Opioid Overdose and Harm Reduction Approaches to Combat the Looming Crisis

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Background

The opioid pandemic in the United States and around the world has evolved into a prolonged crisis, impacting not only human lives, but also national economies. The Centers for Disease Control and Prevention reported that over 106,000 Americans died from drug overdoses between 2020 and 2021, a new high and a grim reminder that the decades-long opioid epidemic continues. Overdose deaths involving opioids (including prescription opioids and heroin) have quadrupled since 1999, and over 1 million Americans have died from drug overdoses since 2001. North America is facing a devastating public health crisis caused by unintentional drug poisoning and overdose deaths. This epidemic of drug overdose deaths is becoming more deadly as it widens to include heroin, illicit fentanyl, cocaine, and stimulant overdoses. This epidemic has become a public health crisis in North America, with catastrophic consequences including an increase in opioid overdoses and deaths, frequent hospitalizations, a decline in quality of life, and devastation to the economic prosperity of communities.

Synthetic opioids and fentanyl have been fueling the crisis in recent years. A significant proportion of fatal overdoses involve fentanyl, a class of powerful synthetic opioids 50-100 times more potent than morphine and increasingly present in cocaine and methamphetamine. The unregulated drug opioid supply is primarily made up of fentanyl, which dominates the illicit drug market in the United States and is accelerating the overdose crisis across North America. To effectively combat the opioid crisis in the United States, it is time to revisit regulatory restrictions, drug policy measures, and large-scale implementation of proven-effective opioid dependence treatments and harm reduction strategies. The United States and the rest of the world have launched a number of public health and treatment programs to combat the overdose crisis, including the development of harm reduction initiatives and programs.

Harm reduction recognizes that licit and illicit drug use are a fragment of our world. It takes multiple steps to reduce harm when an individual continues to use substances and chooses to minimize the harmful effects rather than reject, condemn, or demonize them. A number of strategies have been identified as effective in reducing the harm caused by opioid use, including overdose. Harm reduction approaches include but are not limited to i) supplying naloxone to opioid users, ii) overdose education and prevention, iii) taking on the stigma and discrimination that keep people from getting the help they need, iv) providing services and resources in a nonjudgmental, non-coercive manner, v) safer and managed use to abstinence, and vi) overdose response teams centered across emergency medical centers.

Submissions are welcome for the following article types: original research, review, mini-reviews, innovative research protocol/method, opinion and hypothesis. We particularly welcome contributions that include, but are not limited to, the following topics:

1. Pharmacological-Assisted Treatments (Medication-Assisted Treatment/ Medications for opioid use disorder (MOUD), Opioid treatment programs (OTPs)).

2. Overdose prevention interventions (e.g., naloxone distribution in communities), overdose prevention educational programs/studies.

3. Reports on Syringe Access and Exchange Programs.

4. The use of drug testing equipment (e.g., Fentanyl testing strips).

5. Social services and treatment practices pertain to non-abstinence-based housing and employment initiatives.

6. Harm reduction measures addressing stigma and discrimination based on gender, identity, race, sexual orientation, and economic status.

7. Outreach, Peer Support, and Educational Programs to Promote Safe Use.

Keywords: Opioid Overdose, Stigma, safe drug use, needle exchange, illicit Fentanyl, opioid epidemic. MAT, MOUD, methadone, buprenorphine, naltrexone

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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