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Today is International OD Awareness Day. Whose memory are you honoring today? 

What is today?

International Overdose Awareness Day, started by the Salvation Army in Australia in 2001, is an opportunity for people around the world to publicly mourn loved ones without guilt or shame. Many participating countries also use this day to send a strong message to current and former drug users that their lives are valued and that no one should ever die from a preventable fatal drug overdose.

Lots of events going on around the country, and around the world, including candlelight vigils to overcome the stigma of overdose.In the state, the North Carolina Harm Reduction Coalition in planning to hold some events.There are new laws and initiatives that will help starting in other states, that we in North Carolina can learn from. Internationally, there is some powerful testimony about how overdose deaths can be prevented with naloxone, including this video and blog post about China. Check out the Facebook page of the "I'm the Evidence. Naloxone Works." campaign.

For more reading, there is a great article in Time magazine entitied "On Overdose Awareness Day, a Mother's Plea for Compassion." A strong new voice in the field is Shawn Norton who reminds us: "My Daughter Was Not a Throw-Away!"

And the Overdose Prevention Alliance has a roundup of the day's news and opinion pieces. 

Even celebrities are getting speaking out.

Great wrap-up and videos from the conference from AIDS United.

A new video released by the North Carolina Harm Reduction Coalition.

Harm Reductionists Talk about Opiate Overdose Mortality Prevention from North Carolina Harm Reduction on Vimeo.

(Because of the detailed animated infographics in this video, it is recommended that it be played at full-screen size.)

Jeff McDowell, Executive Director of the Atlanta Harm Reduction Coalition (recently featured on PBS's "Frontline"), discusses Naloxone and shares a vivid story of a street overdose that he reversed and how some users are more concerned about the threat of legal action against them than about saving other's lives. Corey Davis, Staff Attorney for the Network for Public Health Law, talks about Naloxone access, the typical opiate user and "911 Good Samaritan" laws. Whitney Englander, Government Relations Manager for Harm Reduction Coalition, highlights the urgency of prescription medication overdose prevention in light of CDC data and emphasizes the need for Good Sam laws. Allan Clear, Executive Director of Harm Reduction Coalition, discusses the overdose problem both in general and in comparison to the AIDS epidemic and also shares about his personal history of knowing people who have died from overdoses.

Most of this material was recorded at the Southern Harm Reduction and Drug Policy Network conference September 6-8, 2012, in Atlanta, GA.

A second overdose prevention video, focusing on North Carolina users and family members, is coming soon.

This article was published by NC Harm Reduction Coalition on October 23, 2012. Their article is reproduced in its entiriety below.

When Bad Laws Cost Lives: The Case for 911 Good Samaritan Laws in NC: Interview with Chad Sanders, Who Lost a Sister to Overdose

by Tessie Castillo, NCHRC Program Coordinator 

Few experiences are more painful than the sudden passing of a family member. For Chad Sanders, a nurse in Durham, North Carolina, the pain is sharp and fresh as the seven-year anniversary of his sister’s death approaches this November. Chad lost his little sister, 19-year-old Shelly Sanders, to a drug overdose in 2005. He remembers her as a beautiful, spontaneous young woman who loved adventure, travel, dancing, and helping others. She died in her student dorm room in Asheville amidst piles of books and clothes and study guides for exams she’d never take. The most painful part of this loss, other than the fact that he’ll never see her again, is knowing that Shelly’s death was preventable.

Chad admits his sister struggled at times with drug addiction and depression. “Her life was chaotic, but beautiful,” he explains. “Shelly’s joy and pain were always in the same spot.” Her struggle included periods of sobriety, hope, and occasional relapse into the darkness.  

The night of her death, Shelly and a friend were using drugs in her dorm room. When she became unresponsive from a strong dose of heroin, the friend panicked. He’d recently been released from jail on parole and feared that a 911 call could lead to his arrest. So instead of calling for help, he went to sleep. By morning, Shelly had passed.

Unfortunately, her friend’s cowardly actions are typical. Most drug overdoses occur in the presence of another person, but most witnesses do not call 911 for fear of criminal repercussions for drug possession. Some try to revive the victim with ice or cold showers. Others wait and hope that the crisis will pass. Many people die.

Some states, most recently Florida, have passed 911 Good Samaritan laws to prevent overdose fatalities. Though the laws vary from state to state, they generally grant immunity from drug possession or criminal charges to people who call 911 to save a life. Hundreds of college campuses across the U.S. have similar policies, which have been proven successful in encouraging people to call for emergency services and in avoiding preventable death. North Carolina does not have 911 Good Samaritan laws on its books, and needless deaths continue to occur at a rate of about 1000 per year.

