International Overdose Awareness Day
31 August 2023
International Overdose Awareness Day (IOAD) is the world’s largest annual campaign to end overdose, remember without stigma those who have died from overdose, and acknowledge the grief of the family and friends left behind. The IOAD 2023 theme “Recognizing those people who go unseen” is about acknowledging people in our communities who are affected by overdose but might go unseen in the crisis. International Overdose Awareness Day
UpToDate
Cochrane Library
Articles
Harm reduction
Opioid Agonist Therapy
Policy
Research
E-books
E-journals
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Articles
Harm reduction
A scoping review of mHealth technologies for opioid overdose prevention, detection and response
Key Points
Drug and alcohol review 18 March 2023
The impact of polysubstance use patterns on engagement of substance use disorder treatment among emergency department patients at high risk of opioid overdose
Highlights
Addictive behaviors reports 12 August 2023
Patient, family members and community pharmacists' views of a proposed overdose prevention intervention delivered in community pharmacies for patients prescribed high-strength opioids for chronic non-cancer pain: An explorative intervention development study
While patients had low overdose knowledge and did not see themselves as being at risk of opioid overdose, they were receptive to naloxone use and positive about the proposed intervention. A feasibility trial is merited to further investigate how the intervention would be experienced within community pharmacy settings. Drug and alcohol review 27 September 2022
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Opioid Agonist Therapy
It can save your life, that’s all I know. Barriers and facilitators for engagement in take-home naloxone for people receiving opioid substitution treatment in regional Australia: An explorative study
This study found that prior traumatic experience of overdose facilitates acceptance of take-home naloxone (THN), and being offered THN was the most important factor in engagement. Less clear is how to engage people who lack a traumatic overdose experience. Qualitative research in medicine and healthcare 19 July 2023
Buprenorphine versus methadone for the treatment of opioid dependence: a systematic review and meta-analysis of randomised and observational studies
Evidence from trials and observational studies suggest that treatment retention is better for methadone than for sublingual buprenorphine. Comparative evidence on other outcomes examined showed few statistically significant differences and was generally based on small numbers of studies. These findings highlight the imperative for interventions to improve retention, consideration of client-centred factors (such as client preference) when selecting between methadone and buprenorphine, and harmonisation of data collection and reporting to strengthen future syntheses. The Lancet psychiatry 1 June 2023
Injection drug use frequency before and after take-home Naloxone training
This cohort study of people who inject drugs found no evidence of an increase in injecting frequency, along with other markers of overdose risk, after take-home naloxone (THN) training and supply. The findings suggest that THN training should not be withheld because of concerns about risk compensation and that advocacy for availability and uptake of THN is required to address unprecedented opioid-associated mortality. JAMA 4 July 2023
Deimplementation in the provision of opioid agonist treatment to achieve equity of care for people engaged in treatment: a qualitative study
The possibilities for achieving social equity in health are limited by the divergent treatment goals of providers and people receiving opioid agonist treatment. Sustained and equitable deimplementation of obtrusive aspects of OAT provision require co-created treatment goals, patient-centred monitoring and evaluation, and access to a supportive community of practice for providers. Implementation science 9 June 2023
Provision of Naloxone nasal spray: A Northern Territory focus
This study showed the supply of naloxone in the NT is limited. Barriers affecting the provision of naloxone nasal spray were the community pharmacy model of supply and thus increasing access points would assist to expand the supply. The Australian pharmacy students' journal 28 February 2023
Does opioid agonist treatment reduce overdose mortality risk in people who are older or have physical comorbidities? Cohort study using linked administrative health data in New South Wales, Australia, 2002–17
Opioid agonist treatment (OAT) appears to reduce mortality risk in people with opioid use disorder who are older or who have physical comorbidities. Opioid overdose mortality during OAT with buprenorphine appears to be lower and reduced in clients with circulatory and respiratory diseases compared with OAT with methadone. Addiction 26 February 2023
Association between Opioid Agonist Therapy and testing, treatment uptake, and treatment outcomes for Hepatitis C infection among people who inject drugs: A systematic review and meta-analysis
Opioid Agonist Therapy (OAT) can increase linkage to hepatitis C virus (HCV) care, including uptake of HCV testing and treatment among people who inject drugs (PWID). This supports the scale-up of OAT as part of strategies to enhance HCV treatment to further HCV elimination efforts. Clinical infectious diseases 24 May 2020
When will opioid agonist therapy become a normal part of comprehensive health care?
