Blog post: International Overdose Awareness Day – No one left behind

Written by Ugoeze Uchegbu-Okoroh, ESPC Volunteer

Often, there is a disconnect in how we perceive cases of overdose making it seem like a “them” problem and never a “me” problem. What we fail to realize is that we should approach this subject with humility because it indeed concerns us either as affected individuals, close allies, or as members of the society. Consider this hypothetical situation: X, a loving father suffers a workplace injury. The pain is so agonizing that it requires treatment with opioids. X finds himself taking more than he expected to manage the pain. The rest of the story is unfortunately a common reality for so many people. X becomes reliant on opioids to manage the pain, and once he is recovered, he struggles to stop taking them as now his body has become addicted. The psychological impact on a friend or family member whose loved one is struggling with addiction is devastating. Such situations are not occasions to cast blame, guilt, or even wallow in shame, but acknowledging that we cannot always anticipate all the possible ways an addiction can form is the first step. Once someone develops an addiction to opioids, their risk of overdose increases. Overdoses are not only limited to those with addictions, sometimes they happen in regular procedures.

On May 10, 2022, Maria Querales underwent a dental procedure in Texas. She was left with severe brain damage after the anesthesiologist administered too much Fentanyl (Farberov, S. 2021). No one is immune to the risk of overdose. It is not an accurate judge of morality or character; there is a story behind every case. Even the best of us can be affected by an intended or unforeseen overdose. At this point, how a person got there is inconsequential, but rather, recognizing the need for an intervention is what is required to save a life. Importantly, shifting from a mindset of reactiveness to proactiveness could help in curbing overdose incidents.

International Overdose Awareness Day is commemorated yearly on August 31^st. It is the largest campaign to end overdose, raise awareness, and acknowledge the grief of families of people who have died or suffered permanent injury as a result. In reality, this is a daily struggle. In 2023, there was an average of 22 deaths per day in Canada, with the majority of opioid-related deaths occurring in British Columbia, Alberta, and Ontario (Government of Canada, 2023). During this same year, the rate of overdose deaths per 100,000 persons in Alberta reached the highest number since 2016 at 44.1%. This does not include unknown deaths or causes of deaths still being determined (Alberta Substance Use Surveillance System, 2024). Overdose could occur from non-pharmaceutical opioids such as heroin. Other causes include alcohol, sedatives, or even a combination of both. While overdose can be fatal or non-fatal, one thing is sure – it destroys lives.

The Ministry of Mental Health and Addiction has direct supervision over the overdose crisis in Alberta. To support its Alberta Recovery Model, they recently built a world class recovery centre and opened its doors to persons seeking recovery. This is in addition to providing narcotic transition services, and maintaining a 24-hr addiction helpline, amongst others. One cannot underestimate the role of laws and government policies in the prevention and management of the overdose crisis. In Canada, the Good Samaritan Drug Overdose Act provides legal protection in the following instances for people who experience or witness overdose and call for help:

•  where there are charges for possession of a controlled substance (i.e. drugs)
• breaches of conditions regarding simple possession of controlled substances (i.e. drugs)

In most cases, this Act applies to anyone that has to seek emergency support during an overdose crisis including the person experiencing the overdose, with the rationale behind it to always prioritize saving lives. In Alberta, while the Alberta Recovery Model which provides long-term treatment to Albertans struggling with addiction, focuses on holistic recovery ensuring smooth reintegration into the society is laudable, there is still need for policy revision. Formerly, effective in controlling overdose was the use of supervised consumption sites which are controlled sites approved by federal and provincial governments, where individuals can practice safe drug use, access clean supplies to limit the spread of infectious diseases, get in touch with addiction and recovery services, and engage with trained staff.  This policy albeit successful, was limited by the Alberta-led UCP Government, thus, reducing the capacity, locations and services of the supervised consumption site. Following the freeze on funding of supervised consumption sites in 2019, the government released a report on the socio-economic impacts of these sites on communities in Alberta citing public safety issues, social disorder, increased crime rate amongst others. Interestingly, this report also stated that no deaths were recorded among people who used drugs at the supervised consumption sites (Government of Alberta, 2020). Dr James D. Livingston criticized this report, noting the reliance on inadequate assessment of public perception of crime, lack of peer review research evidence linking supervised consumption sites to the increased rate of crime, as well as the reliance on police service call data which was misrepresented as crime data and did not take into consideration that service calls included unfounded allegations, uninvestigated incidents, and non-criminal matters (Livingston, 2021). Apart from these, the existing safe consumption sites only include safe spaces for those who inject, and not for those who inhale. It has been suggested that the addition of inhalation sites will drastically reduce the cases of overdose, especially in those that have the fear of needles (Bellefontaine, M. 2024).

The grief, struggles, and pains of family members, friends and allies is a core component of this discussion. While a solid support system is vital in combatting overdose crisis, caregivers are encouraged to lean to support groups and therapy to give them the strength they need to be there for their loved ones. The stigma and shame surrounding drug and substance abuse makes it difficult for individuals to acknowledge their challenges and seek help. Family members and loved ones of people who have died are affected too, as they are indirectly shamed into mourning in silence for fear of being judged. Another major factor to consider is the role of the media. Where news about abuse, overdose or addiction is reported to perpetuate stereotypes, uphold a culture of shame, or apportion guilt, this could deter people from seeking help. Additionally, we must exercise caution to keep issues of overdose and crime distinct. While both may occasionally intersect, it is important to maintain that overdose is a public health crisis and not a crime.

The need to create and sustain awareness is an ongoing duty. The goal is to prevent it from happening to the next person. It is important to continue to reiterate that the problem is the addiction and not the individual. Remember that it is almost impossible for a person to overcome addiction on their own or prevent overdosing, but we can all help. This is a collective call for “no one to be left behind” because every life matters and every moment counts. If you or anyone is seeking help, you can call the addiction helpline at 1-866-332-2322. In addition, here are two helpful resources for you:

How to reduce risk and prevent opioid overdose:

https://www.albertahealthservices.ca/dsa/Page12491.aspx

Get Naloxone:

https://www.albertahealthservices.ca/dsa/Page15586.aspx

References 

1. Farberov, S. (2021, January). Dental patient left brain-damaged after anesthesiologist allegedly suffering ‘cognitive issues’ overdosed her on fentanyl: lawsuit

https://nypost.com/2024/01/16/news/dental-patient-left-brain-damaged-after-fentanyl-overdose/

2. Opioid- and Stimulant-related Harms in Canada.

https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants/

3. Alberta Substance Use Surveillance System (Updated August 2024).

https://healthanalytics.alberta.ca/SASVisualAnalytics/?reportUri=%2Freports%2Freports%2F1bbb695d-14b1-4346-b66e-d401a40f53e6&sectionIndex=0&sso_guest=true&reportViewOnly=true&reportContextBar=false&sas-welcome=false

4. Impacts: A socio-economic review of supervised consumption sites in Alberta.

https://open.alberta.ca/dataset/dfd35cf7-9955-4d6b-a9c6-60d353ea87c3/resource/11815009-5243-4fe4-8884-11ffa1123631/download/health-socio-economic-review-supervised-consumption-sites.pdf

5. Livingston, J. D. (2021). Supervised consumption sites and crime: Scrutinizing the methodological weaknesses and aberrant results of a government report in Alberta, Canada.Harm Reduction Journal, 18(1)

https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-020-00456-2

6. Bellefontaine, M. (2024, June). Inhalation rooms in safe consumption sites could save lives, Alberta advocates say. https://www.cbc.ca/news/canada/edmonton/inhalation-rooms-in-alberta-supervised-consumption-sites-could-save-lives-advocates-say-1.7231769