Opioid crisis deepens. Credit: Zerbor, Shutterstock.
As International Overdose Awareness Day approaches on August 31 the scale of the opioid crisis in Europe, the UK, and the US is being highlighted.
Health agencies warn that overdoses remain a leading preventable cause of death, with opioids at the centre of a worsening global emergency.
According to the World Health Organization (WHO), “Worldwide, in 2019 about 600 000 deaths were attributable to drug use. Close to 80 per cent of these deaths are related to opioids, with about 25 per cent of those deaths caused by opioid overdose.”
Opioids: medicine vs misuse
Opioids are a class of drugs that include both prescription painkillers such as morphine, fentanyl, tramadol, and methadone, as well as illegal drugs like heroin. Originally valued for their powerful pain relief, their misuse has become a leading driver of drug-related deaths.
The WHO explains that their effects can cause “difficulties with breathing, and opioid overdose can lead to death.” Misuse often begins with prescriptions for chronic pain but can spiral into dependence, street use, or dangerous counterfeit drugs laced with synthetic opioids like fentanyl.
US epidemic: fentanyl
The United States remains the hardest-hit country. The Centers for Disease Control and Prevention recorded more than 80,000 opioid overdose deaths in 2023, driven by fentanyl – a synthetic opioid up to 100 times stronger than morphine.
Greg Nevano, Deputy Assistant Director at U.S. Immigration and Customs Enforcement (ICE), warned, “They can get their fix just by ordering it online for much cheaper and get a much more potent dosage. I think that’s what the phenomenon is today.”
Law enforcement says fentanyl trafficking has transformed with online sales and darknet markets, making deadly substances accessible with a few clicks. Even small doses can be fatal, and fentanyl is often mixed with heroin or sold as counterfeit pills without users’ knowledge.
There are viral videos online of people on fentanyl in New York – it’s frightening, to say the least.
Europe’s growing cocaine crisis
In Europe, overdose deaths are climbing too. The European Union Drugs Agency (EUDA) reported that over 7,500 people died from overdoses in the EU in 2023, rising to 8,100 when including Norway and Türkiye.
Opioids were involved in more than two-thirds of these deaths. New synthetic opioids such as nitazenes are fuelling outbreaks. In Latvia, drug-induced deaths surged from 63 in 2022 to 154 in 2023, with nitazenes present in 66 per cent of cases. In Estonia, deaths jumped from 82 to 119, with 52 per cent linked to nitazenes.
Cocaine is also increasingly implicated. In Portugal, cocaine was involved in 65 per cent of drug-induced deaths, while in Spain it accounted for 60 per cent. Crucially, most cocaine-related overdoses also involved opioids, showing the dangers of polysubstance use.
The UK and naloxone
The UK has taken steps to expand access to naloxone, a life-saving drug that reverses opioid overdoses. The WHO notes that several countries (Australia, Canada, Italy, the United Kingdom…) have introduced naloxone as over-the-counter medication (in certain settings) and have also started proactive dissemination in communities.
Yet gaps remain. Access is inconsistent, and stigma around drug use continues to deter people from seeking help. Campaigners in Scotland and England have pushed for wider distribution in pharmacies, prisons, and schools.
International Overdose Awareness Day, August 31
Each year on August 31, communities worldwide mark International Overdose Awareness Day (IOAD), the world’s largest annual campaign to end overdose. Run by the Penington Institute, the 2024 campaign theme was “Together We Can”.
The 2024 IOAD Partners’ Report recorded over 1,048 events in 42 countries, reaching 134,000 people on social media and seeing 67,000 landmarks lit up in purple.
The campaign stresses six guiding principles, including: “Overdose can and must be prevented… Criminalizing drug use hasn’t worked. Compassionate alternatives must be pursued.”
New alternatives to opioids for pain relief
Researchers are racing to find non-opioid alternatives for managing severe pain. At Kyoto University, scientists have developed ADRIANA, the world’s first selective α2B-adrenoceptor antagonist, which relieves pain without triggering respiratory depression or addiction risks.
“If successfully commercialized, ADRIANA would offer a new pain management option that does not rely on opioids, contributing significantly to the reduction of opioid use in clinical settings,” said Professor Masatoshi Hagiwara of Kyoto University (SciTechDaily).
Clinical trials in Japan and the US are ongoing, raising hopes for a safer future in pain management.
Breaking stigma
IOAD organisers emphasise that stigma remains one of the biggest killers. In Spain, advocacy group Metzineres released videos calling for “safe consumption sites and wider naloxone access.”
A participant from Barcelona said, “My highlight was the visibility of the importance of breaking the stigma and discrimination, as it is essential to avoid increasing the risk of overdose deaths.”
With overdose deaths rising in Europe, the UK, and the US, pressure is mounting for governments to adopt harm reduction strategies rather than punitive measures. The EU’s Drugs Strategy 2021–25 lists overdose prevention as a top priority, with the EUDA urging greater distribution of naloxone, more treatment access, and gender-sensitive approaches.
The upcoming International Overdose Awareness Day 2025 serves as a reminder that behind every statistic is a person whose life has been lost too soon.
The evidence is clear: overdose is preventable, yet thousands die each year. As the WHO notes, “Death following opioid overdose is preventable if the person receives basic life support and the timely administration of the drug naloxone.”
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