Broadcaster, human rights advocate, former Socceroo

Personal Stories of Opioid Overdose and the Use of Take-Home Naloxone to Save Lives

Welcome to Overdose Lifesavers. This website has two aims. First, it aims to support people affected by opioid overdose and thinking about using take-home naloxone. Second, it aims to inform the public about overdose and what can be done about it.

Why this website now? Public discussion of overdose rarely looks further than the statistics, but it’s important to recognise that behind each death from overdose was a human life that had its own story and remains connected to the lives and stories of others. This website sheds light on the stories of people affected by overdose. It also explores the different ways people who consume drugs manage overdose.

Naloxone is now broadly available in Australia. It can be accessed by people concerned about overdose, health professionals and the wider Australian community. In addition to explaining how people who consume opioids are using it to save lives, this website provides information about how and where take-home naloxone is available.

Overdose Lifesavers aims to fill in the many gaps in public discussion of overdose, to counter stigmatising misconceptions, and to promote understanding and more effective community responses.

What is opioid overdose?

Opioid overdose is the body’s response to consuming too much of an opioid drug. It can also occur as a result of consuming a dangerous combination of opioids and other drugs.

While heroin and other illegal opioids often come to mind when people think of overdose, prescription medications are also implicated in many overdoses. Many prescription drugs are opioids (for example, pain medications such as OxyContin® and morphine). Some over-the-counter medications also contain opioids (for example, Panadeine Forte® contains the opioid codeine).

An opioid overdose typically reduces breathing or stops it altogether. Having an overdose, and therefore not breathing properly, involves not taking in enough oxygen. This eventually causes vital organs like the heart and brain to stop working. Lack of oxygen is the primary cause of death from opioid overdose.

Importantly, because opioid overdose deaths are caused by the effects of opioids on breathing, they are very rarely instant. Indeed, many minutes or even hours can elapse after taking opioid drugs before death occurs. This means there is usually time to intervene and avert a tragedy. This is where take-home naloxone and other measures can be used.

Find out more about the signs of overdose and how to respond.

This website presents the stories of people who have responded to overdose and saved the lives of friends, loved ones and strangers.

What is take-home naloxone?

Naloxone is a type of drug known as an ‘opioid antagonist’. This means that when it’s taken into the body it counters the effects of opioids and overdose. If the person receiving the naloxone hasn’t taken opioids, the naloxone has no effect. It doesn’t work on other drugs such as benzodiazepines (such as Xanax®) or alcohol.

Find out where and how to access take-home naloxone in Australia.

Naloxone has been used to treat overdose for many years. Health professionals often use it to reduce opioid effects on patients in medical settings. Take-home naloxone is a term used to refer to the provision of naloxone to non-medically trained people to use during opioid overdose. Under programs introduced in Australia, people who consume opioids and their friends and family can buy naloxone, either on prescription or over the counter at pharmacies, to keep at home or to carry with them in case they witness an overdose. So ‘take-home naloxone’ programs are efforts to make naloxone available to anyone. In addition, take-home naloxone programs often include overdose response training, where participants learn how to identify and respond to opioid overdoses, including the proper use of naloxone.

There are different kinds of naloxone products available in Australia. Some products involve administering naloxone by injecting it into a muscle. This is called ‘intramuscular’ injection. At present these include the prefilled syringe product called Prenoxad® as well as a product supplied in ampoule form that needs to be opened and drawn into a syringe. Other products deliver naloxone through the nose (‘intranasally’). In Australia this is Nyxoid®.

This website

Overdose Lifesavers is based on a carefully conducted research project that collected detailed stories of overdose and take-home naloxone administration from people affected by overdose or who consume opioid drugs. These stories were analysed by a team of highly experienced researchers, and key themes were identified. These themes are presented here using video re-enactments, original audio recordings and written extracts from the interviews.

Because some forms of drug consumption are criminalised in Australia, and many people who consume drugs face stigma and discrimination, the website’s interview material has been altered to protect the identities of participants. Written extracts and audio clips have been edited to remove potentially identifying information, and the video clips have been produced using actors who have re-enacted the original interview material. The video and audio clips and written extracts were selected on the basis that they illustrate key themes identified by the team, for example, how people respond to overdose emergencies, or the issues that make take-home naloxone harder or easier to use.

Who did we interview?

The website content is based on 83 interviews. These were conducted with 46 people who consume opioids and 37 health professionals who encounter opioids and overdose issues in their work. All participants lived in Victoria and New South Wales, Australia.

Consumer participants range in age from 22 to 70 years old, and describe a variety of drug consumption experiences and perspectives on the issue of overdose. This website doesn’t focus on drug consumption specifically (see Lives of Substance for this). Rather the focus is on overdose and experiences of take-home naloxone. About one-third of the participants had experiences with take-home naloxone, others had heard of it but never used it, and some hadn’t heard of it until it was described in their interview.

To explore a broad range of experiences, we interviewed 28 participants who accessed opioids through illegal markets and 18 participants who accessed opioids on prescription to manage chronic pain. To aid clarity, the stories of each group have been clustered together. However, while there are important differences between them, there are similarities too. For example, both groups expressed concern about overdose, but only those who accessed opioids illicitly raised concerns about police encounters.

The 37 health professionals we interviewed worked in a range of relevant settings including pharmacies, general practices, chronic pain clinics, alcohol and other drug specialist services and other community health settings. Their experiences and views form the basis for the topic Health professionals’ reflections on take-home naloxone. As the website focuses primarily on personal experiences of responding to overdoses and using take-home naloxone, health professionals do not appear in the personal stories of this website.

Details of the people interviewed can be found here.

What can you expect to find on Overdose Lifesavers? By browsing our list of topics, you will find perspectives on and experiences of overdose, reflections on and experiences of take-home naloxone, discussions of barriers to accessing take-home naloxone, health professionals’ opinions about it, and other key issues. In our collection of overdose stories, you’ll find detailed descriptions of personal overdose experiences, about half of which involves the use of take-home naloxone. Some stories highlight the life-saving work already being done by people who consume opioids. These narratives also provide insights into what it’s like to use or receive naloxone outside a medical setting, and what happens afterwards.

While the project on which this website is based aimed to gather a range of experiences, the content doesn’t include all experiences.

We hope you find Overdose Lifesavers helpful and informative.

ACKNOWLEDGMENT OF COUNTRY

The Overdose Lifesavers team acknowledges the traditional owners of the lands throughout Australia on which the research behind this website was conducted. We acknowledge their continuing connection to lands, waters and culture, and value their unique contribution to the wider Australian society.