There's growing evidence that an escape from underlying physical or emotional pain is a common driver of many overdoses. Where the person was ambivalent about whether they would live or die, the task of coding becomes almost impossible. That evidence is difficult to find in any intentional death, but for those who suicide by drug overdose, it's even more complex.
So, what do we know about the proportion of overdose deaths that are intentional, or where intent is undetermined?Ī key methodological challenge here is that coding systems that provide official statistics, such as the International Classification of Diseases, require clear evidence of suicidal intent before the death can be considered to be intentional.
Such findings are consistent with research identifying high rates of suicidal ideation and attempts among Australians prescribed opioids for chronic non-cancer pain, many of whom report high rates of physical and mental ill health. While there are likely to be many factors involved, Australian research has found prescription opioid deaths are twice as likely to be identified as intentional when compared with heroin-related deaths. In the US, forced tapering or sudden discontinuation of opioid prescriptions have been followed by an increase in overdose deaths. While such strategies are likely to be important in reducing the number of Australians who develop long-term opioid medication dependence, the effect on those who already rely on opioids for pain management is less clear. However, we're yet to understand the full impact of these measures in terms of reducing deaths.
Opioids – illicit drugs such as heroin, and pain relievers such as codeine, oxycodone and morphine – are the major contributor to these overdose deaths in Australia, nearly doubling in the past 10 years, from 3.8 to 6.6 deaths per 100,000.Ī range of important evidence-based interventions, such as naloxone, opioid agonist treatment, and supervised injecting facilities, have contributed to the reduced heroin use mortality, but this still requires substantial upscaling. The global campaign, which began in Melbourne, also focuses on reducing the stigma of drug-related deaths, as well as the impact of overdose around the world. It's a time to remember those lost to overdose, and acknowledge the enormous loss and grief felt by families and friends. This Monday, 31 August, is International Overdose Awareness Day.
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