Do you personally know anyone who has ever overdosed on drugs or alcohol?
This could be a family member, a friend, a co-worker … maybe even YOU.
If you do, you are not alone. Last year, there were over 68,000 fatal overdoses in America, tragically affecting every part of the country. What’s more, it is estimated that for every single drug death, there are up to 50 additional non-fatal overdoses.
That means that conservatively, there are up to 3.5 million overdoses happening in this country each year, or more than one every second of every day. And because over 24 million Americans currently struggle with some degree of Substance Use Disorder, it’s not just possible that overdose has touched your life, but probable.
But there is support and understanding.
Every August 31st is observed as International Overdose Awareness Day, a time to remember loved ones who died or were permanently injured because of an overdose. Just as important, it is also an opportunity to act to help those people who are still addicted and who are still at-risk right now.
What is International Overdose Awareness Day?
“… I was in such denial. I did not want to believe both my parents died from drug overdoses. I could not use the word ‘addiction’ or ‘overdose’ in the same sentence, because I was adamant that neither one of my parents could be drug addicts.”
~ Lauren Sisler, ESPN Reporter, recalling how her parents fatally overdosed within hours of each other in 2003
International Overdose Awareness Day is a global observance held annually on August 31st, aiming to promote greater awareness of the overdose crisis and to reduce the shame and stigma unfairly associated with drug-related deaths.
Other goals include:
- To allow families and friends to publicly mourn their lost or injured loved ones.
- To put a human face on the overdose health crisis.
- To connect substance abusers and families in need with local treatment resources.
- To reduce the harms caused by substance abuse.
But the biggest and most important goal of International Overdose Awareness Day is to spread the message that drug fatalities are absolutely preventable.
A Truly International Observance
“Globally, some 35 million people, up from an earlier estimate of 30.5 million, suffer from drug use disorders and require treatment services. The death toll is also higher: 585,000 people died as a result of drug use in 2017. Prevention and treatment continue to fall short of needs in many parts of the world.”
~ United Nations Office on Drugs and Crime, World Drug Report
What started as a small observance in Melbourne, Australia in 2001 has grown into a worldwide event that now connects dozens of countries hosting hundreds of memorial events.
- Costa Rica
- Côte D’Ivoire
- Puerto Rico
- South Africa
- United States
As might be expected, the United States hosts more events than any other country. There are literally hundreds of events happening throughout the country, in every state.
The Theme for 2019
“There are many shattered families walking among us, and I feel we as a community have a responsibility to show up for them … Losing someone due to substance use can be especially isolating due to the shame or stigma involved. The vigil is designed to become a healing ritual, a place to be able to talk openly about your loved one, and for people to know they are not alone and that their loved ones are remembered,”
~ Kathy Day, organizer for her community’s annual overdose vigil
The theme for International Overdose Awareness Day 2019 is “Time to Remember, Time to Act”. This dual theme provides bereaved loved ones multiple opportunities to appropriately observe the occasion.
Ways to remember:
- Participating in local memorial events and activities
- Sharing pictures
- Getting together with other family members and friends to tell stories, laugh, and cry.
- Crafting memorial items…bracelets, t-shirts, quilts, artwork, collages, etc.
- Reading poetry
Ways to act:
- Convincing other substance abusers in your life to seek professional treatment
- Personally taking them to Alcoholics Anonymous, Narcotics Anonymous, or other 12-Step fellowship meetings
- Ending any enabling or codependent behaviors on your part
- Learning the warning signs of substance abuse and addiction
- Recognizing the symptoms of a drug overdose
- Training on how to respond to an overdose
- Obtaining and learning how to use Narcan
Remembering is acknowledging the grief you feel because of a lost or permanently-injured loved one. Acting is doing what you can to make sure it doesn’t happen to anyone else.
What Kind of Events are Happening on International Overdose Awareness Day?
“It’s a memorial. It’s to help remember those who have died and suffered permanent injury due to overdose. People need to know they are not alone. It keeps people from reaching out for help.”
