“Overdose deaths pass national road toll for first time” (Herald Sun 27/8/13)

But what is the solution?” [“Permissibility, availability and accessibility - all increase consumption.” Dalgarno Institute.] Can we have some clarity of what this article means? The lead ‘tag’ is “A SURGE in accidental and prescription medicine overdoses has seen drug deaths overtake the national road toll for the first time on record.” Has the line in the evidence been blurred, asked Shane Varcoe, Director of Dalgarno Institute. The issue that needs some clarification for us is about which drug is adding to this broad claim and is prescription overdose stats been hijacked to bolster an agenda? Mr Varcoe Asked. Australian Bureau of Statistics reveals that road accidents claimed 1323 lives nationally in 2011, while 1383 people died of drug overdoses. Over 50% of these deaths are heroin related with approximately another 25% Methadone overdose, leaving only around 24% deaths from other prescription drugs. If people are taking illicit substances, against all law and convention, then certainly the risk of overdose in always there, as the substances are not controlled in either content or quantity. However, if people are overdosing of prescription medicines, it is either because they genuinely don’t understand ‘prescription’ or they are deliberately over medicating for reasons that are too many to perhaps outline here. The reason the distinction is important is in trying to understand what the strategy for the release of NARCAN is based on. The CEO of Anex, Mr Ryan was quoted in the article as saying "Far too many people die or suffer brain damage because friends and loved ones did not recognise signs of overdose," Now, as a stand-alone statement it seems to be placing responsibility for overdose outcome inappropriately in the lap of the non-drug user. Now having used this syntax to posit that, he goes on to prescribe that to help the non-user to manage the problem, the thing to do would be to roll out COPE Strategy where people at risk, and their loved ones, can be trained in how to administer the ‘lifesaving’ drug naloxone to reverse opioid overdose. I’m fascinated by the language use here, (whether deliberate or not) it’s very passionate; ‘Loved ones’ and ‘life saving’, and no doubt these emotive terms are used to help promote the apparent advantage of this pharmacological ‘strategy’. However, Mr Ryan also, as he said earlier in the piece comparing this strategy with that of the Road Toll campaign; "Road safety programs work with all Australians to drive the road toll down. We need to tackle overdoses with the same determination, because at this rate we may be heading the way of the US." This is where we need to pause and give some greater scrutiny, not only to the proposed ‘strategy’, but of the legitimacof the comparison with the argument regarding the road toll. Firstly, Mr Ryan states ‘Road safety programs work …to drive road toll down.’ So we assume from that statement that he would like a similar campaign to ‘drive the overdose rate down’, is that correct? If so, is the administering of Naloxone AFTER the overdose a strategy to prevent overdose, or simply to stop one of the tragic outcomes of overdose? The best thing to prevent overdoses is not to use drugs, isn’t it? Secondly, the Road Toll campaign has an aggressive prevention message to STOP accidents by endeavouring to reduce and finally remove the elements that precipitate accidents; i.e. speed, drug use, use of devices whilst driving, etc. The multi-million dollar prevention marketing campaign had pretty much just ONE significant Key Performance Indicator; stop the activities that cause the accidents! Not a message to keep doing the activities and try and better manage them so you minimise your chances of an accident. Finally, as part of this harm prevention campaign; legislation of both an educational and punitive natture is in place for those who flaunt the strategy to reduce the road toll. This component is indispensable in any public education process. Hence the following questions… a) If drug overdoses are from prescription medicines, will doctors then have to prescribe Naloxone along with them for ‘loved ones’ to monitor the patient? Will this become standard operational protocol with the expectation that patients will deliberately overuse their prescription drugs? b) Is this really about making Naloxone available, at will, for illicit drug users? Will there be any means by which to track use of such rapid detox, or will any illegal drug user be given it, simply because the refuse to obey law or convention? c) Will Naloxone become simply the strategy of choice for the illegal drug user to manage their substance use and have no requirement to cease drug use? d) Whilst this pharmacotherapy may save some lives after an overdose will it inadvertently only add to the HARM of illicit and licit drug use for the user and the rest of the community, because it can better enable longer and greater drug use? If we don’t ask the responsible questions or worse, don’t empower/enable to drug user to exit their Harm-full behaviour, then we are easily intimidated by the Harm Reduction mantras, that care little that a person continues to wilfully self-harm, and only that they are kept alive to keep using – that seems to be the logic emanating from many of these ‘untouchable’ ideologies. It is time to save lives! It is time to educate for harm prevention! It is time to direct and enable drug users to find their way out of drug use into the harm-less space of no longer using. If our ‘strategies’ do not have this as their end, then they are not worthy of our time or resources, they are simply either a) the perpetuation or even promotion, of careless self-indulgence or disturbingly b) the deliberate ploy of callous agencies to continue the ‘incarceration’, that is drug dependency! I don’t know, but all I do know is that people need help and motivation to become drug free – to us at least, that is a NO Brainer! Media Release Dalgarno Institute admin@dalgarnoinstitute.org.au P: 1300 975 002 F: 1300 952 551 Communications Liaison – Dalgarno Institute. References http://www.heraldsun.com.au/news/law-order/overdose-deaths-pass-national-road-toll-for-first-time/story-fni0fee2-1226705302834