approach to combat overdose deaths, I fear it will be more of a “whack-a-mole” outcome and not address the underlying causes and conditions behind substance addiction. Research shows that it takes at least 90 days to form a lasting habit, so taking the time and money now, working together to develop holistic long-term year+ SUD recovery solutions will help create resilient healing to those currently dying of drug overdoses.