Preventing avoidable deaths: what steps to take to mitigate opioid overdose?

In Europe, drug overdose continues to be the leading cause of death among people who use drugs (PUD) [1]. In 2014, it was estimated that overdose caused 18.3 deaths per million population aged 15-64, and rates of more than 40 deaths per million were reported in eight European countries1 [2]. Overdose accounts for more than 3.5% of overall deaths in males under 40 years of age, with 78% of overdose victims being male [2, 3]. Older opioid users were shown to be particularly vulnerable, although a recent slight increase in drug-induced deaths among users aged under 25 has been reported in some countries [2].

In spite of a promising European trend between 2009 and 2013 - when reported overdose deaths declined, thanks to the scaling-up of treatment and harm reduction interventions – the 2016 analysis showed a rise in drug-induced deaths related to heroin and other opioids [2]. This is of particular concern in the most recent data from countries with fairly robust reporting systems (Germany, Sweden and the UK). Moreover, synthetic opioids and medical purposed drugs are acquiring a substantial role in overdose deaths in some European countries (e.g. UK, France, Ireland, Finland), with fentanyl, methadone, buprenorphine and tramadol being more frequently mentioned in toxicology reports [4]. 

This brief snapshot suggests new challenges in the realm of ‘old’ problems. The increasing complexity of Europe’s drugs situation is now challenging practioners, policy makers and researchers to formulate effective responses for the mitigation of these avoidable deaths.

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References
[1] United Nations Office on Drugs and Crime (UNODC) (2013). Opioid overdose: preventing and reducing opioid overdose mortality. Discussion paper UNODC/WHO 2013. Vienna: UNODC. Retrieved from http://www.unodc.org/docs/treatment/overdose.pdf
[2] European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). (2016). Annual report 2016: The state of the drugs problem in Europe. Luxembourg: Publications Office of the European Union.
[3] Data retrieved from:http://epp.eurostat.ec.europa.eu/statistics_explained/index.php/Causes_of_death_statistics#Further_Eurostat_information
[4] European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). (2015). Annual report 2015: The state of the drugs problem in Europe. Luxembourg: Publications Office of the European Union.