Today, August 31, is the International Overdose Awareness Day.
Today, we claim the information, prevention and reduction of overdose and consequently the deaths it causes.
What is an overdose?
According to the IOAD, “[a]n overdose means having more of a drug (or combination of drugs) than your body can cope with. There are a number of signs and symptoms that show someone has overdosed, and these differ with the type of drug used. All drugs can cause an overdose, including prescription medication prescribed by a doctor.”
Deaths from drug overdoses remain higher than the annual total number of deaths from road accidents and AIDS, and their rapid growth in recent years has reduced overall life expectancy in the United States.
In the US from 2013 to 2017 the number of overdose deaths increased by 90%.
In 2017, 70,237 deaths were recorded in the US and 8,238 in EU member states.
4% of all deaths in Europe, between the ages of 15-39, are due to drug overdose.
Two out of three drug overdose deaths in 2018 were related to opioids (most of them due to a combination of drugs). The largest percentage is due to the use of synthetic opioids (fentanyl).
Deaths from illicit psychostimulants, such as methamphetamine, increased by more than 250 percent between 2008 and 2015 and by 33% between 2016-2017.
The COVID-19 pandemic period has also dramatically affected overdose deaths, with a record number of deaths in many US states and provinces, with concerns about a larger increase over the year.
Let’s talk about Greece
Numbers and Recording of Deaths
According to the National Center for Documentation and Information on Drugs (EKTPN) there is a reduction in overdose deaths in the years 2005-2016, while a 50% increase is reported in 2017-2018.
However, the way in which deaths are recorded in Greece is the subject of intense criticism and controversy both nationally and internationally. Until 2017, the recording comes from the Drugs Department of the Public Security Department of the Hellenic Police and since then EKTEPN in collaboration with ELSTAT is investigating the issue further.
Greece is the only European country without official data in the EMCDDA (European Monitoring Center for Drugs and Drug Addiction).
Harm Reduction Policies
Harm reduction in relation to drugs seeks to minimise the harm (prevalence of diseases, deaths, etc.), but without necessarily imposing the reduction of consumption. Some of its policies are:
1. Drug Consumption Rooms (DCR)
The DCRs aim to promote the health of active drug users, protect the public health, prevent and intervene to address overdose, mobilize and link to treatment programs, promote social inclusion.
The creation of DRC was legislated in 2019, 6 years after the closure of ODYSSEA, the first DCR that OKANA had opened. However, today and being a year after the legislation, no action has been taken towards their operation.
Naloxone can bring back to life a person who has had drug overdose. It can be administered intravenously or in the form of a spray, inhaled through the nose. Within a maximum of 5 minutes after its administration, naloxone restores breathing and presents no contraindications at all.
In Europe, its disposal and administration as a harm reduction measure is a common and widespread practice (in DCRs and individually in Take-Home programs).
In Greece, naloxone is only available as a hospital drug and individual access is absent even from national drug planning.
3. Clean use kits provision to street-connected people
The provision of clean injectable material by street-workers is a limited but existed practice in Greece. Outreach actions are usually carried out by KETHEA, OKANA, KELPNO, and other Civil Society organizations.
The supply of inhaled material is completely absent from the Greek field, although the use increases sharply and alongside the subsequent deaths. In Athens, we observe a dramatic increase in the use of “sisa”, that is crystal methamphetamine of questionable quality, that deteriorated health rapidly.
The provision of harm reduction kits lacks institutional coverage. The organizations that provide them act under an uncertain legal framework.
‘Good practices’ are numerous internationally. The only one responsible for overdose deaths is the state and the policies that have been pursued for the last 30 years, at least.
Political parties may alternate, but death policies remain, targeting and stigmatizing people. Social stigma and repression increase the risk of death, as it isolates and marginalizes the person who does not have substantial access to public health, treatment and information services.
During the last year, the repression – mainly on the occasion of the COVID-19 era – is the main narrative of an authoritarian government whose only concern is its image.