911 Good Samaritan laws are just one step to prevent the deaths of young people like Shelly, people with their whole lives ahead of them and much to offer to the world. Other strategies include increasing the availability of Narcan, a medication that blocks opiate receptors to the brain and reverses overdose from opiates, such as heroin or most painkillers. Currently people need a prescription to carry Narcan, and difficulty acquiring a prescription restricts public access to the drug.

 “If I could change one overdose policy in North Carolina…I think Narcan being available over the counter would be ideal…especially on college campuses,” says Chad. “If someone is allergic to bee stings they have easy access to an EpiPen, but if people overdose, the medicine is not [readily] available…because of stigma…that’s not a good excuse.”

In addition to Good Samaritan laws and increasing access to Narcan, education about overdose and the signs of overdose is important to prevention, especially among the friends and family of people who use drugs and within the medical community. 

“Medical professionals should have more of an understanding of the medicines they prescribe and who they are prescribing them to,” says Chad. “If [providers] do write prescriptions, they should educate [the patients] about the risks and what to do in case of an overdose.”

Chad hopes that Shelly’s death can create awareness of the need to change the laws governing overdose and emergency services in North Carolina. 

“[911 Good Samaritan laws] could have prevented my sister’s death. I know if she were still alive she would want to advocate not only for herself, but even for the friend that left her,” says Chad. “Today is my first step to advocate for a vulnerable population that is stigmatized…and not completely understood.”

 The North Carolina Harm Reduction Coalition and community partners are advocating for the passage of 911 Good Samaritan laws, greater access to Narcan, and community overdose education in our state. We remember Shelly, not for how she died but for the beautiful person that she was. Her life was full of meaning and her death will not be in vain.

Excerpt from Shelly’s writings:

Protect yourself but do not be afraid to help...there is hope for everyone...Even those who seem to have a dead soul and cold heart. 

Be honest, be kind, be caring and love yourself.....but do not be conceited and do things out of obligation.

Big Pharma Company Jacks Up Price of Overdose Live Saver by 1100%: Now, More People Will Die

Excellent article today by NC Harm Reduction Coalitions' Tessie Castillo

Naloxone is key to fighting overdose deaths, but sky-high prices threaten community distribution programs. April 8, 2013 AlterNet / By Tessie Castillo

A remarkable thing happened in 2008:  drug overdose surpassed auto fatalities as the leading cause of accidental death in the United States. Public health officials declared an epidemic, and communities united to battle this new enemy that had left a staggering body count in its wake. The people had a weapon,  naloxone, an antidote that reverses opiate overdose, and programs began popping up across the country to provide training and free naloxone to people at risk for overdose. But then Big Pharma stepped in. The same year that naloxone became so critical to saving lives, one pharmaceutical company secured a monopoly on its production and jacked up the prices by 1,100%.

It's official! The Good Samaritan and naloxone bill was signed into law by Gov. McCrory on Tuesday April 9, 2013 in Raleigh, after passing the Senate and House with overwhelming support.

This will make it easier to distribute naloxone and encourage people who witness an overdose to call for medical help. This bill will prevent overdose deaths.

A huge THANK YOU to primary sponsors Senator Allran and Senator Bingham, and all our supporters, including NC Harm Reduction Coalition, NC Department of Public Health, Community Care of North Carolina, UNC Injury Prevention Research Center, and many, many others.

From the Hickory Record:

A bill that gives limited immunity to people who seek help for someone who overdoses and whose primary sponsor is state Sen. Austin Allran got the governor’s signatures Tuesday afternoon. Gov. Pat McCrory signed into law NC Senate Bill 20, referred to as the Good Samaritan Law/Naloxone Access. It also gives immunity to a doctor who prescribes an opioid antagonist and gives immunity to a person who administers the antagonist to someone they think is in the midst of a drug overdose. An opioid antagonist is a drug that counteracts an overdose and can be administered like a nasal spray. If it is administered to someone not using an opioid, it doesn’t have any affect on the person, Allran said. Allran said the bill came out of Project Lazarus in Wilkes County, which is the No. 1 area for the problem in the state.

Casually the law is called "Good Samaritan/Naloxone Access" -- full text below:

GENERAL ASSEMBLY OF NORTH CAROLINA SESSION 2013 SENATE BILL 20 RATIFIED BILL

AN ACT to Provide limited immunity from prosecution for (1) certain drug‑related offenses committed by an individual who seeks medical assistance for a person experiencing a drug‑related overdose and (2) certain drug‑related offenses committed by an individual experiencing a drug‑related overdose and in need of medical assistance; and to provide immunity from civil or criminal liability for (1) practitioners who prescribe, dispense, or distribute an opioid antagonist to certain third parties and (2) certain individuals who administer an opioid antagonist to a person experiencing a drug‑related overdose.

