Overdose Awareness Day

August 31 is International Overdose Awareness Day, an annual campaign to end overdose.^{1, 2}

This is a day to remember people who have died from overdose, and to acknowledge the grief of families and friends. The campaign also raises awareness about overdose prevention and seeks to end overdose stigma.

The theme for 2023 is: ‘recognising those people who go unseen,’ – paying tribute to the lives of anyone affected by overdose, including family and friends grieving the loss of a loved one, healthcare and support service workers providing strength and compassion to people who use drugs, or first responders who help save lives.¹

What is an overdose?

An overdose happens when a person has more of a drug, or a combination of drugs, than their body can handle.³

Taking several drugs at once increases overdose risk. Most accidental overdose deaths happen when multiple drugs (including alcohol) have been taken.⁴

Not all overdoses lead to death – but even non-fatal overdoses can have significant psychological and health impacts on a person, including brain damage and damage to other vital organs.^4-6

Some drugs carry a higher overdose risk, such as opioids or benzodiazepines.^4,7

Australia’s overdose rate

In 2021, there were 1,732 overdose deaths in Australia. This excludes deaths relating to alcohol use. For comparison, there were 1,559 alcohol-induced deaths in Australia in 2021.⁸

Sixty-eight percent of overdose deaths were accidental – 1,180 in total. This figure has continued to rise over the past two decades and has exceeded the road toll since 2014.^4,7

Rates of pharmaceutical drug overdose continue to be higher than illicit drug overdoses.

The most common groups of drugs identified in overdose deaths in 2021 were:

• opioids (including common prescribed medications such as oxycodone and codeine, as well as illegal drugs like heroin)
• antiepileptic, sedative, hypnotic and anti-parkinsonism drugs (benzodiazepines made up 83% of these deaths, which includes drugs like diazepam and alprazolam)
• antidepressants (amitriptyline, escitalopram, sertraline, mirtazapine)
• amphetamine-type stimulants (ice, speed, MDMA).

The age group with the highest overdose rate was 45-54-year-olds – accounting for 30% of all accidental overdose deaths in 2021.⁷

People aged 35-44 were the second highest, making up 27% of all accidental deaths.

More than three in five of all deaths were males.⁷

First Nations Australians continue to experience high rates of overdose death. In 2020, Aboriginal and Torres Strait Islander people were more than three times as likely to die from an accidental overdose than non-Indigenous people.⁴

These deaths are preventable.

Signs and symptoms of overdose

The signs and symptoms of an overdose vary between drugs.

A depressant overdose can result from drugs like alcohol, heroin, benzodiazepines or oxycodone. Signs can include:

• shallow or slow breathing
• clamminess
• a slow pulse
• vomiting
• skin colour changes, especially lips and fingernails. This can look different for people with different skin tones - typically bluish purple skin (for people with lighter complexions) or greyish or ashen skin (for people with darker complexions).^9,10

A stimulant overdose can occur from drugs like methamphetamine (ice), MDMA (ecstasy) or amphetamine (speed). Signs may include:

• chest pain
• hot, flushed or sweaty skin
• spasms or seizures
• severe agitation or panic.³

Other types of overdoses, such as from psychedelics or dissociative drugs, can result in various signs and symptoms.

Check out the Drug Wheel to find more information on specific drugs and their overdose symptoms.

How to respond to an overdose

Knowing how to respond to an overdose can save someone’s life.

This is why initiatives like the medically supervised injecting rooms (MSIR) in Richmond, Victoria, and Kings Cross, Sydney, are critical.

Providing access to, and training in, administering naloxone (a drug that can temporarily reverse an opioid overdose) can also help save lives.

If someone might be in trouble or can’t be woken after drinking alcohol or using drugs, it’s essential they get medical help.

If you can’t get a response from someone, don’t assume they’re asleep.

Not all overdoses happen quickly and sometimes it can take hours for someone to die.

Acting quickly can save a life:

• call an ambulance by dialling triple zero (000) - ambulance officers are not required to involve the police unless they feel they are in danger
• administer naloxone if you think the person may have taken opioids
• stay with the person until the ambulance arrives
• listen to - and follow - the instructions over the phone from emergency services
• find out if anyone nearby knows CPR, in case the person stops breathing
• ensure the person has enough air – keep crowds back and open windows or take them outside
• loosen tight clothing
• put the person in the recovery position – lay them onto their side and slightly tilt their head back (check out a diagram on the Overdose Day website). This stops them from choking if they vomit and allows them to breathe more easily.⁹

Provide ambulance officers with as much information as you can – the type of drug, how much the person took, how long ago, whether they mixed with other drugs, and if they have any pre-existing medical conditions.

It can also be helpful to provide ambulance officers with any packaging that may have held the drug.

Show your support

The tragedy of overdose death is preventable and more can be done to save lives.

Show your support on August 31 by:

• posting a tribute
• wearing a badge, wristband or lanyard
• engaging with the online International Overdose Awareness Day community on social media.

You can also get involved by holding an event. The campaign website provides an event support kit to help you run your event.

Visit the International Overdose Awareness Day website for more information.