The opioid epidemic is decades old and shows no signs of slowing down. The Department of Health and Human Resources notes that, since 1999, the rates of synthetic opioid overdoses have increased over 100 fold. To combat these alarming numbers, policymakers nationwide have found innovative ways to lower overdose rates. Strategies include overdose prevention education, harm reduction programs, evidence-based treatment when the client is ready for rehab, and aftercare support. While all four approaches are crucial for a client’s ongoing recovery, overdose prevention may be the most effective in preventing loss of life while clients are still actively taking drugs, either before entering treatment or during a relapse.

Clients have multiple options when it comes to overdose prevention. Self-help, collaborative, and professional interventions can prevent overdose-related injuries and fatalities.

What Are Overdose Prevention Centers?

Clients can increase their chances of preventing an overdose through harm reduction methods. Briefly, harm reduction refers to the ways that clients can maximize their health, even if they have a chemical dependency. Strategies include mitigating the risks of opioid use and minimizing the stigma surrounding drug use. A supportive setting can encourage clients to minimize high-risk behaviors related to their drug use and even to seek treatment when they are ready.

Overdose prevention centers play a major role in deterring drug overdoses. The U.S. Drug Policy Alliance has recommended clients with substance use disorders to go to one of these centers. Here, trained healthcare professionals can supervise clients when they take their drugs. Clients bring their own drugs and administer them through the sterilized supplies made available at the center. The controlled, clean environment helps to deter infection from dirty or used needles. Clinicians can assist in caring for wounds, which are a common complication of injectable drug use, and provide preventive measures to avoid accidental overdose.

Some critics have argued that overdose prevention centers can encourage drug users to indulge in their controlled substances. However, research has shown that these centers effectively limit infections from spreading and isolate substance intake from the public. Most importantly, the supportive environment influences users to seek treatment for their disorder.

The Opioid Epidemic and Rising Overdose Rates

According to the Centers for Disease Control and Prevention (CDC), the epidemic began in the early 1990s as many physicians prescribed opioids to large numbers of people. A second wave began in 2010, as overdoses involving heroin accelerated. In 2013, synthetic opioids hit the streets, and the current phase of the epidemic began. The combination of prescribed and manufactured drugs like fentanyl led to over 107,000 fatal opioid overdoses in 2021 alone.

Free Naloxone Distribution

One of the most effective strategies for preventing opioid overdose is through the use of opioid agonist medications, such as naloxone. Naloxone, more popularly known by its brand name, Narcan, is a medication that can reverse the effects of an overdose. The CDC describes naloxone as easy to use. Clients can either inhale it as a spray or inject it into a muscle with a syringe. When a client overdoses, a clinician or a non-medical professional companion can use naloxone to revive the client, including restoring normal breathing. This fast-acting drug does not require pre-authorization from a healthcare provider or medical training.

Clients can get naloxone at an overdose center or they may be able to pick up naloxone at their local pharmacy without a prescription. Many overdose prevention centers also offer mobile distribution services, providing free naloxone in high-risk areas throughout the community.

Clients who prefer to not go to a pharmacy or their physician may also receive naloxone from a standalone harm reduction clinic or syringe exchange program sites. Syringe exchange programs are not available in every state, but harm reduction centers generally provide naloxone at little to no cost, maintain the client’s confidentiality, and offer a judgment-free environment. Harm reduction centers may also provide training for non-medical persons to know if a client is overdosing and, if so, how to safely administer naloxone and treat the client until medical units arrive.

The CDC cautions that, while naloxone is effective with many opioids, stronger drugs like fentanyl may require a second dose. Naloxone training programs can teach clients to know how and when to administer naloxone. In addition, while all 50 states have made naloxone widely available, each state has its own guidelines for how clients can access it. If you or your loved ones are interested in getting naloxone, please make sure you’re familiar with state and local laws.

Drug Testing/Test Strips

In addition to the risk of overdose, active drug users also face the potential of exposure to unknown substances in the drugs they are using. Toxic adulterants are now found in a significant proportion of common street drugs, which is thought to have contributed to the surge in drug-related fatalities in recent years.

To reduce the risk of exposure to unknown substances, many overdose prevention centers provide drug test strips, which can detect the presence of fentanyl, xylazine, and other potentially lethal adulterants. These drug test strips can identify toxic adulterants in myriad drugs, including pill, powder, and injectable cocaine, heroin, and methamphetamine. This ensures that clients understand exactly what they are consuming, and how much, thus reducing the likelihood of an accidental overdose.

In addition to the use of drug test strips, some overdose prevention programs also offer onsite lab testing, including the use of infrared spectrometry to immediately identify the components of an illicit drug. Infrared spectrometry can, for instance, quickly, affordably, and accurately detect the presence of potentially, lethal adulterants, such as xylazine or fentanyl.

Supervised Use

While it’s impossible to render illicit drug use safe, the most significant risks can be mitigated through supervised use. Those who consume illicit substances alone, after all, have no means to receive help if they should become incapacitated by the drug.

In overdose prevention centers, clients are actively monitored by persons trained to render aid when needed. Staff and volunteers have typically been trained to detect signs of an overdose, to administer naloxone promptly and effectively, and to provide emergency support, including resuscitation efforts as needed, until medical teams arrive.