Overdose, Stigma and the Great Challenge
Last year on the 31st of August 2011, (International Overdose Awareness Day) I posted an image of Jimi Hendrix to Twitter with the following caption; ‘Imagine how much sweeter the world would sound with a little more harm reduction’. (While there are varying reports regarding the nature of Hendrix’s death the official finding was that he asphyxiated on his own vomit after consuming more alcohol than he was able to tolerate – effectively an overdose of alcohol). It was my way of acknowledging that when a fatal overdose occurs it is not just a death that occurs but the loss of an opportunity.
With a little more harm reduction, Jimi Hendrix may have well gone on to record many more revolutionary albums enriching our lives artistically and culturally, but just as important are the many non celebrities who have experienced overdose. They too have lost the myriad and unforeseeable opportunities that a longer future could have entailed. Really, everyone’s world would rock with a little more harm reduction. It is these thoughts I ponder as we approach International Overdose Awareness Day 2012.
I live in Australia, a nation with relatively well developed harm reduction programs. The Medically Supervised Injecting Centre in Sydney has now been operating for over a decade and has saved countless lives, not only intervening when people overdose but also providing a gateway to a myriad of health and treatment services to an all too often marginalised population of injecting drug users. In the Australian Capital Territory a pilot program designed to widen the availability of naloxone to the peers and families of opiate users is under way with the aim of increasing the speed in which we can respond to opiate overdose. Australia’s well developed needle syringe programs are also playing their part, providing crucial harm reduction information to people who use drugs.
Responding to overdose however is not just about providing a safe physical environment, it’s not just about providing the right medications in a timely manner and it’s not just about getting technique right. While all of these things are vitally important, a crucial ingredient in addressing overdose is overcoming stigmatising attitudes towards people who use drugs. Stigma kills. It drives people who use drugs to the fringes of our community. Stigma has the power to separate people from much needed supports, marginalising them from health services and even their families. People use in secret or fail to let others know when something goes wrong due to fear of the judgement and condemnation.
I’ve known many, many people who have used drugs throughout my life. Some have been mad, some have been sad and some have been bad, but if I looked hard enough I could always find something positive about them. With the vast majority I haven’t had to look very hard at all. The reality is that people who use drugs are mothers and fathers, policemen and poets, sons and daughters – in short they are just people like you and me.
While I’ve known many people who use drugs, I’ve also met many people over the years who have held very strong negative opinions about people who use drugs. Possibly the most callous opinion I have heard uttered was the idea that we should ‘put buckets of the shit out in the street and let them all kill themselves.’ Many in our communities have dehumanised people who use drugs and fail to recognise the loss that lives cut short by overdose entails.
This loss may be best encapsulated not in my words but by the words of Kat Daley who recently published a stunningly honest account of her own experience of the overdose of a loved one.
There are so many assumptions that come with drug related deaths. People assume an overdose is a heroin overdose. And that heroin overdoses happen in laneways somewhere. They assume the person was a ‘junkie’ and had probably caused their loved ones much angst and heartache, having stolen from them and abused them and all of those other things that drug addicts do.”
“Sometimes all of that is true. But a lot of the time it’s not. Either way, it doesn’t matter. Losing a child who stole from you is still losing a child. Only a parent who has been through this can understand that losing your child means losing part of you. The day I lost my brother part of my mother went with him.
The great challenge in addressing overdose is not which programs we can put into place. The harm reduction sector has demonstrated time and again that through a combination of effective advocacy and the systematic collection and analysis of evidence, we can implement effective harm reduction programs (even highly contentious ones like drug consumption rooms) that prevent or reduce the likelihood of overdose. The greater challenge is how to address stigma in our communities. How can we convince the wider community that people who use drugs are human beings not that much different from anyone else? How can we convince our communities that reducing drug related deaths provides opportunities so broad and so large that the potential loss is unimaginable? Saving even one life from overdose may result in the greatest rock and roll album ever made or it might result in tender moments shared between a parent and a child that otherwise might not have been.