This has been a tough year on all fronts. And yet, even in the face of an ongoing overdose crisis which has worsened during the global COVID-19 pandemic, people are saving lives every day by preventing and reversing overdoses.
We aren’t talking about the people traditionally thought of as first responders, like EMTs, nurses and doctors - though they rightfully deserve praise for stepping up in unprecedented ways to aid in COVID-19 response.
While undoubtedly heroic, medical professionals have never been the true overdose first responders. That duty and honor belongs to people who use drugs - all individuals that have the most crucial role in saving lives. In fact, they do more to prevent and reverse overdose than any other group, and deserve recognition and support for that.
Beyond people who use drugs themselves, we wanted to shine a light on some of the lesser-known groups that play a role in preventing and reversing overdose. The “unsung heroes.”
Pharmacists were some of the first people to realize what a game changer the life-saving opioid overdose reversal drug naloxone had the potential to be. But despite the first naloxone access laws being passed in 2001 (by DPA, in New Mexico!) and all 50 states having some version on the books, it’s still more difficult for a pharmacist to give out naloxone than it ought to be. States that allow pharmacists to dispense naloxone without a physician’s prescription saw fatal opioid overdoses fall by an average of 27% during the second year following passage and 34% in subsequent years, but only a handful of states give direct authority to pharmacists to prescribe. Pharmacists save lives.
Jail and prison administrators oversee people targeted by drug law enforcement who are incarcerated for their addiction. Not only can stopping drug use abruptly be dangerous and lead to increased rates of overdose upon release, but “detox” also fails 90% of the time. And yet, only a handful of jails and prisons offer medications for addiction treatment (MAT), like methadone and buprenorphine, to people who are incarcerated. Rhode Island was able to reduce the number of recently incarcerated people who died from overdose by two-thirds after offering MAT in their correctional institutions. Jail and prison administrators have the potential to save lives if they embrace proven treatments for substance use disorder that can both promote recovery and prevent overdose deaths.
This could really refer to many kinds of employees - from baristas to bus drivers to librarians to fast food workers and more. People in jobs like these are frequently interacting with homeless or unstably housed people who may struggle with drug use. If someone overdoses where they work, baristas and others are in a position to help. But ideally every community would have a location where people who use drugs could go to receive support services and the care of staff explicitly trained to prevent and reverse overdose.
Contrary to what some people believe, many people who sell drugs know and care about the people they sell to, and are often users themselves. People who sell or share drugs are also often the true first responders at the scene of an overdose, with the power to reverse it. Their care ought to be recognized and encouraged. And yet in some states simply selling or even handing over a substance to someone who then overdoses is considered murder.
Everyone has the capacity to be an “unsung hero” and prevent or reverse overdose. Unfortunately, our past and current drug education in schools leaves most people uninformed about the realities of drug use and unprepared if and when they witness an overdose. Harm reduction-based drug education and training ought to be more widely available, and from a young age.
We must shift our policy approach to drug use away from punitive measures and to solutions that value life. Help us move towards a reality in which we reduce overdose and embrace education, health, and harm reduction.