Preventing overdoses and drug-related deaths

Reducing fatal drug overdoses and other drug-related deaths is a major public health challenge in Europe. Targeted responses in this area focus either on preventing the occurrence of overdoses, or on improving the likelihood of surviving an overdose.

A meta-analysis of observational studies supports the effectiveness of methadone substitution treatment in reducing mortality (overdose and all causes) among opioid-dependent people. The mortality rate of clients in methadone treatment was less than a third of the expected rate in opioid users out of treatment. Analysis of risk of death at different stages of treatment suggests a need to focus interventions at the start of treatment (during the first 4 weeks, in particular with methadone) and once it has finished. After the conclusion of treatment, the first 4 weeks are associated with a higher risk of overdose. This suggests patients who frequently enter and leave treatment are particularly vulnerable to overdose.

Supervised drug consumption facilities aim both to prevent overdoses from occurring and to ensure professional support is available if an overdose occurs. Such facilities currently operate in 6 EU countries and Norway; 78 facilities in total. In 2016, 2 consumption rooms opened in France for a 6-year trial, and new facilities were established in Denmark and Norway.