“Reducing stigma, saving lives” is the final blog in the 10 blog series on overdose awareness and overdose prevention topics.

Did you miss the latest overdose research and overdose statistics report, released on the 31^st of August 2021 (International Overdose Awareness Day)?

The 2021 overdose research report was compiled and published by John Ryan and his team at the Penington Institute. It is available to download at the links below.

Report Summary(recommended viewing): watch a ~3-minute video summary of the latest Australian Overdose Research Report for an overview of the startling overdose statistics in Australia — and what needs to happen to prevent more deaths.

Latest Australian overdose research/drug overdose statistics (download links):

How reducing overdose stigma can save more lives

Before we explore how reducing overdose stigma can save lives, let’s briefly discuss chronic pain conditions, which are closely linked with overdose deaths.

Chronic pain conditions are associated with a significant percentage of unintentional overdose deaths

Research indicates that opioid dependencies, and a majority of overdose deaths, are (a) unintentional and (b) strongly linked with chronic pain conditions.
Chronic pain conditions are common and notoriously difficult to treat health conditions.
Read the CDC’s guidelines for prescribing pain medications linked with overdose deaths.

This was one of the key factors highlighted by the Penington Institute’s CEO John Ryan, in his International Overdose Awareness Day interview and in the 2021 Australian Overdose Research report.

Overdose risks, and fatalities, impact all communities.

While all Australian communities have been impacted by overdose-related fatalities, most community members remain unaware of overdose risks.

This lack of awareness is alarming, given these risks could readily lead to the unintentional death of a loved one, neighbour, colleague – or even themselves.

People mistakenly believe that overdose-related deaths ‘only happen to other people’ (or to ‘other families’) — until it suddenly happens at home.

Or suddenly happens to a neighbour, parent, grandparent, or workplace colleague.

An overdose death could happen to almost anyone.
The majority of these deaths are not intended.

Overdose deaths are preventable deaths.

Sadly, research funding and overdose education programs are direly underfunded.

Overdose stigma

Why it’s important to reduce stigma and other drug-use misinformation

Here’s a brief outline of how overdose stigma harms our communities and loved ones.

Stigma alienates people from others in their communities.
Stigma leads to social distance, and social distance is a well-recognised risk factor for early death.
Stigma keeps people from getting directly involved in overdose prevention efforts.
Stigma undermines education efforts (people ‘tune out’ information they believe does not apply to themselves or loved ones).
Stigma stops people from taking action to help reduce preventable deaths.

Stigma stimies overdose awareness

Stigma also prevents people from taking time to learn “what to do” during an overdose emergency, such as when they’re a first responder.

Learn more about overdose reactions and responses.

Stigma and healthcare

Chronic pain conditions, substance-use dependencies, and the impact of stigma on care-seeking

Chronic pain conditions are a leading contributor to the recent increases in accidental overdose deaths.

Dependencies on prescription medications are often stigmatised.
Patients experiencing chronic pain conditions are also often stigmatised, including by the healthcare providers assisting them.

Stigmatisation is, unfortunately, something experienced by individuals:

diagnosed with chronic pain conditions
suffering from recurring pain (e.g. cluster migraines, PCOS pains)
having an ambiguous diagnosis and/or a misunderstood condition
experiencing social anxiety, depression, post-partum depression, and/or panic attacks
deemed to be at risk of developing, or experiencing, a dependency on prescription medications
impacted by overdose symptoms (e.g., delays in treatment-seeking behaviours)

Stigma is known to deter timely seeking of healthcare services.

Timely assistance from a qualified healthcare professional:

helps prevent bio-physiological dependencies on pain medications
can potentially avert an unintended overdose fatality

Delay in seeking professional-level care for evolving pain medication dependencies — or for a drug-related overdose/drug poisoning incident — significantly decreases the person’s survival rates.

Reducing stigma increases “timely healthcare-seeking” — a crucial factor for survival.

A suspected overdose scenario should always be treated as an urgent medical emergency.

Learn the symptoms of an overdose.
Call an ambulance right away if you suspect an overdose has occurred.
Learn the DO’s and DON’TS of overdose response care.
Refresh your overdose education efforts on a regular basis.

Overdose stigma harms us all.

Stigma results in a lack of awareness of drug poisoning risks.

Stigma is also partially responsible for underfunding of overdose prevention measures.

Reducing stigma is crucial to prevent more deaths.

Stigma minimises involvement in overdose prevention efforts
Stigma deters overdose prevention education as well as access to naloxone
Stigma reduces early help-seeking behaviours
Stigma leads to an increased sense of isolation (social distance) for individuals experiencing a dependency on pain medications.

Stigma can be deadly. Isolation, social distance, and delays in seeking healthcare are all significant risk factors for premature deaths.

Overcoming misperceptions about prescription overdose deaths and impacted populations

So what can be done to reduce stigma linked with overdose experiences and drug-related deaths?

What is stigma (stigmatisation definition)?

WA Health: “stigma represents ‘a mark of disgrace’ [or negative viewpoint held by others] that sets a person apart from others. When a person is labelled by their illness, they are no longer seen as an individual, but as part of a stereotyped group. Negative attitudes and beliefs toward this group create prejudice which leads to negative actions and discrimination.”

Stigma typically relates to attitudes of superiority, evolving from a blend of cultural influences, family-of-origin discussions, doctrines, and personal experiences.
Stigma thrives on ignorance of facts.

Can stigma be changed?

Stigma can often be changed through evidence-based awareness-building.

It’s not a straightforward nor simple task. Lifelong attitudes can be difficult to sway.

Even so, lives are at stake — over 800,000 people in the USA have already died from overdose-related deaths in the last few decades alone.

