Stigma of drug overdose causing extra pain for grieving families

Peter McNevin with his sisters Hilary (centre) and Meg (right). (Supplied) Source: s

Australian families who lose loved ones to drug overdose are dealing with their grief alone because of a damaging and persistent stigma.

When Peter McNevin didn't turn up to a family dinner in March 1999, his family tried calling him but his phone went flat. Pushing aside their fears, they figured he must have forgotten.

The 35-year-old had struggled with a heroin addiction for years but was now on methadone and doing well. Peter had been the one to set his sister Hilary up with her partner and was looking forward to the couple’s wedding later that year.

But after two days, the family still hadn’t heard from him and was becoming increasingly worried. Hilary, then 30, walked the streets of his Melbourne neighbourhood looking for him and placed a note with her telephone number at his door.

On Sunday, Peter was found dead inside his home from a heroin overdose. The police found Hilary’s number on the note and called her with the news.

She then had the job of calling her parents in Brisbane. One of her older sisters - there were five children in the family - answered the phone. "I think I yelled out 'He's dead'," she said. "I remember she said, 'I love you' and just cried."

A silent problem

John Ryan is the CEO of the Penington Institute, the organisation responsible for International Overdose Awareness Day (IOAD), taking place on August 31.

The event was started in 2001 by Sally J. Finn, a needle-exchange worker in St Kilda who saw the families of many overdose victims suffering in silence because of the stigma attached to it.

IOAD is now marked in countries all over the world including the US, Ukraine, Norway and New Zealand. It's just as much about providing support to families as it is about opening up conversation around drug use.

"Overdose is preventable if people are equipped and know the signs and know how to deal with drug problems," Mr Ryan said.

Another aim of the day is to break down myths about overdose.

"One of the biggest misconceptions about overdose is that it only applies to street-based heroin users and that’s completely untrue," Mr Ryan said. "It affects men and women. It affects people in country areas just as much as in big cities."

He said there had been a huge change in the way Australians used drugs in the past 15 years, despite efforts by state and federal governments to crack down.

"There's been a huge increase in the use of pharmaceutical drugs, particularly pain killers like Oxycontin and Morphine," he said.

Pharmaceutical drugs are also the most common to overdose on, usually in combination with alcohol or other drugs. 

"People often don’t know that combining pharmaceutical drugs – which they think are safe because they come in plastic packets from the pharmacy – with alcohol, for example, really multiplies your risk of an overdose," he said.

Shame

After Peter died, most people the family told were not even aware he had a problem.

"When you put things out there, attention can turn to gossip and be misconstrued and you don’t want that," Hilary said.

But if a stigma existed around drug use, that only became more pronounced in death.

"I've had other people say – when I tell them how he died – 'Well that’s nothing to be proud of'," she said.

"Someone said to me, 'Your brother must be ashamed of what he's done to your family'."

"You get all this judgment thrown at you."

"One of the biggest misconceptions about overdose is that it only applies to street-based heroin users and that’s completely untrue." 

She said the death of Australian actor Heath Ledger catapulted the term 'accidental overdose' into the public consciousness, which was a welcome side effect to a terrible tragedy.

"If I just said the word 'overdose' [to describe Peter's death] people would immediately assume that [he killed himself]," she said.

"In the weeks after his death, people would call me and say 'I'm so sorry your brother killed himself' and I would say, 'But he didn't' and they would say, 'Oh' as if I was in denial."

Reversing overdose

Most drug overdoses in Australia are caused by opioid consumption and Mr Ryan said a drug named Naloxone - used by paramedics to reverse the effects of overdose - can be obtained on perscription. 

"If you are at risk of overdose, it is still important to call an ambulance but family members can administer [Naloxone]," he said. "It's not being used nearly enough in community."

However this drug is only effective in treating the use of opioids and can't be used on someone who has taken stimulants such as ice. Doctors recommend family or friends of drug users thinking of obtaining Naloxone as a protective measure for an overdose should seek medical advice about its use.

There is also a risk that anyone who survives an overdose may be left with lasting effects. "Overdose is a lack of oxygen to the brain," he said, "and starving your brain of oxygen can result in permanent brain damage."

The war on drugs

Drug overdose is a worldwide problem that claims thousands of lives each year. In the United States alone, the number of people dying of drug overdose has steadily risen in the past 12 years. According to The United Nations Office on Drugs and Crime (UNODC) 2014 World Drug Report, 41,340 died in the US of overdose in 2011.

The report stated that Oceania - which includes Australia and New Zealand - had between 1,600 and 1,900 drug-related deaths in 2012, making the region's drug mortality rate higher than average. 

Mr Ryan said the approach to dealing with drug addiction needed to change, in order to curb these statistics.

"We need to acknowledge that war-on-drugs approach has failed," he said. "It’s been going since early '70s and drugs are more available and cheaper than ever."

"The police are often saying, 'We can’t arrest our way out of this problem'."

"Someone said to me, 'Your brother must be ashamed of what he's done to your family'."

"Our biggest problem is that we have drug using culture which, other than alcohol and tobacco, is mostly secretive and we’re much better off as a community is we were open and honest about the level of drug use in the community and the harms of drug use and how to better prevent them."

Hilary McNevin said that providing appropriate support to people struggling with drug addiction was crucial to moving forward.

"If we could just realise that this is - hopefully, most of the time - a phase of your life that we want to get you through alive. [Then] there’s a sense of positivity in a problem," he said.

"Because overdose if so final and it breaks families and it breaks hearts."

Find out more about International Drug Overdose Awareness Day here.

* Readers seeking support and information about suicide prevention can contact Lifeline on 13 11 14 or Suicide Call Back Service 1300 659 467 or follow @LifelineAust @OntheLineAus @kidshelp @beyondblue @headspace_aus @ReachOut_AUS on Twitter.

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