Every August, SAMHSA commemorates Overdose Awareness Week (August 27 to September 2, 2023) and International Overdose Awareness Day (August 31, 2023) to remember the individuals, families, and communities who have all been impacted by overdose. According to the latest provisional data from the Centers for Disease Control and Prevention (CDC), an estimated 110,000 lives were lost to overdose in the 12-months ending in March 2023, with fentanyl and other synthetic opioids as the main drivers of these deaths. Adding to the challenge of rising fentanyl-involved overdoses is the emergence of xylazine, a non-opioid tranquilizer, increasingly mixed with fentanyl in the illicit drug supply.
Too many lives have been taken and too many people have been personally affected by overdose. Overdose can be attributed to many factors. For example, it can happen when an individual uses a substance that has been contaminated with highly potent opioids or other drugs or when the person misunderstands the dosage of the medication they are taking. Irrespective of the cause, overdose can have devastating, long lasting impacts in our communities – but we also know that overdoses can be prevented. To address the overdose crisis, the Department of Health and Human Services developed the Overdose Prevention Strategy with four main pillars:
Primary Prevention - These strategies promote tiered, multidisciplinary prevention activities, ranging from population-level strategies to targeted interventions aimed at high-risk individuals. These activities engage health and human services providers directly and facilitate cross-sector collaboration on prevention to address key upstream risk and protective factors.
Harm Reduction - Evidence-based harm reduction strategies minimize negative consequences of drug use. These activities further expand access to harm reduction interventions such as opioid overdose reversal medications and fentanyl and xylazine test strips and better integrate harm reduction into specialty and general medical care.
Evidence-Based Treatment - These strategies focus on reducing barriers to accessing the most effective treatments, including medications for opioid use disorder, using motivational and cultural enhancements to encourage those who might be reluctant, advancing strategies to improve engagement and retention, and continuing to develop new therapeutic approaches.
Recovery Support - These strategies recognize that treatment alone may not be enough to support long-term recovery. Despite the demonstrated benefits of recovery support services — such as peer supports, employment and housing services — various challenges impede their availability and uptake. Enhancing coverage and integration of recovery support services is critical to promoting access to and use of these services. Strengthening the recovery support services workforce also is essential to promoting access and quality.
Preventing substance use and overdose is one of SAMHSA’s top priorities emphasized in the new SAMHSA 2023-2026 Strategic Plan. SAMHSA is working to address the overdose crisis by providing technical assistance, thought leadership and partnership with communities, and funding multiple complementary grant programs. These efforts focus on preventing opioid and substance use in the first place, increasing access to medications for opioid use disorder, supporting harm reduction services, and improving access to treatment and recovery support services. A few of these programs include Medication-Assisted Treatment – Prescription Drug and Opioid Addiction, Harm Reduction, Improving Access to Overdose Treatment, and First Responders – Comprehensive Addiction and Recovery Act.
As we commemorate Overdose Awareness Week and International Overdose Awareness Day, we know there is hope. This requires a collective effort, and SAMHSA remains committed to being at the forefront of providing lifesaving information and resources to the public, health care providers, and other partners in the community. The following are resources that SAMHSA will be releasing soon to help communities address these challenges:
Opioid-Overdose Reduction Continuum of Care Approach (ORCCA) Practice Guide. This Guide includes a menu of evidence-based strategies for reducing opioid overdose deaths. The ORCCA Guide has three focus areas: opioid overdose education and reversal medication distribution, medication treatment for opioid use disorder, and safer opioid prescribing and disposal.
Engaging Community Coalitions to Decrease Opioid Overdose Deaths Practice Guide. This provides guidance on building and maintaining community coalitions that focus on the opioid crisis, as well as approaches for assessing how well coalitions are functioning.
The final Harm Reduction Framework which will incorporate public feedback and provide a roadmap of best practices, principles, and pillars that every entity can apply to their work.
Our efforts at SAMHSA are pursued through a shared collective vision and partnership with other federal, state, and community partners. This week, CDC is releasing a Morbidity and Mortality Weekly Report on the increasing role counterfeit pills that contain illicit fentanyl and other synthetic opioids are playing in the overdose crisis. In addition, CDC has a dedicated site for International Overdose Awareness Day that provides ideas on how everyone can engage and take action such as wearing a purple ribbon or sharing an IOAD message on social media to facilitate discussion.
Every community across our country has been impacted by the overdose crisis. And behind all of the statistics are families, friends, and communities that will be forever changed. Everyone has a role to play and observing Overdose Awareness Week and International Overdose Awareness Day provide an important opportunity to remember those who have been lost and recommit to doing everything we can to prevent substance use and overdose.
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