The General Assembly of North Carolina enacts: SECTION 1.  Article 5 of Chapter 90 of the General Statutes is amended by adding a new section to read: "§ 90‑96.2.  Drug‑related overdose treatment; limited immunity. (a)        As used in this section, "drug‑related overdose" means an acute condition, including mania, hysteria, extreme physical illness, coma, or death resulting from the consumption or use of a controlled substance, or another substance with which a controlled substance was combined, and that a layperson would reasonably believe to be a drug overdose that requires medical assistance. (b)        A person acting in good faith who seeks medical assistance for an individual experiencing a drug‑related overdose shall not be prosecuted for (i) a misdemeanor violation of G.S. 90‑95(a)(3), (ii) a felony violation of G.S. 90‑95(a)(3) for possession of less than one gram of cocaine, (iii) a felony violation of G.S. 90‑95(a)(3) for possession of less than one gram of heroin, or (iv) a violation of G.S. 90‑113.22 if the evidence for prosecution under those sections was obtained as a result of the person seeking medical assistance for the drug‑related overdose. (c)        A person who experiences a drug‑related overdose and is in need of medical assistance shall not be prosecuted for (i) a misdemeanor violation of G.S. 90‑95(a)(3), (ii) a felony violation of G.S. 90‑95(a)(3) for possession of less than one gram of cocaine, (iii) a felony violation of G.S. 90‑95(a)(3) for possession of less than one gram of heroin, or (iv) a violation of G.S. 90‑113.22 if the evidence for prosecution under those sections was obtained as a result of the drug‑related overdose and need for medical assistance. (d)        Nothing in this section shall be construed to bar the admissibility of any evidence obtained in connection with the investigation and prosecution of other crimes committed by a person who otherwise qualifies for limited immunity under this section."

SECTION 2.  Article 5 of Chapter 90 of the General Statutes is amended by adding a new section to read: "§ 90‑106.2.  Treatment of overdose with opioid antagonist; immunity. (a)        As used in this section, "opioid antagonist" means naloxone hydrochloride that is approved by the federal Food and Drug Administration for the treatment of a drug overdose. (b)        A practitioner acting in good faith and exercising reasonable care may directly or by standing order prescribe an opioid antagonist to (i) a person at risk of experiencing an opiate‑related overdose or (ii) a family member, friend, or other person in a position to assist a person at risk of experiencing an opiate‑related overdose. As an indicator of good faith, the practitioner, prior to prescribing an opioid under this subsection, may require receipt of a written communication that provides a factual basis for a reasonable conclusion as to either of the following: (1)        The person seeking the opioid antagonist is at risk of experiencing an opiate‑related overdose. (2)        The person other than the person who is at risk of experiencing an opiate‑related overdose, and who is seeking the opioid antagonist, is in relation to the person at risk of experiencing an opiate‑related overdose: a.         A family member, friend, or other person. b.         In the position to assist a person at risk of experiencing an opiate‑related overdose.(c)         A person who receives an opioid antagonist that was prescribed pursuant to subsection (b) of this section may administer an opioid antagonist to another person if (i) the person has a good faith belief that the other person is experiencing a drug‑related overdose and (ii) the person exercises reasonable care in administering the drug to the other person. Evidence of the use of reasonable care in administering the drug shall include the receipt of basic instruction and information on how to administer the opioid antagonist. (d)        All of the following individuals are immune from any civil or criminal liability for actions authorized by this section: (1)        Any practitioner who prescribes an opioid antagonist pursuant to subsection (b) of this section. (2)        Any person who administers an opioid antagonist pursuant to subsection (c) of this section."

SECTION 3.  Chapter 18B of the General Statutes is amended by adding a new section to read: "§ 18B-302.2. Medical treatment; limited immunity. Notwithstanding any other provision of law, a person under the age of 21 shall not be prosecuted for a violation of G.S. 18B-302 for the possession or consumption of alcoholic beverages if law enforcement, including campus safety police, became aware of the possession or consumption of alcohol by the person solely because the person was seeking medical assistance for another individual. This section shall apply if, when seeking medical assistance on behalf of another, the person did all of the following: (1)        Acted in good faith, upon a reasonable belief that he or she was the first to call for assistance. (2)        Used his or her own name when contacting authorities. (3)        Remained with the individual needing medical assistance until help arrived."

SECTION 4.  This act is effective when it becomes law. In the General Assembly read three times and ratified this the 4th day of April, 2013.

s/  Daniel J. Forest President of the Senate

s/  Thom Tillis Speaker of the House of Representatives