~ Darlana Treolar, talking about the Overdose Awareness March planned in her community
Every community has been impacted to a different degree by the drug crisis, so the local responses vary. Depending on where you live, activities may include:
- Balloon releases
- Candlelight vigils
- Connection with local resources
- Educational Panels
- Fentanyl detection kits
- Grief sharing
- Guest speakers
- Hepatitis C/HIV testing
- Lantern launches
- Medication lock box giveaways
- Memorial walks
- Moments of silence
- Narcan distribution, at no cost, and training in its use
- Overdose recognition
- Photo sharing
- Prayer service
- Put a purple light bulb on your porch or front window
- Quilt projects
- Recovery literature
- Remembrance videos
- Social media campaigns
- Shoe displays
- Tree planting
- Wearing silver badges or purple lanyards or bracelets
For information about Overdose Day events near you, click here.
Why is International Overdose Awareness Day Important?
“This is a time to grieve or those whom we have lost, to acknowledge the pain of those left behind, and to raise awareness of the impact this epidemic has on American families.”
~ Barbara Sprechman, Assistant Executive Director, Prevention Coalition, Mercer County, New Jersey
For all the talk of the “opioid epidemic”, what America is really dealing with is a drug overdose problem that has been called the worst public health crisis is U.S. history. Between 1979 and 2017, drug deaths increased every year.
In fact, take a look at the number of fatal overdoses that have happened just since 1999:
- 1999: 16,849
- 2000: 17,415
- 2001: 19,394
- 2002: 23,514
- 2003: 25,785
- 2004: 27,424
- 2005: 29,813
- 2006: 34,425
- 2007: 36,010
- 2008: 36,450
- 2009: 37,004
- 2010: 38,329
- 2011: 41,340
- 2012: 41,502
- 2013: 43,982
- 2014: 47,055
- 2015: 52,404
- 2016: 63,632
- 2017: 72,147
- 2018: 68,557
That works out to over 770,000 drug deaths. To give that number perspective, that means that within one generation, fatal overdoses have killed more Americans than every armed conflict since World War I combined.
And while 2018’s total marks the first yearly decline since 1990, there is still a tremendous amount of work to do. For example, while the number of prescription painkiller deaths has gone down, fatal overdoses involving other substances are still on the rise, especially methamphetamine and powerful synthetic opioids like fentanyl and its chemically-related analogues.
How much work?
Even with that one-year decrease, the number of drug deaths is still over 400% higher than it was a generation ago. This why overdoses are the leading cause of accidental deaths for Americans under the age of 50, killing more people than gun homicides and automobile accidents put together.
Overdoses Affect Every Part of America
“Long before we receive data from death certificates, emergency department data can point to alarming increases in opioid overdoses. This fast-moving epidemic affects both men and women, and people of every age. It does not respect state or county lines and is still increasing in every region in the United States.”
~ Dr. Anne Schuchat, M.D., Acting Director, Centers for Disease Control and Prevention, in a March 2018 Press Release
According to a recent “Vital Signs” report from the Centers for Disease Control and Prevention, every part of America saw an increase in opioid-related overdoses between 2016 and 2017. Across the country, emergency room trips resulting from opioid overdoses spiked by 30%,
Look at the statistics about the increase in the number of opioid experienced by various locations and demographics between 2016 and 2017:
- Midwest: +70%
- Large Metros: +54%
- Medium Metros: +43%
- Small Metros: +37%
- Micropolitan communities: +24%
- Large “fringe” metros: +21%
- Non-core cities: +21%
- Men: +30%
- 35-54 age group: +36%
- 55 and older: +32%
- 25-34 age group: +31%
Overdose Deaths by State
“The opioid crisis is an emergency, and I am saying, officially, right now, it is an emergency. It’s a national emergency…It’s a serious problem the likes of which we have never had.”
