Overdose risk is changing, and our service system needs to catch up
When people think about overdose, they often think illicit drugs. They don't picture their ageing mum or their neighbour or the tradie managing chronic pain.
But that reality has changed.
The people at greatest risk are now no longer defined by a substance or diagnosis. They have an interaction of multiple risk factors that sit across different parts of the service system.
A person could be on opioid pharmacotherapy while also taking prescribed benzodiazepines. They may drink alcohol, experience chronic pain, live with mental ill health or in unstable housing. Each factor may be managed by a different service, each working effectively within its own remit.
But overdose risk does not stick to service boundaries.
In 2024, Australia recorded over 2,000 unintentional drug induced deaths for the first time. The Penington Institute's most recent Overdose Snapshot found that seven people die from overdose every day. More than four in five drug induced deaths are unintentional.
These deaths rarely occur because of a single issue in isolation. They emerge from the interaction of multiple vulnerabilities, medications, other substances and life circumstances.
It’s moved from an alcohol and other drug challenge to a service system challenge.
General practice, pharmacies, hospitals, mental health services, housing providers, community services and specialist alcohol and other drug services all encounter people who may be at risk of overdose. Yet risk assessment, care planning and referral pathways are often designed around individual services rather than cumulative risk.
It’s not a question of whether individual services are doing their jobs. The question is whether the system is designed to identify and respond to overlapping risks that sit across multiple services and sectors.
Overdose prevention is most effective when it becomes everyone's business. This means building overdose awareness and risk identification capabilities across the service system, strengthening referral pathways, embedding routine conversations about medications and substance use, and creating clearer mechanisms for shared care and coordinated responses.
This doesn't in any way reduce the need for traditional harm reduction services like medically supervised injecting facilities. In fact, they have been instrumental in reducing the overdose rate among people who use illicit drugs and should be significantly expanded.
But the challenge for the next decade is creating a service system capable of recognising and responding to complexity before it becomes acute.
Because for many people at risk of overdose, the issue is not a lack of contact with services. The issue is that no single part of the system can see the whole picture.
Service and workforce improvement can be challenging. The real world is messy, and working on the frontline you need clear practical solutions that work.
We provide practical tailored solutions for any service who works with people who use drugs. We support better responses to alcohol and other drug issues in mental health, primary care, welfare, justice and education sectors, as well as the specialist alcohol and other drug sector. Learn more about how 360Edge can help your service.
Are you interested building your skills in responding to alcohol and other drugs? Check out our diverse range of clinical practice workshops.
