The last day of August each year is International Overdose Awareness Day (IOAD). This year, we encourage everyone to recognize this day with the hashtag #iOAD2023.
This awareness day is organized by a non-profit health advocacy group based in Australia called the Pennington Institute. The overall goals of iOAD are to:
- Set aside a day for family and friends to mourn loved ones lost to overdose.
- Remind people who use drugs and people in recovery that we recognize their value and seek to support them in any way we can.
- Raise awareness worldwide about the risk of drug overdose.
- Supply helpful, practical, accurate information on the support services available to people in recovery, people who use drugs, and people at risk of overdose.
- Prevent and/or end harm associated with drug use and overdose by recognizing and supporting the value of evidence-based prevention and treatment practices.
The theme for IOAD2023 is “Recognizing Those People Who Go Unseen.” This theme allows us to bring attention to people directly affected by overdose, but for various reasons, may go unrecognized, be undervalued, or be otherwise overlooked when our attention is on supporting victims of both fatal and nonfatal overdose.
These unseen heroes include:
- Family and friends of lost loved ones
- Healthcare workers and support service workers who display strength, resiliency, and compassion every day
- First responders who save lives every day
The organizers of IOAD2023 and everyone at Pinnacle Treatment Centers has one message for these underappreciated and underrecognized people:
We see your strength, we see your courage, and we see your commitment to helping other people. On international overdose awareness day, we want to amplify your voices and recognize everything you do behind the scenes. You should not bear this burden in silence: today, we loudly and proudly lift you up so the world can see the heroic deeds – large and small – you perform every day, not just on overdose awareness day.
Why Do We Need International Overdose Awareness Day?
If you follow the news, or read this blog regularly, you know we need an overdose awareness day in the United States because of the opioid overdose crisis. To read our library of over sixty articles on the opioid crisis, please navigate to the blog section of our website and browse our articles, or click this link:
The need for an overdose awareness day in the U.S. is further bolstered by recognition from our highest-ranking public officials. Here’s A White House Proclamation from last year that describes the importance of iOAD, and established the last week in August of every year as Overdose Awareness Week:
“Overdose Awareness Week is a time to remember those tragically lost to overdose and the pain of the families who are left behind. But it is also an opportunity to recommit ourselves to working together to build safe, healthy, and resilient communities. By adopting evidence-based approaches to reducing overdose risks and lowering barriers to treatment and support, we can save more American lives.
Now, therefore, I do hereby proclaim August 28 through September 3, 2022, as Overdose Awareness Week.”
In 2023, Overdose Awareness Week will occur from August 27th to September 3rd. We’ll publish articles on that week soon. For the moment, we’ll return to the topic of why we need an international overdose awareness day.
The answer is simple.
We need one for the same reason we need overdose awareness in the U.S.: the entire world is in the midst of a drug overdose crisis.
Let’s take a look at the data.
Drug Overdose Worldwide: Facts and Figures
It’s important to recognize that like in the United States, misuse of opioids drives the worldwide overdose crisis. At the end of 2022, the organizers of iOAD, Pennington Institute, released a study called “The Global Overdose Snapshot: 2022.” We’ll draw on data from that report throughout this section of this article.
Here’s the first salient fact from that report: the increase in opioid use around the world.
Global Number of Opioid Users
- 2010: 31 million
- 2020: 61.3 million
That’s an increase of 65 percent in ten years. That qualifies as a red flag and indicates the presence of a real public health crisis that puts millions of lives at risk every day. Next, we’ll look at the rates of fatal overdose around the world. We’ll report the data available in the Pennington Report: reports from some countries includes all drugs, while reports from others include opioids only.
Drug-Related Deaths: The Most Recent Worldwide Data
(For data on the 29 countries in the European Union, click here and scroll to “EU”)
Australia, All Drugs:
- 2010: 1,756
- 2020: 2,220
- 2010: 1,160
- 2020: 7,560
England and Wales:
- 2010: 2,747
- 2020: 4,561
- 2014-2018, All Drugs: 46 per year, average
- 2019, Opioids: 307
- 2010: 92
- 2020: 218
- 2013: 527
- 2020: 1,339
- 2018: 47
- 2019: 57
- 2019, All Drugs: 421
- 2018: 335
- 2018, Opioids: 319
- 2010, All Drugs: 38,329
- 2010, Opioids: 21,089
- 2020, All Drugs: 91,799
- 2020, Opioids: 68,5630
- 2021, All Drugs: 107,622
- 2021, Opioids: 80,411
That information makes the case clear. There’s a worldwide drug overdose crisis. Within that drug overdose crisis, there’s an opioid overdose crisis driving the fatalities. That’s true in the United States, Canada, and throughout Europe. While access and accurate records are difficult to obtain for Africa, Asia, the Middle East, Central America, the Caribbean, and South America, here’s the information we do have:
- The WHO reports a serious problem with the drug tramadol, and estimate drug use will increase by 40% by 2030 in Africa.
- Unofficial estimates indicate 49,000 drug related deaths
- Chinese media reported 14 million drug users
- The Office of China National Narcotics Control Commission reported “The situation of drug abuse continues to improve and that drug abuse in China has been curbed.”
South America and Latin America:
- Reliable, verifiable opioid use and overdose data is unavailable
- South America and Latin America report the highest rate of individuals in treatment for cocaine addiction
- In Mexico, hospital records indicate methamphetamine is the most common drug detected in overdose deaths
- Authorities report an increased presence of fentanyl in street and party drugs in Colombia, Argentina, Uruguay, and Chile
Clearly, we have a worldwide crisis on our hands. It revolves around the misuse of drugs, specifically opioids. Therefore, we’ll now share the signs of opioid overdose, so that anyone reading this article knows what to look for, and can share this information with anyone who needs it.
