Drug overdose has become a menace in the United States and is reported to be a major cause of deaths in the country. According to statista.com, the state of West Virginia recorded the highest death rate in the country at 31.3 per 100,000 inhabitants during 2014. The lowest rate of 3 deaths per 100,000 was recorded in North Dakota, while the California figure stood at 11 per 100,000 people.
Drug abuse has become a major concern for the nation’s health. Injecting drug abusers are 14 to 17 times more likely to die than non-drug abusers, says a study published in BMJ Open journal. According to the lead author, Dr Chukwudi Okolie of College of Medicine at the Swansea University, the alarming sign is that it has rose significantly over the years. The annual number of deaths due to drug overdose stood at 6,100 in 1980 and it rose drastically to 38,329 in 2010.
It is not that preventive measures have not been initiated by the government and other agencies. While many such measures could not help much in preventing or reducing drug overdose deaths, a community-based approach has showed positive signs in controlling death rate over the years. Findings from several such community programs have brought to light that this menace could somewhat be tackled by community intervention.
In order to achieve long-term detoxification, preventing relapses and abstinence from opioid abuses, researches have focused on drug treatment of these patients. Systematic reviews have concluded that various pharmacological treatments have proved to be beneficial. It has been done by comparing them with each other and they are also compliant with abstinence programs.
A probe into community-based treatment and prevention programs has shown significant success rate in preventing drug overdose deaths. These programs involve imprisoned former offenders and safe injecting facilities.
Enough interest has been generated since the 1990s to reduce overdose deaths by providing ‘take-home’ naloxone to users, families and drug services. It has also been observed that at events related to drug overdose people are generally open to intervention and training, as in cardiopulmonary resuscitation or naloxone delivery. It has evoked the desired response.
The WHO has also compiled a range of psychosocially assisted pharmacological treatments for opioid dependence by studying several cases. But there is a lack in their conclusion as they have not assessed the range of interventions available and their effectiveness to treat or prevent overdose deaths.
There is also a gap between the methods to administer and deliver treatments in the pre-hospital setting. However, there has been a considerable rise of voices advocating research into preventative interventions for drug addicts at high risk of death in order to reduce the escalating numbers of fatal and non-fatal overdoses.
One of the recent systematic reviews studied the effectiveness of community-based drug overdose prevention programs that included the distribution of naloxone. However, the emergency medical services or the harm reduction programs such as supervised injection facilities (SIFs) were not included in this review. The review also did not adhere to PRISMA-P guidelines and did not conduct a meta-analysis on its data.
At present, there are no other reviews assessing the effectiveness of SIFs. Looking at the high mortality rate of drug overdose it is imperative to undertake reviews that assess the effectiveness of each type of overdose prevention program offered in the community. As government machineries have failed to reduce the mortality rate involving drug overdose, many suggest that community-based programs would be quite successful.
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