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Moore, Joan (2005) Drugs in Focus - policy briefing. Drugnet Ireland , Issue 13, Spring 2005 , pp. 22-23.

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No 13: Overdose – a major cause of avoidable death among young people  

The current EU drugs strategy and action plan specially target drug-related deaths, and the European Council calls on member states to make available a range of measures that can reduce overdose deaths. The 13th policy briefing in the Drugs in focus series, issued by the EMCDDA in January 2005, concludes that many deaths from drug overdose among young people in Europe could be avoided by increasing the proportion of drug users in treatment and bringing untreated users into contact with drug services. Other practical measures include educating users in avoiding risks, and in recognising overdoses in their peers and responding appropriately.

This briefing states that overdose, mostly involving opiates, is a major cause of deaths among young people in Europe: more than 8,000 acute drug-related deaths are reported each year. Most overdose victims are males aged between 20 and 40 years, in most cases opiate injectors and often homeless or marginalised. Evidence strongly suggests that a significant reduction in drug overdose can only be achieved by implementing a broad range of interventions targeting different types of risk behaviour.  

Six policy considerations are outlined in the briefing’s conclusions:

  1. Drug overdose has not yet received adequate attention as a public health issue. 
  2. Further improvements in the reporting of drug-related deaths at population level are required, especially in those countries where registers remain poor. Follow-up studies and assessment of innovative interventions, such as the use of opiate antagonists, are also needed. 
  3. Opiates still account for most overdose deaths, but awareness of the role of other illegal and legal substances needs to be heightened. 
  4. That overdose is avoidable must become a central message and a priority issue for drugs services. 
  5. Recent reversals in the long-term upward trend in overdose deaths in some member states are likely to reflect increased treatment coverage and decreased levels of risk taking, especially injecting. 
  6. The new member states are in a position to avoid the increases in drug-related deaths previously seen in west European countries if they invest in comprehensive programmes informed by the available evidence on effective practices. 

No. 14: Co-morbidity – drug use and mental disorders

The EMCDDA and the World Health Organization (WHO) have been collaborating over the last year to raise awareness of the hidden problem of co-morbidity in Europe. Between 50 and 90 per cent of drug users are reported to suffer from personality disorders and around one-fifth from more serious psychotic illness.

This policy briefing from the EMCDDA’s Drugs in focus series identifies some of the problems of treating such patients. Because the condition is notoriously difficult to diagnose, both drug treatment services and psychiatric teams regularly fail to spot patients with co-morbidity. Drug addiction and disruptive behaviour often mask genuine personality disorders and psychiatric syndromes are often mistaken for substance-induced states. According to the briefing, professionals are often ill-equipped to cope with co-morbidity, resulting in patients being shuttled between psychiatric and drug services, which disrupts their treatment and increases drop-out rates. Co-ordination between services at all points in the treatment chain is essential for successful treatment of co-morbidity and for ensuring a continuum of care and aftercare. Treatment is effective if highly structured, integrating multi-professional teams, and customised via individual case management.  This is both time consuming and demanding on human and organisational resources, but in the end is cost-effective. 

Policy considerations summarised in the briefing include:

  • Treatment for co-morbidity is effective if delivered according to evidence-based practice, planned and managed individually.
  • Co-morbid patients need carefully co-ordinated and integrated treatment services.
  • Training at all levels of each involved organisation is necessary to enhance staff capacity to deal with these patients in a holistic way.
  • Co-ordinated, integrated and flexible treatment services, including aftercare, will reduce staff turnover and be cost-efficient. 

A report on co-morbidity in Ireland commissioned by the National Advisory Committee on Drugs is reviewed in this newsletter. 

Drugs in focus is a series of policy briefings published by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). The briefings are published three times a year in the 20 official languages of the European Union plus Norwegian. An electronic version of Drugs in focus is available from the EMCDDA website at http://www.emcdda.europa.eu/

 

 

Item Type:Article
Issue Title:Issue 13, Spring 2005
Date:January 2005
Page Range:pp. 22-23
Publisher:Health Research Board
Volume:Issue 13, Spring 2005
EndNote:View
Accession Number:HRB (Available)
Subjects:G Health and disease > Substance use disorder > Drug use > Drug intoxication > Poisoning (overdose)
G Health and disease > Substance related disorder > Dual diagnosis (comorbidity)
VA Geographic area > Europe

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