Drug Overdose Prevention Strategies and Resources

Drug overdoses, especially those associated with opioids like fentanyl, have become a national epidemic— 841,000 people have died of a drug overdose since 1999.1 However, overdose prevention strategies and resources can help prevent a fatal overdose in you or someone you know.

In this article:

Drug Overdose Statistics and Figures

In the United States, we are currently experiencing an unprecedented opioid crisis or epidemic, including opioid misuse, illicit opioid use, and opioid overdoses. Plus, many people are experiencing life-threatening adverse effects from non-opioid drugs as well, such as methamphetamine, cocaine, and synthetic drugs like bath salts.

According to the Centers for Disease Control and Prevention (CDC):1

  • Nearly 71,000 people died from drug overdoses in 2019 in the U.S.
  • Just under 73% of opioid overdoses involved synthetic opioids like fentanyl in 2019
  • Nearly 71% of all drug overdose deaths involved opioids in 2019
  • Overdose deaths on psychostimulants like methamphetamine are on the rise

More recent data from the CDC indicates that there were over 100,000 drug overdose fatalities in the U.S. in a one-year period ending in April 2021. This is a 28.5% increase from the previous year. Overdose deaths related to synthetic opioids like fentanyl, psychostimulants like methamphetamine, cocaine, and natural and semi-synthetic opioids like prescription painkillers all increased in that same 12-month period.2

Overdose Prevention Opportunities and Risk Factors

According to the CDC, more than 3 out of 5 drug overdose deaths in 2019 involved at least one opportunity to connect individuals to addiction care before an overdose occurred or to emergency care after an overdose.3 Some examples of opportunities for linkage to care include:3

  • Previous overdose: About 10% of people who died of opioid overdoses had experienced a previous overdose.
  • Mental health disorder: About 25% of people who died of drug overdoses had been diagnosed with a mental health condition.
  • Recent release from an institution: Approximately 10% of people who died from an opioid overdose had recently been released from prison, jail, rehab, or the psychiatric hospital.
  • Addiction treatment: Nearly 20% of people who died from opioid overdoses had previously received addiction treatment services.
  • Witness: Just under 40% of stimulant and opioid overdoses occurred while a witness was present.

Increased access to overdose prevention strategies as well as knowledge about prevention and overdose treatment, can help save lives.

Overdose Prevention Strategies

The rate of drug overdose deaths is alarming; however, the fight against overdoses is not hopeless. There are many drug overdose prevention strategies that can help.

Prevent Substance Misuse and Abuse

Preventing substance misuse begins with safe prescribing practices. Many people who overdose on opioids begin misusing them after receiving a prescription. And this may be due to the increases in opioid prescriptions written over the past decade or so.

Safer guidelines, developed by the CDC, for prescribing opioids for chronic pain can help:

  • Improve patient outcomes, such as improved function and decreased pain
  • Reduce over-prescribing by physicians
  • Decrease the number of people who develop an opioid addiction
  • Decrease the number of opioid-related overdoses

These safer and more effective prescribing guidelines also apply to the over-prescribing of benzodiazepines like Xanax, which have a moderate risk of misuse and addiction. People also commonly mix drugs like benzodiazepines and alcohol or benzodiazepines and opioids, which increases the risk of overdose. The Food and Drug Administration (FDA) is collaborating with the medical community to improve the safe use of benzodiazepines.

Tips for Patients Receiving Opioid Prescriptions: Know the Signs of Overdose

If you or someone you know has been prescribed opioids, it’s important to know the signs of an opioid overdose so you can take action right away. The signs of an opioid overdose include:4

  • Loss of consciousness
  • Slow, shallow breathing or stopped breathing
  • Small, constricted pupils (“pinpoint pupils”)
  • Limp body
  • Choking or gurgling sounds
  • Pale, blue, or cold skin

If you suspect you or someone else has overdosed, call 911 immediately. If you have naloxone (Narcan), available, administer it immediately. Roll the person onto their side to prevent them from choking on their vomit. Stay by their side until first responders arrive.

Many people do not call 911 because they’re worried they’ll be arrested for drug possession, but in most states, the Good Samaritan Law protects you from being arrested or prosecuted when seeking emergency medical attention for someone who has overdosed.

Harm Reduction Services

The term “harm reduction” refers to strategies and practices aimed at mitigating the negative effects of substance use. These practices don’t intend to force people to stop using drugs; rather, they want to keep people as safe as possible. As such, harm reduction strategies can help prevent overdoses in people who use drugs.