~ President Donald Trump
By using data from the CDC, we can get a clearer picture of just how bad the overdose epidemic in America really is. Ranking the states from most to least total drug deaths in 2018:
- California: 5,510
- Florida: 5222
- Pennsylvania: 5070
- Ohio: 4197
- Texas: 3079
- Illinois: 2900
- Michigan: 2727
- New Jersey: 27 81
- Massachusetts: 2471
- Maryland: 2467
- New York: 2447
- North Carolina: 2407
- Tennessee: 1918
- Indiana: 170
- Arizona: 1680
- Missouri: 1505
- Georgia: 1461
- Virginia: 1415
- Kentucky: 1386
- Louisiana: 1218
- Wisconsin: 1188
- Washington: 1170
- Connecticut: 1103
- South Carolina: 1056
- Colorado: 1043
- West Virginia: 958
- Alabama: 792
- Nevada: 739
- Oklahoma: 729
- Utah: 689
- Minnesota: 679
- Oregon: 581
- New Mexico: 521
- Arkansas: 449
- New Hampshire: 445
- Maine: 406
- Delaware: 369
- Kansas: 350
- Rhode Island: 334
- Mississippi: 312
- Iowa: 308
- District of Columbia: 285
- Idaho: 235
- Hawaii: 224
- Nebraska: 167
- Vermont: 136
- Alaska: 125
- Montana: 106
- North Dakota: 75
- Wyoming: 64
- South Dakota: 62
While the total number of overdose deaths in the United States decreased from 2017 to 2018, there were still 26 states that saw an increase. In fact, 10 states had double-digit increases:
- Nebraska: +38%
- Louisiana: +19.3%
- Delaware: +17.1%
- Illinois: +16.8%
- Oregon: +16%
- Kansas: +14.8%
- Hawaii: +13.7%
- Maine: +13.4%
- Arkansas: +10.9%
- New Jersey: +10.4%
EVERYBODY Knows SOMEBODY with a Drinking or Drug Problem
“Drug use is on the rise in this country, and 23.5 million Americans are addicted to alcohol and drugs. That’s approximately 1 in 10 Americans over the age of 12 — roughly equal to the entire population of Texas.”
Dr. Kima Joy Taylor, MD, Director, Closing the Addiction Treatment Gap Initiative
Does addiction REALLY affect all of us?
According to the New York Times, the average American personally knows an estimated 600 people. And because approximately 1 out of every 10 adults struggles with problematic substance abuse, that means we each personally know at least 60 people who drink to excess or abuse drugs.
But that same Times survey says that most of us know between 10 and 25 people well enough to trust them. That means that among those closest to us — our family, our friends, our trusted coworkers, people we depend on — there are at least two or 3 people who are battling an addictive disorder RIGHT NOW.
The Stigma of Addiction and Overdose
“Our research suggests that shaming people for difficult-to-curb behaviors may be exactly the wrong approach to take. Rather than prevent future occurrences of such behaviors, shaming may lead to an increase in these behaviors.”
~ Drs. Jessica Tracy and Daniel Randles, Ph.D.s, the University of British Columba
Addiction, properly called Substance Use Disorder, is a recognized mental illness, and this can unfortunately mean the added burdens of stigma and shame. Not only are these feelings unnecessary, but they are also counter-productive. In fact, they are often barriers that prevent the person from getting the professional help. It can even lead someone who is trying to stay clean to suffer a relapse.
Stigma involves the embarrassment felt by the addict and their families. They worry, right or wrong, about what other people might think. They are still held hostage by the outdated perception that addiction is somehow a moral weakness or character flaw. Because of that, they feel guilty about their behaviors and ashamed because they can’t stop drinking and using.
A 2013 study from the Association for Psychological Science suggests that a recovering alcoholic who is still experiencing overwhelming shame about their past drinking has a greater likelihood of health problems, including relapse.
For example, the research shows that non-verbal signs of shame — unhappy expression, hunched shoulders, etc. — directly correlate with both relapse and the amount of alcohol consumed. Specifically, someone with a “moderate” amount of shame-indicating body language will consume an average of 20 weekly drinks more than a person who shows no such signs.
Dr. Tracy explained, saying, “The extent to which they showed shame behaviors when talking about the last time they drank quite strongly predicts whether they will relapse within about four months.”
Overdose Warning Signs
“The epidemic of deaths involving opioids continues to worsen. Prescription opioid misuse and use of heroin and illicitly manufactured fentanyl are intertwined and deeply troubling problems.”
~ Tom Frieden, Director of the Centers for Disease Control and Prevention
A drug overdose is ALWAYS a medical emergency, and knowing what to look for and how to respond can mean the difference between life and death for the overdose victim.
Here are some warning signs to help you recognize an impending or in-progress overdose:
- Extreme confusion
- Difficulty staying awake/conscious
- Trouble breathing
- Slowed heartbeat
- Low body temperature
- Cold and clammy skin
- Impaired stimuli response – unresponsive to pain, no gag reflex, etc.
