Here we are, marking another International Overdose Prevention Awareness Day, following another year when more than 100,000 of our friends and loved ones died of a preventable overdose in the United States alone. This day is an important opportunity to remember and honor those we’ve lost – but we know that for those personally impacted by overdose we don’t need a special day to remember. For us, that loss and grief is part of the fabric of our lives every day. But International Overdose Awareness Day is also a critical opportunity to agitate – to raise our voices with urgency and with anger and with love for all those who are still at unnecessarily high risk due to insufficient action to implement and importantly, to scale, evidence-based, compassionate, and innovative overdose prevention strategies such as overdose education and naloxone distribution, widespread syringe service programs, drug checking, and overdose prevention centers.

Too often, in our policies and in our relationships, we identify individuals and their drug use as “the problem,” placing the burden of change on them. This approach overlooks the historical and structural inequities, racialized drug policies, stigma, insufficient resources, and flawed systems that set people up to fail and put them at increased risk of harm and destabilization. Until we as a community and society change these systems, we will continue to lose lives.

Stigma is one of the primary barriers to effective overdose prevention. Normalized, insidious, and dangerous – drug-related stigma is more than just harmful beliefs; it is a social process that reinforces power and control, leading to discrimination and significant status loss for those affected. Stigma, with its moral underpinnings, has long driven the policy decisions around what services a community has access to or doesn’t. Stigma has held up a decades of racist drug policies, the reverberations of which are crystal clear as Black, Indigenous and People of Color carry a disproportionate burden of overdose morbidity and mortality in this country. Stigma contributes to keeping people who use drugs out of critical conversations about the decisions, policies, and services that impact their lives.

Stigma also bleeds into our relationships, with ourselves and with each other. It affects how comfortably we share information about our drug use, whether we inform someone we trust before using so they can help if needed, or whether we use in secret. Stigma perpetuates an overemphasis on treatment and recovery-oriented solutions in response to the overdose crisis, often at the expense of more immediate overdose prevention strategies. While of course we need to expand the treatment continuum and ensure that anyone who wants it has easy, accessible treatment services on demand, we also know that change is hard, it doesn’t happen overnight, and not everyone is interested in changing their use. We need to prioritize harm reduction and overdose response efforts that allow people who are using drugs today and might still be using drugs tomorrow to stay safe.

Some of the most valuable work NACCHO’s overdose prevention team does is have critical conversations to uproot stigma and uplift humanity. These conversations led us to design an anti-stigma campaign meant to challenge outdated ideas about the most effective ways to engage with people who use drugs. Although the concept of “tough love” has been normalized, it is rooted in stigma and there is growing evidence that coercive approaches to substance use are not only ineffective, but actually increase risk. The campaign, produced in partnership with Luceo, amplifies the need for radical and unconditional love in overdose prevention.

When we lose someone to overdose, our inability to tell them we love them is glaring. We must center our love for each other before it’s too late, investing in every person’s right to survive regardless of whether we understand or agree with their behavior. The campaign, highlights connection as overdose prevention which is a central tenet of the harm reduction philosophy – it is through connection to each other, to service providers, to health care, that folks are able to ask for the support they need, when they need it. By pushing people away, in our personal relationships and in our policies, we make it harder for them to get their needs met and more likely they will be forced into riskier situations.

This International Overdose Awareness Day, visit www.OverdosePrevention.love to connect with NACCHO for updates on our upcoming media campaign. We are developing a series of anti-stigma campaign materials that center love and connection that you can brand and use in your community!

References

https://www.naccho.org/uploads/downloadable-resources/05-09-Harm-Reduction.pdf

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Friedman, Joseph, Leo Beletsky, and Ayana Jordan. 2022. “Surging Racial Disparities in the U.S. Overdose Crisis.” American Journal of Psychiatry 179 (2): 166–69. https://doi.org/10.1176/appi. ajp.2021.21040381

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