Mortality, Overdose, and Drug-Related Deaths: How Do We Address Overdose Deaths and Underlying Risk and Protective Factors?

The Grim Reaper is one of the most common and enduring cultural representations of death. It is believed to have emerged during the fourteenth century when Europe was dealing with what was then the world’s worst pandemic, the Black Death. The current epidemic of overdose and death due to novel psychoactive substances and in particular fentanyl and related substances has prompted global responses. These have however often been slow to be implemented and have not been rolled out adequately where needed. The aim of this chapter is to acknowledge the scale and nature of the challenge, identify the risk and protective factors and to provide some simple, yet necessary steps to aid prevention, reduce harm, and increase awareness and training of overdose risk and response. Within this chapter we provide a range of definitions, biological explanations depending on the substance involved, we provide a step-by-step approach for responding to an overdose, reducing harm and saving lives. We conclude by presenting two innovative case studies in a school and in a prison setting.