So let’s explore what needs to happen to reduce drug-related deaths.

**Stigma reduction measure #1: Increase awareness of how widespread overdose risks actually are in our society.**

The first way to reduce overdose stigma — and save more lives — is to overcome widespread misperceptions in the community relating to overdose fatalities.

There is a widespread misperception that overdoses only impact young adults experimenting with recreational substances (such as party drugs). Or that overdoses only occur when a person is heavily addicted to an illicit substance or intentionally aims to end their life. Nothing could be further from the truth, with a significant percentage of overdose deaths related to unintentional ‘dosing errors’ and/or to polysubstance use, and legally-attained medications prescribed for chronic pain conditions.

Overdose deaths impact people of ALL ages.

When people become aware of the fact that overdose risks are “closer to home” than they ever thought possible, they are more likely to:

get directly involved in prevention efforts BEFORE it impacts them directly
educate themselves and others about risks and prevention measures
learn to recognise the symptoms of an overdose
learn to recognise the warning signs of a pain medicine dependency or increased dosing (above safe-use dosing recommendations)
assist an overdose victim if they become an ‘accidental first responder’

Stigma reduction measure #2: Provide education for safe use of medicines, including recognising and responding to an overdose reaction.

The second way to reduce overdose stigma relates to improving education about the safe use of prescription medications, pain-relieving substances, and other drugs.

A demographic analysis of overdose deaths shows the average age of overdose deaths is changing; often linked with chronic pain conditions and pain-relieving medications.

Because the majority of medicine-related overdoses are unintentional, these are also considered preventable overdose deaths.
Education, particularly education in terms of risks and appropriate responses to overdose scenarios, can help.

What is also known to help save lives is to understand the value of recognising symptoms — e.g., as an educational endeavour — and of having naloxone available for emergency overdose treatments. (Source: ADF)

It’s stigma, along with a lack of community awareness in relation to overdose symptoms (drug poisonings), that are key issues at the present time.

Excerpt from the interview with CEO John Ryan (Penington Institute):

“We need better community awareness that it’s not just young people who are dying from an overdose. It’s the elderly woman down the street who confuses her daily dosing. It’s the retired tradie who takes strong painkillers to deal with a lifetime of back pain. It’s everyday people like you and me.” John Ryan, CEO of the Penington Institute.

Stigma reduction measure #3: Increase overdose research and prevention funding

The third way to reduce overdose stigma relates to increasing research funding and committing to nationwide overdose awareness-building initiatives, by overdose research groups such as the Penington Institute.

As the Penington Institute’s latest report shows, research indicates that a significant percentage of overdose deaths are unintentional vs intentional deaths (e.g., suicides).

Watch this brief video, featuring Jimeoin, on drug-related deaths in Australia (2021 report).

But more healthcare research funding for overdose prevention, particularly in terms of safe-drug-use education programs, is sorely needed.
And that’s needed across ALL age groups, not just teens and young adults.

Donate to the Penington Institute by clicking here – every contribution helps research projects that help save lives.

Chronic pain and overdose deaths

Chronic pain and overdose deaths are closely linked.

We are well aware of the opioid epidemic in the United States, more frequently termed the ‘opioid overdose crisis‘.

Increases in drug overdose deaths are linked with an increase in the use of pain medications.
But these deaths are generally NOT linked with pre-existing dependencies.

In fact, prescription medicine overdose deaths are often linked with chronic pain conditions, such as neck pain and back pain.

These conditions were also typically diagnosed within the preceding 12 months of the individual’s unintentional overdose fatality.

Clinical studies on overdose risks relating to chronic pain conditions

How to effectively use emerging clinical information relating to chronic pain medications and unintentional overdose deaths is a target research area that’s in need of further funding.

Clinical studies suggest our ageing population is particularly at risk of premature deaths due to unrecognised and/or untreated overdose scenarios – a stark reminder that ANYONE can experience an overdose fatality – not just young adults embarking on a nightclub outing.

Our ageing population is most likely to experience chronic pain conditions — and this makes them vulnerable to experiencing an unintended, overdose-related death.

CDC overdose statistics (chronic pain conditions)

CDC statistics: 7 of 10 unintentional overdose deaths in women are linked with chronic pain conditions and pain-relieving medications.

Chronic pain conditions are, unfortunately, very common. When an individual experiences either acute and/or ongoing pain, such as neck or back pain, they often become desperate for relief.

In terms of pain-relieving medications and overdose risks:

these prescription drugs can significantly improve the quality of life for individuals suffering acute pain, such as from an injury; and chronic pain conditions, when carefully prescribed and monitored by the medical team AND when well-tolerated by the patient
condition examples include but are not limited to fibromyalgia, endometriosis, neck pain and back pain
in terms of overdose risks, however, these are elevated when a person is:
- suffering from a chronic pain condition
- taking unfamiliar medicines
- mixing a variety of prescribed medications and/or medicines with alcohol, as these drugs may interact with one another in a detrimental, health-harming way

Chronic pain conditions are, unfortunately, very common — especially amongst an ageing population. And our ageing population are increasingly at risk of dying early from an unintentional over-dosing situation.

For example, “neck pain is a leading cause of disability in adults, reported in up to 20% of adults”. (Source: RACGP)
Arthritis pain is also common amongst an ageing population; so, too, is pain from broken bones from falls and/or lowered bone density.

So, read the rest of the blogs on overdose statistics.

Donate to the research efforts of the Penington Institute, if you can.
Do your own research on the safe use of medications, so that you clearly understand the risks.
Inform others of the latest statistics — including how they can help by reducing stigma and saving lives.
And learn how to respond to someone you think may have experienced an overdose.