Australia faces a pharmaceutical opioid crisis. Rates of prescribing, morbidity and mortality have dramatically increased since 1990. Fifty‐six percent of unintentional opioid deaths now involve pharmaceutical opioids (as either sole drug or polydrug overdose), compared with 45% of deaths involving heroin and 23% involving methadone.2 Despite this, methadone carries considerable stigma and misconceptions among clinicians and community members.3 The cost of private prescriptions, provider unfamiliarity with the medication and clinician reluctance to manage patients with illicit and prescription opioid use disorder are common barriers to opioid agonist therapy (OAT). MJA 21 June 2021
Non-fatal overdose risk associated with prescribing opioid agonists concurrently with other medication: Cohort study conducted using linked primary care, secondary care and mortality records
Elevated risk of non-fatal overdose among opioid agonist treatment recipients is associated with concurrent use of medication prescribed for other reasons. Addiction 4 August 2023
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Policy
Prevention and intervention with young people as a critical public health strategy to curtail the opioid epidemic: A call to action
The opioid epidemic has motivated advances in the effective treatment of opioid use disorder (OUD), with a particular focus on medications for OUD (MOUD), including methadone, buprenorphine, and naltrexone. Although these medications are remarkably effective, MOUD expansion initiatives alone have not been sufficient to combat the opioid epidemic. The authors we argue that targeted interventions for adolescents with substance use problems, including for non-opioid drugs (i.e., cannabis, alcohol), is critical to prevent the onset of OUD and turn the tide of the opioid overdose epidemic. Journal of addiction research & therapy 27 April 2023
Who supports drug-checking services in Australia? An analysis of 2019 National Drug Strategy Household Survey data
This report highlights that, while there were different degrees of support based on demographic characteristics, substance use status and social attitudes towards drug and alcohol policy, the overall majority of the sample supported the provision of drug-checking services. Drug and alcohol review 4 July 2023
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Research
Lives worth grieving: Differential coverage of overdose deaths in Australian news media (2015–2020)
This article explores the differential coverage of drug overdose death in three major Australian newspapers between 2015 and 2020. It outlines the number of articles, the types of voices, and emotional collectives drawn on in three types of overdose death stories: those related to injecting drug use, pharmaceuticals (largely opioids), and those that occurred at music festivals. Contemporary drug problems 1 June 2023
The onset and severity of acute opioid toxicity in heroin overdose cases: a retrospective cohort study at a supervised injecting facility in Melbourne, Australia
The author’s demonstrated that heroin overdose is a dynamic illness and cases differ in the severity of acute opioid toxicity. The risk of airway occlusion including positional asphyxia was an early and consistent feature across all levels of toxicity, while exaggerated respiratory depression together with exaggerated depression of consciousness was increasingly observed with greater levels of toxicity. They also demonstrated the importance of early intervention in overdose cases, where in a large cohort of heroin overdose cases there were no fatal outcomes, a very low hospitalisation rate and most cases were able to be managed to clinical resolution on-site. Clinical toxicology 6 October 2022
Twenty-one years at the Uniting Medically Supervised Injecting Centre, Sydney: addressing the remaining questions
There is a substantial evidence base on the efficacy of supervised injecting facilities (SIFs). Early research established that the MSIC did not result in a “honeypot” effect (ie, attract new users to the area), but led to improved and sustained public amenity. Yet, there are currently only about 120 SIFs operating globally, with two in Australia. MJA 19 September 2022
Incidence and factors associated with discontinuation of opioid agonist therapy among people who inject drugs in Australia
People who inject drugs attending needle–syringe programmes in Australia appear to be significantly more likely to discontinue opioid agonist treatment if they were prescribed buprenorphine or buprenorphine–naloxone compared with methadone, are male or report injection risk behaviours and recent incarceration. Addiction 18 June 2020
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