“Traditional” remedies such as cold showers and hot coffee do not work. ALWAYS seek emergency medical attention.
Stimulants (Cocaine, Methamphetamine, and MDMA):
- Bluish lips and skin
- Rapid breathing
- Breathing difficulty
- Dangerously high body temperature
- Profuse sweating
- Accelerated heartbeat
- Irregular heart rhythm
- Chest pains
- Blood pressure spike
- Loss of bladder control
Immediately call 911. Reassure the victim, keeping them as calm as possible, but do not try to restrain them. If they are having seizures, remove any nearby objects that may cause injury, and try to put them on their side to make breathing easier. If they appear to stop breathing and you cannot detect a pulse, start CPR immediately.
Tranquilizers (Benzodiazepines, Barbiturates):
- Slurred speech
- Trouble breathing, to the point of respiratory failure
- Bluish skin, lips, and fingertips
- Extreme dizziness
- Blurred/double vision
- Loss of coordination
- Extremely low blood pressure
- Slowed heart rate
- Lowered body temperature
- Aspiration into the lungs
SPECIAL NOTE: The elderly and people with chronic illnesses are much more vulnerable to the effects of these drugs, and can fatally overdose at relatively low doses.
Call 911. Check breathing and pulse. If the victim stops breathing, start CPR. Turn them onto their sides and keep their airways clear.
Opioids (Painkillers, Heroin, Fentanyl):
- Blue lips/fingertips (reported in 20% of cases)
- Snoring, gasping, or gurgling sounds, aka the “death rattle” (16%)
- Muscle rigidity and seizures (13%)
- Foaming at the mouth (6%)
- Confusion or strange behavior before passing out (6%)
- Skin discoloration: Bluish-purple for people with light skin and ashy-grey for people with dark skin.
- Slowed, shallow breathing
- Barely-detectable pulse
- Dangerously low blood pressure
- Cold, clammy skin
- Pinpoint pupils
- Discolored tongue
- Vomiting, often incomplete, creating a danger of aspiration
- Loss of consciousness
- Unresponsiveness to outside stimuli
SPECIAL NOTE: 2 out of every 3 overdose deaths involve an opioid, especially when combined with a benzo tranquilizer, alcohol, or another opioid.
Call 911. If Narcan is available, administer it immediately. (Note, Narcan IS NOT effective at reversing overdoses from any drugs other than opioids. If the opioid dose was high enough, reversal may require multiple administrations) Similar to a tranquilizer overdose, place the victim on their side and keep their airway clear. If the victim stops breathing, perform CPR until medical personnel arrive.
Everyone Should Carry Narcan
“You don’t have to be a policeman or a firefighter or a paramedic to save a life.”
~ Dr. Jerome Adams, US Surgeon General
In April 2018, SG Adams spoke at the National RX Drug Abuse & Heroin Summit in Atlanta, Georgia. He remarked that he wants more American citizens to carry Narcan, to be better prepared in the event of an opioid overdose emergency. It was the first time in 13 years the United States’ top physician needed to put out a public health advisory.
SG Adams also said that over half of all opioid drug deaths occur at home, indicating that one of the best ways to address the American drug crisis could be for at-risk users, their families, and their friends, to obtain Narcan, learn how to use it, and then carry it with them everywhere they go.
This is a brilliantly simple solution for most people, because 95% of insured Americans are covered to buy naloxone. Even people without insurance can purchase brand-name Narcan nasal applications for around $80 a dose, while injectable generics are even cheaper. And most public health programs have naloxone available for free or at a subsidized lower price.
SG Adams has asked for an increase in federal funding to expand the availability even further, saying, “Costs should not and, in the near future, will not be a barrier to accessing naloxone for anyone in America.”
Overdoses Touch Us All, Even Celebrities
Despite seemingly having it all — fame, glamor, riches — celebrities are just a vulnerable as the rest of us to the disease of addiction and its tragic consequences.
