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Date: November 25, 2024 Mon
Time: 8:10 pm
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1 results foundAuthor: United Nations Office on Drugs and Crime (UNODC) Title: Opioid overdose: preventing and reducing opioid overdose mortality Summary: Although data are limited, an estimated 70,000-100,000 people die from opioid overdose each year. Opioid overdose was the main cause of the estimated 99,000- 253,000 deaths worldwide related to illicit drug use in 2010. Opioid overdose is both preventable and, if witnessed, treatable (reversible). In its resolution 55/7 on promoting measures to prevent drug overdose, in particular opioid overdose, the Commission on Narcotic Drugs called upon Member States to include effective measures to prevent and treat drug overdose in national drug policies. In that resolution, the Commission requested the United Nations Office on Drugs and Crime (UNODC), in collaboration with the World Health Organization (WHO), to collect and circulate available best practices on the prevention and treatment of and emergency response to drug overdose, in particular opioid overdose, including on the use and availability of opioid receptor antagonists such as naloxone and other measures based on scientific evidence. This discussion paper outlines the facts about opioid overdose, the actions that can be taken to prevent and treat (reverse) opioid overdose and areas requiring further investigation. Opioids, which can be chemically synthesized or derived from the opium poppy plant, are a group of compounds that activate the brain's opioid receptors, a class of receptors that influence perceptions of pain and euphoria and are involved in the regulation of breathing. Some of the more commonly known and used opioids are morphine, heroin, methadone, buprenorphine, codeine, tramado, oxycodone and hydrocodone. They are used as medicines to treat pain and opioid dependence. If used in excess or without proper medical supervision, opioids can cause fatal respiratory depression. In cases of fatal overdose, the victim's breathing slows to the point where oxygen levels in the blood fall below the level needed to transfer oxygen to the vital organs. As oxygen saturation (normally greater than 97 per cent) falls below 86 per cent, the brain struggles to function. Typically, the individual becomes unresponsive, blood pressure progressively decreases and the heart rate slows, ultimately leading to cardiac arrest. Death can occur within minutes of opioid ingestion. But often, prior to death there is a longer period of unresponsiveness lasting up to several hours. This period is sometimes associated with loud snoring, leading to the term "unrousable snorers". Worldwide, overdose is the leading cause of avoidable death among people who inject drugs. However, it is difficult to accurately estimate the number of fatal opioid overdoses because of the poor quality or limited nature of mortality data available. According to UNODC estimates, drug-related deaths account for between 0.5 percent and 1.3 percent of all-cause mortality at the global level among persons aged 15-64. In that regard, the recent Global Burden of Diseases, Injuries, and Risk Factors Study, 2010 found that there were an estimated 43,000 deaths in 2010 due to opioid dependence and 180,000 deaths due to drug poisoning, resulting in more than 2 million years of life lost. In the United States of America alone, there were an estimated 38,329 drug poisoning deaths in 2010, including 16,651 fatal opioid overdoses related to prescription opioid analgesics in 2010, with the remainder of those deaths largely involving heroin and/or cocaine. Opioid overdose accounts for nearly half of all deaths among heroin injectors, exceeding HIV and other disease-related deaths. Overdose was reported more frequently than were other causes in the 58 cohort studies examined in a 2011 meta-analysis. That meta-analysis also indicated that overdose represented the most common specific cause of death, at 6.5 deaths per 1,000 person-years. Among the 10 per cent of people living with HIV in the United States who also inject drugs, overdose is a common cause of non-AIDS related death. A recent meta-analysis showed that HIV sero-positivity is associated with an increased risk of overdose: people who use drugs have a 74 percent greater risk of overdose if they are HIV-positive compared with their HIV-negative counterparts. In the Russian Federation, overdose is the second leading cause of death for people with HIV after tuberculosis. Nationally reported mortality data in both low-income and high-income countries are often insufficient to estimate overdose deaths. Current data on overdose mortality derive mostly from prospective cohort studies and national reporting systems, largely from high-income countries. To address these challenges, some countries have now adopted a standard case definition, contributing to an improved capacity for reliable overdose data. However, in a significant number of countries, data on overdose are limited, with the result that alternative data sources, often combined with expert opinion, are required to estimate rates. Consequently, overdose mortality generally tends to be underestimated, and nationally reported statistics in that regard are likely to be conservative. For example, against the backdrop of negligible numbers of fatal overdoses reported by national authorities of Central Asian countries, 25.1 percent of injecting drug users surveyed in Kazakhstan, Kyrgyzstan and Tajikistan in 2010 reported having witnessed someone die from an overdose in the previous 12 months. It is likely that people who use opioids also experience a high rate of non-fatal overdose. For instance, 59 percent of known heroin injectors in a study conducted in 16 Russian cities reported having had at least one non-fatal overdose in their lifetime. The proportion of heroin injectors reporting lifetime non-fatal overdose is similarly high in several other cities: 41 percent in Baltimore, 42 percent in New York City, 68 percent in Sydney, 38 percent in London, 30 percent in Bangkok, and 83 percent in Bac Ninh, Viet Nam. Non-fatal overdose can significantly contribute to morbidity, including cerebral hypoxia, pulmonary oedema, pneumonia and cardiac arrhythmia, that may result in prolonged hospitalizations and brain damage. Details: Vienna: UNODC, 2013. 28p. Source: Internet Resource: Discussion paper, UNODC/WHO: Accessed April 18, 2018 at: https://www.unodc.org/docs/treatment/overdose.pdf Year: 2013 Country: International URL: https://www.unodc.org/docs/treatment/overdose.pdf Shelf Number: 149846 Keywords: Drug Abuse and AddictionDrug OverdosesDrug-Related DeathsNarcoticsOpioid CrisisOpioid EpidemicOpioidsPrescriptions Drugs |