By Lt. Cmdr. (Dr.) Trinity Dunham, U.S. Navy
Sep. 28, 2023

Connecticut National Guard Photo by Capt. David Pytlik

Drug misuse and overdose is far-reaching into the lives of individuals and communities, creating a ripple effect and changing lives from grieving families and peers to first responders and emergency personnel. Despite the remarkable personal and community impact of drug overdose, the National Institute on Drug Abuse indicated a continued rise in the number of reported drug-involved overdose deaths from 1999-2021¹. Rises in drug-involved overdose deaths are consistent across gender, age, or drug (i.e., synthetic opioid, psychostimulants, prescribed opioids, illicit substances, etc.) with greater than 106,000 Americans succumbing to drug overdose in 2021, making overdose deaths a leading cause of injury-related deaths in the United States². These trends highlight the ongoing concern for the drug overdose epidemic and the continued emotional and economic toll drug overdoses (fatal and nonfatal) take on the nation. One of the greatest tragedies associated with overdose is the fact that it can be preventable. 

Overdose Awareness Day was established to educate the public about how to prevent overdoses. Initially established in 2001 in Melbourne, Australia, Overdose Awareness Day was observed by local communities and governments until reaching international attention and being recognized as International Overdose Awareness Day in 2012³. International Overdose Awareness Day is observed annually on August 31 to increase awareness and provide a day of remembrance for those who have died from overdose. The event also promotes advancement of prevention strategies, policy and practice changes, and destigmatizing drug use and overdose. 

International Overdose Awareness Day communicates the extensive impact of drug misuse and overdose on global communities through a variety of goals associated with awareness, prevention, and remembrance of loved ones lost. These goals include, but are not limited to, public grief processing, discussion of policy and practice regarding overdose prevention, and resource sharing. 

Public Grief Processing

International Overdose Awareness Day provides an opportunity for public mourning, which may facilitate help-seeking and mitigate stigma around overdose or drug related harm³. Grief and bereavement following the death of a loved one are natural processes; however, these processes can be influenced by the circumstances of the loss (i.e., sudden versus expectant) which in turn can influence the health and well-being of the bereaved⁴. Research notes persons grieving loss associated with overdose experience increased interpersonal stress and exacerbated mental health concerns secondary to attitudes toward drug use, and perceived actual public stigma related to fatal overdose⁴. While interventions such as social support networks or therapy may be beneficial, the use of these resources may be influenced by stigma associated with fatal overdose. Research suggests that persons experiencing grief associated with overdose express greater psychoeducational, emotional, and relational needs compared with those who have experienced a sudden-natural loss⁴. International Overdose Awareness Day supports public acknowledgement of overdose loss and identification of the needs of those experiencing such losses which in turn helps to mitigate stigma and facilitate help-seeking⁵.

Policy and Practice Discussion

Scientific evidence supports continued investigation into the efficacy of prevention programs and drug testing services as a source of harm and risk reduction for substance use and potential overdose⁶. Research identified structural drivers (i.e., law enforcement, housing, unemployment), disparities (i.e., gender, race, ethnicity), and barriers (e.g., stigma) to policy development and implementation of practice and highlights research gaps and potential areas for progress within overdose prevention⁷. International Overdose Awareness Day 2023 emphasizes the theme of “Recognizing those people who go unseen,” by raising awareness and stimulating discussions regarding current research and policy practices, gaps, and progress³.

Resources and Sharing

Resources provide psychoeducational materials and references addressing questions or concerns related to substance use/misuse, policies, prevention, treatment, and stigma reduction, as well as contact and referral information for those who are seeking support. Regardless of the need, there are a variety of resources and support available to DOD personnel, family members, veterans, peers, and providers including: 

• Military OneSource
• inTransition Program
• Psychological Health Resource Center
• Psychological Health Center of Excellence
• National Institute of Mental Health
• National Institute on Drug Abuse
• Substance Abuse and Mental Health Services Administration
• White House Office of National Drug Control Policy
• 988 Suicide & Crisis Lifeline
• Real Warriors Campaign
• Psychological Fitness
• World Health Organization

References

1. U.S. Department of Health and Human Services. (2023, July 10). Drug overdose death rates. National Institutes of Health. https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates 
2. Centers for Disease Control and Prevention. (2023, May 8). Understanding drug overdoses and deaths. Centers for Disease Control and Prevention. https://www.cdc.gov/drugoverdose/epidemic/index.html  
3. Penington Institute. (2023, July 21). International Overdose Awareness Day: 31st August. International Overdose Awareness Day. https://www.overdoseday.com/
4. Bottomley, J. S., & Smigelsky, M. A. (2023). Bereavement in the aftermath of suicide, overdose, and sudden-natural death: Evaluating a new measure of needs. Assessment, 30(4), 1052-1064.
5. Schlosser, A. V., & Hoffer, L. D. (2022). “I don’t go to funerals anymore”: how people who use opioids grieve drug-related death in the US overdose epidemic. Harm Reduction Journal, 19(1), 110.
6. Friedman, N. M., Molina, C. A., & Glenn, M. J. (2023). Harm reduction and emergency medical services: Opportunities for evidence-based programming. The American Journal of Emergency Medicine, 72, 85-87.
7. Valasek, C. J., & Bazzi, A. R. (2023). Intersectionality and Structural Drivers of Fatal Overdose Disparities in the United States: a Narrative Review. Current Addiction Reports, 1-9.

LCDR (Dr.) Trinity Dunham , board certified in Clinical Psychology by the American Board of Professional Psychology, is a Navy clinical psychologist supporting the Research Adoption section of the Psychological Health Center of Excellence. She specializes in clinical and military psychology.