- Brian Adams, professional wrestler better known as Crush (tranquilizers and painkillers)
- John Belushi, actor and comedian (heroin and cocaine)
- Bam Bam Bigelow, wrestler (cocaine and tranquilizers)
- Bobbi Kristina Brown, media personality (alcohol and tranquilizers)
- Lenny Bruce, comedian (heroin)
- Ken Caminiti, baseball player (heroin and cocaine)
- Chyna, wrestler (alcohol, tranquilizers, and painkillers)
- Tommy Dorsey, bandleader (sleeping pills)
- Chris Farley, actor and comedian (morphine and cocaine)
- Judy Garland, actress and singer (barbiturate tranquilizers)
- Paul Gauin, painter (laudanum)
- Greg Giraldo, comedian (prescription medications)
- Mitch Hedberg, comedian (heroin and cocaine)
- Margeaux Hemingway, actress (phenobarbital, a barbiturate tranquilizer)
- Jimi Hendrix, musician (barbiturate tranquilizers)
- Abbie Hoffman, political activist (barbiturates tranquilizers and alcohol)
- Phillip Seymour Hoffman, actor, (heroin, cocaine, amphetamine, and benzodiazepine tranquilizers)
- Whitney Houston, singer (cocaine and tranquilizers)
- Michael Jackson, singer (anaesthetic and tranquilizers)
- Janis Joplin, singer (heroin)
- Frida Kahlo, painter (painkillers)
- Margot Kidder, actress (alcohol and undisclosed drugs)
- Thomas Kincaid, painter (alcohol and tranquilizers)
- Alan Ladd, actor (alcohol and sleeping pills)
- Heath Ledger, actor (painkillers and tranquilizers)
- Mac Miller, rapper (alcohol, cocaine, and fentanyl)
- Marilyn Monroe (barbiturate tranquilizers)
- Cory Monteith, actor (alcohol and heroin)
- Jim Morrison, singer (heroin)
- Ol’ Dirty Bastard, rapper (cocaine and painkillers)
- Tom Petty, musician (painkillers and tranquilizers)
- River Phoenix, actor (cocaine and heroin)
- Edgar AllanPoe, writer (laudanum and alcohol)
- Prince, musician (fentanyl)
- Vern Troyer, actor (alcohol)
- Scott Weiland, singer (alcohol, cocaine, MDMA)
- Keith Whitley, singer (alcohol)
- Amy Winehouse (alcohol)
What Can be Done at the Local Level to Address the Overdose Problem?
“There are a lot of judgments out there against people who have addicted children. When you’re walking around with a secret, your stomach is upset all the time, your heart is always pounding. You feel a lot of “Why my son?””
~ Vicki Bishop, who lost her son Brian to addiction in 2017
To successfully fight overdoses deaths will take an all-hands-on-deck cooperative approach:
Local County Health Departments
- Alert the local community about the real scope of the problem.
- Develop an appropriate and timely response plan.
- Arrange for a sufficient supply of naloxone (Narcan) to meet the projected demand.
- Increase access to treatment programs and recovery services.
- Coordinate with other local resources and organizations.
Law Enforcement and First Responders
- Provide first responders with adequate supplies of Narcan, including proper training on its emergency administration.
- Identify current and emerging illicit drug trends and share any relevant information with other agencies.
- Partner with local public health departments and healthcare providers to facilitate access to available resources and recovery services for the people they come in contact with.
- Provide the families of overdose patients with Narcan and training
- Connect overdose patients with local treatment programs and 12-Step groups
- Develop a safety plan to prevent and to respond to further overdoses.
Mental Health/Substance Abuse Treatment Providers
- Adjust the availability of treatment services to accommodate changes in public need.
- Expand Medication-Assisted Treatment (MAT), using FDA-approved anti-addiction medications.
- Provide comprehensive and integrative care to address both the addiction and any co-occurring mental disorders.
- Focus resources and efforts on those people who are most at-risk.
- Offer targeted harm-reduction strategies for IV drug users.
- Make Narcan freely available.
- Provide referrals to local treatment programs.
Members of the Community
- Participate in community discussions.
- Cooperate with outreach programs.
- Support local efforts such as sober living homes, needle exchanges, and methadone clinics.
- Become familiar with and use the multiple resources available within the community.
There is no single approach or strategy that will completely eliminate the drug crisis in our communities. But when cooperative efforts are made at every level, then they will have a cumulative positive impact and lives will be saved.
The best way to protect yourself and the people you care about from being another name on a memorial is to seek professional help. If you are ready to take your first step on your own personal sober journey contact us.