Opioid overdose prevention strategies often change, but that doesn’t mean that some of them aren’t already working. However, although some programs are showing some success, there is still more work to be done.
Lisa McElhaney, president of the National Association of Drug Diversion Investigators, believes that existing opioid prevention programs are moving in the right direction, "but there needs to be a more uniform multifaceted approach across the United States to make the greatest impact."
According to the US Centers for Disease Control and Prevention, the number of heroin-related overdose deaths is on the rise: The heroin-related overdose death rate increased 286% from 2002 to 2013. In addition, heroin use more than doubled among young adults ages 18 to 25 during the past decade. Additionally, more than 9 in 10 people who used heroin also used at least one other drug.1
Although the belief may be that users are replacing opioids with heroin as their drug of choice, Ms. McElhaney believes that “it’s not truly a switch, it’s a direct access and availability issue.”
“When you reduce the supply of a demanded (abused) substance of any type without correcting the behavioral demand actions (addiction), the individual will find another source to fill the desire,” she said. “In this case, heroin is a strong filler for the need; the price and access makes it an easy substitute. That is why we need to approach this issue from so many different levels.”
She added: “There is no one answer.”
Initiatives promoting the use of naloxone, an opioid antagonist, are “very effective at providing a large number of overdose reversals, thus saving lives,” Ms. McElhaney said, “but unless there is a strong rehabilitation/recovery support program to accompany the reversal event, the rate of recidivism regarding the drug usage and repeat overdose event is enormous.”
Naloxone has been used for more than three decades by medical personnel to reverse overdoses. Laws focused on the use of naloxone to assist with the ongoing opioid epidemic have been implemented in 40 states since 2001.
Although drugs are available to reverse the effects of opioid overdose, this doesn’t necessarily mean they will be readily accessible to patients, friends, and family members. Ms. McElhaney believes this is due to politics.
“The stigma that is attached to drug abuse and misuse carries a strong negative connotation with it,” she said. “Many individuals believe that an addict makes a conscious choice to continue their drug usage. Until each of the stakeholders understands the complexities of the addiction process, the necessary resources will not be freed up for access to address this issue.”
A strategy that combines a multifaceted approach with early prevention programs can therefore assist the medical community with curbing opioid abuse, overdose, and misuse. Broad-based educational programs, wide access to rehabilitation and recovery programs, and strong community awareness events can also contribute to the suppression of opioid-related deaths, she noted.
“While there are limitations to the existing overdose prevention strategies, it is a start that needs stronger attention,” Ms. McElhaney said. “This is a community problem that crosses all lines of ages and demographics. The time to act is now and the problem belongs to all of us. With greater education and a stronger awareness of the issue, we as a community can begin to constructively manage and reduce this growing problem.”
1. US Centers for Disease Control and Prevention. Today’s heroin epidemic infographics. Available at: http://www.cdc.gov/vitalsigns/heroin/infographic.html. Accessed August 13, 2015.