Examples of harm reduction strategies include:

  • Fentanyl test strips: Dealers often cut other drugs with fentanyl, which significantly increases the risk of overdose. Fentanyl can be difficult to detect just by tasting or smelling your drugs, which is why fentanyl test strips are so important. Using these strips can tell you if fentanyl has been detected in your drugs or not. This knowledge can then empower you to make a decision that can save your life. You can buy them online through a third-party distributor or receive them through harm reduction sites, such as syringe exchange programs.
  • Syringe services programs: Also known as needle exchange programs, these community-based programs offer many services, including access to sterile syringes and needles and linkage to other services like treatment referrals, education about overdose prevention and safe injection practices, naloxone education, and more.
  • Naloxone (Narcan): Naloxone is a life-saving opioid overdose medication that rapidly reverses the life-threatening effects of opioids like heroin, fentanyl, and prescription painkillers. Narcan is available over the counter in most states, and the nasal spray (Narcan) is extremely easy for the layperson to learn to use.

Many more organizations are embracing harm reduction strategies in the mainstream now. For instance, music festivals may employ harm reduction techniques, such as free drug testing services in which people can bring a sample of their drugs to a tent to test their purity.

Education on Naloxone (Narcan) Use

Even if you don’t personally use opioids, it’s essential that you know how to administer Narcan, because you never know who might need your help. It’s not always possible for us to know what our loved ones are struggling with, and many people with an opioid addiction struggle in silence. Knowing how to administer Narcan can empower you to take action and save someone’s life.

Here’s how to use the Narcan nasal spray:5

  • Remove Narcan nasal spray from the box
  • Peel back the circle to open it
  • Hold the nasal spray with your thumb beneath the plunger and your pointer and middle fingers on either side of the nozzle
  • Tilt the person’s head back and support their neck
  • Insert the tip of the nozzle into one nostril and press the plunger to administer the Narcan
  • Remove the nozzle
  • Wait and watch them
  • If they are still nonresponsive after two minutes, give a second dose

Ultimately, better laws and regulations need to be in place that provide widespread naloxone education to the public as well as increased access to this medication.

Linkage to Addiction Treatment

When an individual is ready to quit using drugs, evidence-based addiction treatment should be available immediately. Readily available access to substance abuse treatment can reduce the risk of overdose and help people live a substance-free life. Unfortunately, that isn’t always the case, and many people experience barriers to high-quality care, such as:

  • High cost of treatment
  • Lack of insurance
  • Lack of reliable transportation to care
  • Stigmatization
  • Lack of culturally responsive treatment providers
  • Lack of specialized care in their area

However, new strategies are being implemented to improve treatment engagement and retention as well as devising new treatment modalities and approaches. The goal of these initiatives is to make treatment easy to obtain, no matter who and where you are. If you are ready to enter a rehab program, you can browse our treatment directory, where you’ll learn which programs accept insurance, as well as other financing options like sliding scale which can help reduce the financial burden of rehab.

Long-Term Recovery Support

Recovery is a lifelong process. After completing an addiction treatment program, it’s important that people feel supported in their long-term recovery. This means being linked to aftercare options, such as:

  • Community support groups
  • Ongoing therapy and counseling
  • Sober living homes
  • Step-down care
  • Employment services
  • Methadone maintenance or Suboxone access

Long-term recovery support can improve treatment outcomes as well as prevent relapse and drug overdose. People who recently completed a drug treatment program have a much lower tolerance than they did when they were using drugs. This means that if they return to use, they could accidentally overdose, especially if they return to using the same dose they were previously. But preventing relapse by connecting people with quality aftercare can help reduce accidental overdose and save lives.

Resources

  1. Centers for Disease Control and Prevention. (2021). Drug Overdose Deaths.
  2. Centers for Disease Control and Prevention. (2021). Drug Overdose Deaths in the U.S. Top 100,000 Annually.
  3. Centers for Disease Control and Prevention. (2020). Overdose Deaths and the Involvement of Illicit Drugs.
  4. Centers for Disease Control and Prevention. (n.d.). Preventing an Opioid Overdose: Know the Signs, Save a Life.
  5. New York State Department of Health. (n.d.). How to Use Narcan Nasal Spray for an opioid overdose.

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