Opioid Overdose: What to Watch For
First, let’s define overdose:
Overdose occurs when a person’s body has a severely harmful reaction to taking too much of a drug or a combination of different drugs. Overdose can be fatal or non-fatal.
Next, it’s important to understand the risk factors associated with opioid overdose:
Opioid Overdose Risk Factors
- Diagnosis of opioid use disorder (OUD)
- Excessive opioid, regardless of OUD diagnosis
- Use of powerful opioids such as fentanyl or carfentanil
- Long-term opioid use
- Misuse of prescription opioids
- Mixing opioids with drugs such as benzodiazepines, alcohol, or any sedative
- Intravenous (IV) opioid use, a.k.a. injecting any opioid
- Relapse to opioid use after a period of abstinence
- Presence of chronic health conditions including obesity or sleep apnea
Those are the risk factors, which means the presence of one or more increase risk of opioid overdose. Now let’s discuss how to recognize an opioid overdose when it’s happening. The Centers for Disease Control (CDC) maintains International Overdose Awareness Day page filled with useful information on overdose awareness and prevention.
CDC: How to Recognize an Opioid Overdose
It’s not always easy to recognize an overdose. If there’s any uncertainty, it’s best to err on the side of caution, and call 911 immediately. If naloxone is available, administer it immediately – and do not leave the possible overdose victim alone.
Physical Signs of Opioid Overdose
- Small pupils, called pinpoint pupils
- Passing out/losing consciousness
- Slow, weak, or absence of breathing
- Unusual, uncharacteristic choking/gurgling sounds
- Any strange noises related to breathing
- Limp, unresponsive body
- Cold, clammy skin
- Discolored skin
- Discolored lips and/or fingernails
The best way to reverse and overdose is with the medication naloxone. Naloxone can reverse an overdose due to opioids such as heroin, fentanyl, and prescription opioids. It’s available in two forms:
- Injectable liquid in a pre-filled syringe
- Intra-nasal spray
Naloxone can be administered as follows:
- Injection into the muscles of upper arm (injectable form)
- Injection into the outer part of the thigh muscle (injectable form)
- Spray directly into the nose (nasal spray)
The CDC indicates you should carry naloxone if:
- You’re at risk increased risk of opioid overdose, as determined by the risk factors listed above
- A friend or family member is at risk of opioid overdose, as determined by the risk factors listed above
- You have an opioid use disorder (OUD) diagnosis
- A friend or family member has an opioid use disorder (OUD) diagnosis
- You take high-dose prescription opioids
- A friend or family member takes high-dose prescription opioids
- You have prescriptions for both opioid and benzodiazepine medication
- A friend or family member has prescriptions for both opioid and benzodiazepine medications prescriptions
- You use illicit substances like heroin or fentanyl
- A friend or family member uses illicit substances like heroin or fentanyl
If you meet any of the criteria above, we recommend gaining access to naloxone and either asking your doctor how to use it or find a local resource for naloxone training. You can find out where to acquire naloxone and receive naloxone training on this website:
You can also watch tutorials, read information flyers, and engage in virtual role-play scenarios involving naloxone administration here:
All of that information on naloxone is essential for people who use opioids either legally or illegally, and it’s equally essential for people with friends or family who use opioids either legally or illegally. In either case, the importance of having the means at hand to immediately reverse an opioid overdose is impossible to overstate.
Stated simply, having naloxone on hand can save your life, or the life of someone you love.
How We Can All Participate in International Overdose Awareness Day
Let’s remind ourselves of the theme for iOAD2023: The theme for iOAD2023:
“Recognizing Those People Who Go Unseen”
The unseen include family members of fatal overdose victims, addiction treatment providers, case managers, peer support workers, and social support experts that show up every day to help people with opioid use disorder (OUD) or any other type of addiction that increases risk of overdose. The theme is to recognize the unseen, and the message is this:
That’s what we want our colleagues around the country and world to know: we see you, we see the work you do, we see the suffering you experience, we see the suffering you alleviate, we see the same harm you see every day, and we see your efforts to reduce that harm. We see ourselves in you and your work, and we thank you for doing it.
To reduce risk of overdose, providers at Pinnacle Treatment Centers and other treatment centers around the world engage in daily efforts to:
- Educate patients and families on factors that increase overdose risk
- Raise awareness about naloxone
- Encourage patients at risk of overdose to carry naloxone
- Teach patients and families how, why, and when to administer naloxone
- Stress the importance of the steps to take after an overdose
We’ll focus on that last point. Administering naloxone and stopping a potential overdose does not solve the problems that led to the opioid overdose: it’s a short-term, lifesaving solution to an acute medical emergency caused by opioids.
After an overdose, the most important thing to do is connect the overdose victim to professional support for opioid use disorder (OUD). An overdose can be the wake-up call a person needs to get into treatment – but if no one is around to answer that call, the moment can pass, and the person may lose the desire to seek treatment. Therefore, following up after the overdose is essential. Getting the overdose victim into the care of treatment professionals is the best way to prevent another overdose.
We’ll end this article on iOAD2023 with two messages. To our treatment colleagues in the U.S. and around the world, this is well worth saying again: #weseeyou.
And to everyone else, this message: