International Overdose Awareness Day is an annual event, held on 31 August, to raise awareness of overdose and reduce the stigma of drug-related death (1). The EU drugs agency (EMCDDA) marks the day by highlighting its latest figures on overdose deaths in Europe and expressing support for interventions that prevent such harms.
Latest evidence from the EMCDDA shows that drug overdose deaths in Europe have risen for the third consecutive year (2). A total of 8 441 overdose deaths, mainly related to heroin and other opioids, are estimated to have occurred in Europe in 2015 (28 EU, Turkey and Norway), representing a 6% increase on the 2014 figure of 7 950 in the 30 countries. Preliminary data for 2016 suggest that this increasing trend is continuing. Europe’s 1.3 million problem opioid users are among the most vulnerable.
EMCDDA Director Alexis Goosdeel says: ‘Through its Strategy 2025, the EMCDDA is committed to contributing to a healthier Europe by acting as a catalyst for improving the quality and delivery of responses to reduce the health and social consequences of drug use. This requires us to keep abreast of new prevention, treatment and harm-reduction approaches and support our stakeholders in identifying and adopting best practices. One of our priorities is to help tackle the thousands of premature and preventable drug-related deaths that occur every year’.
Heroin, often taken with other substances, is present in the majority of fatal overdoses reported in Europe, with the most recent data showing a rise in heroin-related deaths in several European countries. North America has also experienced rising levels of heroin use and considerable morbidity and mortality associated with the misuse of prescription opioids.
In Europe and North America, highly potent synthetic opioids, which mimic the effects of heroin and morphine, are also growing health threat. While representing a small share of the market, there are increasing reports of the emergence of these substances and of the harms they cause, including non-fatal intoxications and deaths. Twenty-five new synthetic opioids were detected in Europe between 2009 and 2016 (18 of these were fentanils, which are subject to particular scrutiny).
Preventing drug-related harms and offering effective treatment to those with substance use problems are central pillars of Europe’s response to drugs. A strong evidence base supports the appropriate use of opioid substitution treatment (OST) to reduce morbidity and mortality. Good clinical practice and understanding how to reduce the diversion of prescription opioids from their legitimate use are crucial to reap the health benefits of this treatment approach.
Interventions to prevent overdoses in Europe include supervised drug consumption room (DCRs), which aim to prevent overdoses from occurring and ensure professional support if an overdose occurs. DCRs now operate in six EU countries and Norway (78 facilities in total). In recent years, there has been a growth in the provision of ‘take-home’ naloxone (opioid overdose-reversal drug) to opioid users, their peers and families, alongside training in recognising and responding to overdose. Take-home naloxone programmes now exist in nine EU countries and Norway.
The EMCDDA — together with the EU Member States, Turkey and Norway — is constantly working on this issue (see ‘Related links’ below). From 18–20 September, the agency will hold its annual expert meeting on drug-related deaths to share the latest information in this field and to reflect on current experience and practice in reducing drug-related deaths in Europe.
Preventing overdose deaths in Europe (Perspectives on drugs): This analysis describes some of the factors that increase the risk of fatal and non-fatal overdoses and a number of interventions developed to prevent these events.
Drug consumption rooms: an overview of provision and evidence (Perspectives on drugs): This publication provides a map with the location and number of drug consumption room facilities throughout Europe and an overview of the range of services available at drug consumption facilities.
Preventing opioid overdose deaths with take-home naloxone (Insights): This publication examines the case for distributing naloxone, an emergency medication, to people who inject opioid (such as heroin) and to others who might witness an opioid overdose. The comprehensive review looks at opioid overdose, and how naloxone counteracts it, and discusses the circumstances of opioid overdose deaths and the use of naloxone in regular clinical practice.
Take-home naloxone programmes in Europe — overdose prevention (Video): This video brings together the perspectives of many European public and clinician experts on take-home naloxone programmes.
Statistical Bulletin 2017: The Statistical Bulletin is published annually by the EMCDDA and consists of the most recent available data on the drug situation in Europe, all available to view interactively on screen and download in Excel format. Drug-related death data.
DRD-related deaths annual expert meeting 2016: The EMCDDA brings together more than 40 European and international experts every year for an annual meeting on drug-related deaths. The meeting provides a space for sharing and discussing new studies, new findings and experiences at regional, national and European level. The 2017 meeting will take place in Lisbon from 18–20 September 2017.
Action 8 of the EU Action Plan on Drugs calls for the:
Coming soon from the EMCDDA — Health and Social Responses to Drug Problems: a European Guide
Health and social responses to drug problems in Europe will be placed in the spotlight this autumn in a pioneering new EMCDDA guide to be launched in October. The guide is designed to provide an overview of health and social responses to drug problems — defined as any actions or interventions undertaken to address the negative consequences associated with the illicit drugs phenomenon — along with more detailed coverage of some of the most salient issues in responding to drug problems from a European perspective.
See Drugnet Europe 99 for more.