Too Little, Too Late is Not Enough: International Overdose Awareness Day 2013

The right medical help at the right time can help avert overdose-related deaths. (Photo by Prashant Panjiar for India HIV/AIDS Alliance)

The right medical help at the right time can help avert overdose-related deaths. (Photo by Prashant Panjiar for India HIV/AIDS Alliance)

In the past few years, a number of famous celebrities including Michael Jackson have died due to fatal drug overdose. The media is quick to target the lifestyles of these stars, paying little heed to the grieving families and fans. Some of these deaths have left us surprised, while others we saw coming.

For people who inject drugs (PWID), a fatal drug overdose is an occupational hazard. In India, overdose deaths are particularly common among street-based drug users in bigger cities. Often, these deaths are not reported or even recorded for fear of legal consequences. Like most countries, Indian law criminalises illicit drug use. When someone overdoses, they seek medical help as the last resort, not wanting to deal with the possibility that the police might be called to the hospital.

Anyone who has witnessed an overdose will tell you about frustration and helplessness. The extent of the problem in India is unknown, as there is little reliable data on the annual number of drug overdose deaths. Estimations by NGOs working in the field indicate that in areas with high levels of injecting drug use, hundreds of people die from overdose each year. These cases are mainly due to mixing drugs or use of drugs of poor or unknown quality. Those of us who use drugs or know people who do always need to be aware of the underlying dangers of using drugs in combination. People who have been trying to quit or have been abstinent for a while — such as after a treatment programme or incarceration— are more prone to overdose than those who regularly use drugs.

Preventing overdose-related deaths can require just a few simple steps. A Naloxone injection in time can save a person’s life. What is needed is to ensure that Naloxone — a drug included in India’s National List of Essential Medicines — is readily available at all public healthcare facilities. Unfortunately this is not yet the case. In a number of recent cases, the emergency ward has had no Naloxone available. Relatives or friends of the overdosing PWID have had to rush to procure Naloxone from nearby pharmacies, where they are charged 10- to 20-times the actual price by staff who exploit the urgency of the situation.

Naloxone is an integral and necessary part of effective programming for PWID, but it still needs to be fully integrated into India’s national programme. Alliance India has incorporated overdose prevention and management into the harm reduction services provided to PWID under our Hridaya programme. Our Asia Action programme complements these efforts by supporting advocacy for expanded access to Naloxone and other interventions to reduce overdose-related deaths.

International Overdose Awareness Day is an opportunity to raise awareness about drug overdose, reduce stigma, and advocate for expanded access to overdose-related services. Join Alliance India in solidarity with friends from all over the world as we remember those who have died and recommit to our efforts to end the epidemic of overdose-related deaths.

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The author of this post, Simon W. Beddoe, is Advocacy Officer: Drug Use & Harm Reduction at Alliance India.

With funding from European Commission, the Asia Action on Harm Reduction programme supports advocacy to increase access by people who inject drugs (PWID) to comprehensive harm reduction services and reduce stigma, discrimination and abuse towards this vulnerable population. In India, the three-year programme will initially engage with PWID and local partners in Bihar, Haryana, Uttarakhand, Delhi and Manipur. 

Spanning five countries (India, China, Indonesia, Kenya, and Malaysia), Community Action on Harm Reduction (CAHR) expands harm reduction services to more than 180,000 people who inject drugs (PWID), their partners and children. The programme protects and promotes the rights of these groups by fostering an enabling environment for HIV and harm reduction programming in these five countries. CAHR is supported by the Ministry of Foreign Affairs, Government of Netherlands. 

In India, CAHR is called ‘Hridaya’ and is implemented by India HIV/AIDS Alliance in partnership with SASO, Sharan, and a number of community-based harm reduction organisations and networks. This programme helps build the capacity of service providers, makes harm reduction programmes more gender-responsive, improves access to services and advocates for the rights of PWIDs. In addition to providing services, Hridaya has a strong capacity building component to support advocacy, knowledge management and improved services for PWIDs.

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