Drug overdose: the quiet epidemic

For all the attention that violent crime gets in the media, the average American is much more likely to die from another largely preventable tragedy. Fatal drug overdoses have risen sharply in recent years. In Congress this month, Maryland Rep. Donna F. Edwards introduced bipartisan legislation known as the Stop Overdose Stat (S.O.S.) Act to help reverse this national trend.

Every year, the lives of more than 28,000 Americans and more than 200 Baltimore City residents are claimed by a drug overdose. In Baltimore, heroin is responsible for more than 60 percent of fatal overdose cases, but overdoses from prescription medications used to treat pain have become increasingly commonplace in many other parts of the country.


People overdose for a variety of reasons. Consider the following scenarios:

•A father of two severely injures his back on the job, and his primary care physician prescribes one dose per day of an opioid pain medication. But the patient experiences significant pain before his next dose is due and makes a fatal decision that it won't hurt to double up his dose.


•A stay-at-home mother was once prescribed Percocet for a painful injury but continued using the drug as a way of coping with the stressors of life. After deciding she wants to stop, she seeks treatment and abstains. Several months later, however, a traumatic event triggers her desire for more Percocet, and she mistakenly takes the same dose she did before her period of abstinence even though her body doesn't have the same tolerance to the drug.

•Three months after a young woman returns home from detox, her mother discovers her passed out on her bed. Her breathing is shallow, and her skin is ashen. She has relapsed and is overdosing.

Fortunately, there are highly effective, low-cost interventions that can help prevent overdoses from becoming fatal. Health officials in Baltimore and a growing number of places are training people to prevent fatal overdoses in their communities through overdose prevention programs to recognize the symptoms of overdose and to properly administer first aid and naloxone. Naloxone greatly reduces mortality from overdoses caused by heroin, oxycodone and other opioid drugs.

Recently, the American Medical Association declared its support for overdose prevention programs, and earlier this year the Food and Drug Administration held a workshop to discuss making naloxone more available.

Trained individuals are more likely to know how to help a person survive an overdose. Take, for example, the illustration of the mother finding her daughter unconscious from a heroin overdose. Having been trained on how to recognize and respond, her mother immediately calls 911 and begins giving mouth-to-mouth resuscitation. The excess heroin is suppressing breathing, and she needs oxygen fast. Her mother then remembers the naloxone. In each nostril, she sprays the naloxone that was provided to her by the overdose prevention program. Within a couple minutes, her daughter awakes.

An overdose prevention program operated by the Baltimore City Health Department has documented more than 220 naloxone rescues and has been credited with contributing to an ongoing, citywide decline in heroin overdose deaths across the city. Nationwide, a report by the Centers for Disease Control and Prevention credits these programs with saving more than 10,000 lives. Overdose prevention programs are also thought to reduce health care costs that result when failure to secure medical intervention during an overdose results in coma and other serious complications.

Unfortunately, most communities across Maryland and elsewhere do not yet have these programs in place. Ms. Edwards has shown leadership by introducing the S.O.S. Act, and Congress should follow her example by swiftly passing this bill to make funding available to overdose prevention programs.

On Friday, vigils will be held worldwide to mark Overdose Awareness Day, which provides parents, family members and others affected by an overdose with a moment to unite and grieve the loss of a loved one. The pressure for government and health officials to bring an end to this epidemic will not cease until the tools to prevent deaths are in every community and being put to good use.


Grant Smith is the federal policy coordinator for the Drug Policy Alliance. His email is