As recently reported in Times of Malta, the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) has published data relating to 2017 which shows that Malta has its fair share of deaths from overdose from illicit drug use and that, to differing extents, this phenomenon affects all age groups. The younger abusers seem to be very vulnerable in this respect.
Among those who use illicit substances, overdoses are common. Some of these overdoses cause death.
The adulteration of drugs by dealers with other, often dangerous, substances and the state of health of the drug users are but two of the many factors which can determine why a particular instance of use may result in an accidental fatal overdose.
Overdoses of this type are by no means inevitable. Alexis Goosdeel, director of EMCDDA, stated this very clearly in the report: “We know that effective preventive and response measures exist that would allow us to avoid many deaths.”
As the report indicates, injected heroin is often the substance which is responsible for death from overdose.
All heroin users who frequent outpatient and inpatient services can be educated about the ways and means of avoiding overdoses and about remedial measures their friends, relatives and acquaintances can take in case of accidental excessive use.
Sedqa, Caritas and OASI, whose sterling efforts in this field have helped many drug users kick the habit and turn their lives around or reduce the potential harm associated with opiate use, are often in a position to reach users and their significant others and pass on the necessary information in a simple and effective way.
Known heavy users whose lifestyles are unstable and those who are known to have overdosed in the past – and are therefore susceptible to a repetition of this sort of behaviour – should have easy access to immediate help in cases of emergency.
It is known that there is an effective antidote to excessive doses of heroin, the timely administration of which has saved many lives of drug users who had accidentally self-administered lethal amounts of the illicit drug.
Has the time come when users, or at least reliable relatives, can be supplied with similar substance and informed about how and when to use it?
There was a time when friends and companions of drug users who had overdosed were very reluctant to accompany them to the Accident and Emergency Unit in hospital for fear of legally compromising themselves.
Changes in attitudes and in legislation regulating the possession of drugs in small amounts have now practically removed the legal dangers previously inherent in these situations. The culture of harm reduction, as opposed to the more judgemental and condemnatory ethos prevailing previously, has helped considerably to encourage friends and relatives to seek help in situations involving overdose of illicit substances.
Over the years, deaths from heroin overdose have declined considerably. It is precisely the practical applications of harm reduction philosophy which can provide the key to the further reduction of overall deaths from illicit drug overdoses.
Accepting the reality of a persistent pattern of abuse within society and working with addicts and their relatives about managing the dangers associated with the habit – without in any way facilitating drug use – is the way forward if we really wish to lessen the dangers of accidental death associated with the abuse of illegal substances.