preventing most overdose deaths would be easy so, why don’t we?
TRANSCRIPT
INTERNATIONAL DOCTORS FOR HEALTHIER DRUG POLICIES
Preventing most overdose deathswould be easy
So, why don’t we?
Dr Chris Ford, Clinical DirectorIDHDP
ISAM Conference Dundee
Physicians globally unite for health based drug policy
Reducing overdose drug related deaths: A major challenge for Public Health
• Over 250,000 lives were lost to drug overdoses in world (2010)– This represents 2 million years of life lost
• 6,100 overdose deaths in Europe in 2012, 70,000 in first decade– 3.5% of all deaths in males under 40 in Europe– England & Scotland highest since records began
• 41,340 deaths in overdose deaths in USPreventing opioid overdoses in Europe EMCDDA, Lisbon,
October 2012 (revised 2014)
Prevalence of use of opioids worldwide
Reducing drug related deaths
• What increases the risk of fatal and non-fatal overdoses?
• What can be done to reduce these?
1. Individual factors that increase the risk of fatal and non-fatal overdose
• Type of substance used, heroin most• Route of administration• Health of the person• Poly-drug use increases risk– Particularly heroin + benzodiazepines,
antidepressants, alcohol– non-medical use of prescribed substitution
medications and opioid analgesics Giraudon et al., 2013
2. Environmental factors that increase risk of drug overdose deaths
• Disruption or discontinuation of treatment
• After detoxification in rehab or particularly prison
• Inadequate through-care between prison and community
Zlodre and Fazel, 2012
3. Lack of response or inadequate interventions by those witnessing
overdoses • Poor first aid knowledge
• Inadequate access to naloxone
• Fear of legal repercussions
What we can do to reduce overdoses
1. Interventions geared towards preventing of overdoses
2. Reducing fatal outcomes when overdoses do occur
Frisher et al., 2012
1. Interventions geared towards preventing of overdoses
• Increase awareness of overdose risks to the general public particularly people who use drugs, their family and friends
• The provision of good effective drug treatment and therefore retention in treatment
• Improve through-care between prison and the community
2. Reducing fatal outcomes when overdoses do occur
a. Supervised drug consumption rooms
"Research to prove that injecting inside drug consumption rooms is safer than injecting elsewhere,
is like needing to prove that jumping from a plane with a parachute is safer than jumping without one.”
Joan Colom I Faran in Viral Hepatitis in Europe, 2014
b. Improved bystander response
• Training for all• Increase access to
naloxone• Involve ambulance
and police
Improved bystander response
“People likely to witness an opioid overdose should have access to naloxone and be instructed in its administration to enable them to use it for the emergency management of suspected opioid overdose.”
Community management of opioid overdose
World Health Organization 2014
Improved bystander response
Most heroin users witness/experience an overdose at some point:
From a sample of 155 drug using clients:– 46% had overdosed
themselves– 82% had witnessed an
overdose– 43 of which were fatal
46%
82%
43
Best D., Man LH., Gossop M., Noble A., Strang J., 2000
Part of the solution
“…naloxone is part of a comprehensive approach to services for drug users and can reverse the effects of opioids and prevent mortality.”
UN Resolution 55/7: Promoting measures to prevent drug overdose, 2014
Countries which have Naloxone
Counries with naloxone
Counries without naloxone
No data
What joins all factors that affect overdose deaths?
INTERNATIONAL DOCTORS FOR HEALTHIER DRUG POLICIES
Overdose deaths can be reduced
The science is easy
It’s the policies that need changing
Physicians globally unite for health based drug policy
Opportunity for doctors:
April 2016 will see the next UN General Assembly Special Session (“UNGASS”) where future drug policy will be debated. Until then physicians can make themselves heard and ensure health is pushed up the drug policy agenda.
What can you do………….?
INTERNATIONAL DOCTORS FOR HEALTHIER DRUG POLICIES
Physicians globally unite for health based drug policy
By joining IDHDP you will be adding your voice to a growing number of physicians calling for health based drug policies.
Join at www.idhdp.com
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INTERNATIONAL DOCTORS FOR HEALTHIER DRUG POLICIES
Physicians globally unite for health based drug policy
INTERNATIONAL DOCTORS FOR HEALTHIER DRUG POLICIES
Physicians globally unite for health based drug policy
Thank you
Dr Chris Ford
www.idhdp.com
@IDHDP