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Opioid Overdose Stigma, Risk, and Prevention

Updated: Mar 24, 2023

Toxic drugs claimed more than 7,560 lives in Canada in 2020; approximately 21 deaths per day. During the first year of the pandemic, there was a 96% increase in apparent opioid toxicity deaths, compared to the year before. Since then, opioid deaths have remained high. This year, we mark International Overdose Awareness Day with a continued sense of grief, urgency, and hope that stigma and failed drug policy will become a thing of the past.

A particularly tragic dimension of the issue is that overdoses are occurring right in people’s homes, where they use drugs that they thought would be safe. Many of those lost didn’t necessarily grapple with addiction issues but were using recreationally but with tainted drugs. And far too many are dying from overdose because they’re using alone.

Observed on the 31st of August every year, International Overdose Awareness Day (IOAD) seeks to create better understanding of overdose, reduce the stigma of drug-related deaths, and create change that reduces the harms associated with drug use. Overdose can affect anybody and one of the messages of this day is that the people who overdose are our sons, daughters, mothers, fathers, brothers and sisters – they are loved and they are missed. No family should ever have to go through the pain of losing a loved one because of overdose.

Stigma around drug use

Studies show that stigma is a major underlying factor driving the opioid crisis in Canada and acts as a major barrier to effective addiction prevention, treatment, and recovery efforts of the individual. The personal shame and public stigma attached to drug use have largely contributed to the worsening of the opioid crisis.

Most of the public still think that substance use disorder or addiction only impacts people who struggle with homelessness or are on the streets, but most of the people dying from these toxic drugs are actually from families like our own, living in cities, suburbia, and rural communities. And while men 20 – 60 are at highest risk, rates are increasing at a faster rate for women, seniors (due to additional health issues/medications), and young children who are accidently exposed.

According to the Canadian Mental Health Association, 21% of the population of Canada (approximately 6 million people) will meet the criteria for addiction at some point in their lifetime. When seen in this light, we begin to realize that substance abuse and addictions’ challenges are incredibly common across Canada.

Risk Factors for an Overdose

The following are the top risk factors for overdose:

  • Tolerance Shift: Individuals with decreased tolerance due to recent release from incarceration, drug treatment/detoxification, hospitalization, abstinence, or intermittent non-daily use of opioids are at risk.

  • Mixing Drugs: Combining opioids with other legal (including alcohol) or illegal substances may enhance their effects and thus increase the overdose risk.

  • Previous History of Overdose: Individuals who have had a prior overdose event at any point in their lifetime are more likely to experience another overdose.

  • Physical Health Issues: If a person’s body is already burdened with an acute or chronic illness (e.g., asthma, other substance use disorder, HIV, etc.), the person is more vulnerable to overdose.

  • Variation in Strength/Content: Illegally purchased substances vary greatly in their strength (e.g., one bag of heroin or fentanyl might not be as strong as another bag even when obtained from the same seller).

  • Switching Ingestion Method: How a person ingests a substance plays an important role in overdose risk. Injecting is usually riskier than other forms of administration, but an overdose can also occur when a person just swallows a single pill.

  • Using Alone: If no one is there, no one can help. Overdose reversal can be effective 1-3 hours after use of the opioid, but the risk of fatality is high if the user is alone.

Prevention and Harm Reduction

If you use substances, follow these tips to reduce the chance of experiencing an overdose and to stay safe:

  • Learn about Overdose Prevention Strategies and Support Lines (see resource links below)

  • Don't use alone; but if you do, tell someone and use the Lifeguard App or Brave App

  • Check for tainted drug warnings, and start with a small amount

  • Do not mix substances, including alcohol

  • Use where help is easily available (e.g. Supervised Consumption sites)

  • Make a plan/know how to respond in case of an overdose

  • Carry a Take Home Naloxone (THN) kit (Obtain a free kit learn how to use it before you need it)

  • Talk to your health care provider about substance use and alternatives to toxic substances

If you or your dependent family member are struggling with substance use, reach out to your EFAP for support. We’re here to help.

If you want to participate in World Overdose Day events August 26th - 31st, follow these links to a list of events:

Support Lines and Services

National Overdose Response Service (NORS): a peer-run, peer-led overdose prevention hotline for Canadians providing loving, confidential, nonjudgmental support for you, whenever and wherever you use drugs. Call: 1-888-688-NORS (6677)

Federal and Provincial Support Services:

Other Resources

Brave App: The Brave App connects app users with someone who can send help while using drugs alone. Users set up an overdose plan, detailing how, when, and who is sent for help; supporters activate the plan if an overdose is detected.

Lifeguard App: The Lifeguard App offers a lifeline to people using drugs alone -- by monitoring the window during which an overdose can occur.

Drug and Overdose information sites:

Overdose Prevention Toolkits for Organizations


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