Practice Tip of the Week | Overdose Awareness and Prevention

By Lucindra Campbell-Law

Overdose is highly stigmatized, and that’s one of the problems International Overdose Awareness Day, celebrated August 31, seeks to address. As nurses, our aim is to raise awareness of overdose and reduce the stigma of overdose-related deaths.

It is important to ensure that your patients know the right amount and the right time to take medication. It is also vital to make sure they know what drugs should not be mixed, and how to seek help if they feel they are not in control of their drug use. make a difference by sending a strong message to the community that the consequences related to overdose are preventable.

Some combination substances such as stimulants (e.g., cocaine, methamphetamine), opioids, and depressants (e.g., benzodiazepines, alcohol, and sleep medications), place users at greater risk of an overdose. In combination, these substances can tax the heart and the respiratory system, greatly compromising the individual’s health. Making sure that the greater community is aware of these dangers is crucial.

Analysis of the latest publicly available data from each country finds that in 2020, the U.S. had the highest unadjusted rate of drug overdose deaths (277 deaths per million residents. May 19, 2022). (CDC’s Drug Overdose Surveillance and Epidemiology (DOSE) system). According to the World Drug Report (UNODC, 2021), about 275 million people used drugs at least once in the previous year. Death related mainly due to overdose has increased by 45% over the last decade (UNODC, 2021) and COVID-19 appears to have accelerated the trend of increasing overdose deaths (UNODC, 2021).

Recently, with support from the Division of Overdose Prevention in the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention, the National Association of County and City Health Officials has released a new resource designed to identify existing barriers local and state health departments face to advancing health equity in their overdose prevention or response efforts. Through an environmental scan of the community needs, state and local health departments must be able to better identify gaps and implement innovative strategies to leverage health equity and the social determinants of health within drug overdose prevention and response.

Decades of robust research on harm reduction strategies, specifically syringe services and naloxone distribution, demonstrate that these strategies are associated with reduced morbidity, mortality, and transmission of infectious diseases and improved individual health outcomes and services engagement and high cost-effectiveness.

Another area that nurses can address is the stigma that remains surrounding substance use disorders and overdoses. Instead of using terms that blame the individual for the misuse or overuse of substances that can lead to overdose, nurses can reduce the stigma by promoting a synergy of change and by changing the language when educating the public. 

Preventing overdose deaths can be addressed at two levels: implementing a set of interventions geared towards full-blown prevention or reducing the fatal outcomes after overdoses have occurred. At both levels, strategies used include the scaling-up of protective factors and the reduction of risks. Some of the most important strategies used are increased awareness of overdose risks. Bystander responses must also be improved, through information and training in overdose prevention, recognition and response.

Steps to action:

• To stimulate discussion about overdose prevention and drug policy.
• To provide basic information on the range of available support services.
• 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.

Initiatives to support prevention of substance misuse, overuse, and overdose would increase the awareness of and educate the public about factors that can lead to overdose. Nurses should use research-based strategies that have proven successful in a variety of activities such as awareness, education, and training. Engage community sectors, healthcare organizations, religious entities, schools, educational organizations and substance abuse organizations to garner ongoing support.

REFERENCES

John F Kelly, Valerie Earnshaw, Society of Behavioral Medicine (SBM) position statement: End the fatal paradox: change the names of our Federal Institutes on Addiction, Translational Behavioral Medicine, Volume 11, Issue 5, May 2021, Pages 1160–1161,  https://doi.org/10.1093/tbm/ibaa117

Heley K, Kennedy-Hendricks A, Niederdeppe J, Barry CL. Reducing Health-Related Stigma Through Narrative Messages. Health Commun. 2020 Jun;35(7):849-860. doi: 10.1080/10410236.2019.1598614. Epub 2019 Apr 23. PMID: 31014112.

Elizabeth A. Samuels, MD, MPH, MHS¹ ; Dennis A. Bailer, PRS² ;  Annajane Yolken, MPH² ; JAMA Netw Open.  2022;5(7): e2222153. doi:10.1001/jamanetworkopen.2022.22153

Harocopos A , Gibson BE , Saha N , et al.  First 2 months of operation at first publicly recognized overdose prevention centers in US. JAMA Netw Open. 2022;5(7): e2222149. doi: 10.1001/jamanetworkopen.2022.22149

https://www.cdc.gov/nchs/data/databriefs/db394-H.pdf  Centers for Disease Control and Prevention. Drug Overdose Deaths in the United States, 1999–2019. Retrieved March 31, 2020, from https://www.cdc.gov/nchs/data/databriefs/db394-H.pdf

Centers for Disease Control and Prevention. Drug Overdose Deaths in the United States, 1999-2018. Retrieved September 1, 2020, from  https://www.cdc.gov/nchs/products/databriefs/db356.htm

John F Kelly, Valerie Earnshaw, Society of Behavioral Medicine (SBM) position statement: End the fatal paradox: change the names of our Federal Institutes on Addiction, Translational Behavioral Medicine, Volume 11, Issue 5, May 2021, Pages 1160–1161,  https://doi.org/10.1093/tbm/ibaa117

Heley K, Kennedy-Hendricks A, Niederdeppe J, Barry CL. Reducing Health-Related Stigma Through Narrative Messages. Health Commun. 2020 Jun;35(7):849-860. doi: 10.1080/10410236.2019.1598614. Epub 2019 Apr 23. PMID: 31014112.