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Irish overdose mortality rates among the highest in Europe

08 Sep 2016

Pic: Getty Images

The statistics for overdose deaths in Ireland are among the highest in Europe and many of these deaths and injuries are preventable, according to the HSE.

Ireland’s overdose mortality rate, at 71 per million, compares poorly with the European average of 18.3 deaths per million of population, aged between 15 and 64. High rates were also reported in Estonia (113 per million) and Sweden (93 per million).

The HSE last week (August 31) marked International Overdose Awareness Day, to raise awareness of the risks of drug overdoses and their impact on individuals and their families. The theme for 2016 was ‘Time to Remember, Time to Act’, and events were held aimed at reducing the stigma of drug-related deaths. The Executive also launched last week an external review of the Naloxone Demonstration Project, which found that five administrations of naloxone occurred resulting in the prevention of five potentially fatal overdoses.

Naloxone is a medicine that acts within minutes to reverse the effects of opioid overdose. In 2014, the World Health Organization recommended that countries expand naloxone access (opioid antidote) to people likely to witness an overdose in their community, such as friends, family members, partners of people who use drugs, and social workers.

In most countries, naloxone is accessible only through hospitals and ambulance crews. However, in 2015, the HSE followed the WHO recommendation with the development of a demonstration project to introduce naloxone into local communities.

The HSE commissioned an external evaluation of the Naloxone Demonstration Project by Ann Clarke and Anne Eustace, which was launched in Temple Bar last week (August 31) by Minister of State Catherine Byrne.

Denis O’Driscoll, Chief Pharmacist for HSE Addiction Services, said: “To date we have trained over 600 people in the use of naloxone and we look forward to rolling out more training in 2017 as we work to expand the service.”

Training in the use of the opioid antagonist naloxone is available nationally to drug users, their peers and their families and is available to all staff working in statutory and community/ voluntary addiction services.

The Naloxone Report recommends improving communications on the project nationally, with a strengthening of the governance of the Quality Assurance Group (QAG). Planning for the roll-out of naloxone should continue, in a measured, phased and strategic way, the report adds.

Training should be refined, by having front-line workers’ training accredited by an identified and appropriate body.

This should be done in a similar manner to the recently accredited and delivered Irish Institute of Pharmacy (IIOP) training for pharmacists, the report suggested.

Specific attention should also be paid to monitoring those service users who have been briefed and prescribed naloxone, including tracking their health, well-being and drug-related behaviour over time, for example, through replenishment records and recorded overdose incidents.

Research, tracking and monitoring all needed to be done in a multi-disciplinary manner and overseen by the QAG, and partnering with an academic establishment or research organisation would “drive and support future research evidenced interventions”.

Gary Culliton

Click here to view the full article which appeared in Irish Medical Times