Every day is International Overdose Awareness Day, which aims to inform people about the risks of drug overdose and preventative resources. Nationally, overdose accounts for one death every 5 minutes (ONDCP, 2022). In Iowa, 384 individuals died by overdose in 2022. Of those, about 85% had at least one potential opportunity for intervention (SUDORS, 2022).
Anyone using illicit substances is at risk of overdose, with some populations experiencing higher rates of overdose than others. In 2022, males, Black non-Hispanic individuals, and individuals ages 25-34 experienced the highest overdose death rates in Iowa (SUDORS, 2022). Additionally, nearly 53% of individuals who died by overdose in Iowa in 2022 had a co-occurring mental health diagnosis (SUDORS, 2022). Improving access to person-centered behavioral health services and educating providers and the community about the linkage between mental health conditions and overdose risk are important tools in preventing overdose. Iowa HHS is working to build a well-coordinated, easy-to-access, person-centered Behavioral Health System through ongoing system redesign efforts.
Working alongside community partners and people with lived experience is important in the development of effective overdose prevention strategies. The Substance Abuse and Mental Health Services Administration (SAMHSA) has an Opioid Overdose Reduction Continuum of Care Approach Practice Guide that outlines evidence-based practices to address the opioid epidemic in higher-risk populations.
Educating communities on overdose prevention, recognition, and response is an important part of the continuum of response to the opioid epidemic. In Iowa, over 60% of overdose deaths in 2022 had a potential bystander present (SUDORS, 2022). Potential bystanders are people who were nearby that, if they were aware of the situation, may have responded to prevent the individual's death. Of these potential bystanders present, 75% provided no response, mainly because they were physically separated from the individual (such as in another room) and/or they did not recognize signs of an overdose. There are many ways Iowa works to empower individuals with information about recognizing the signs of overdose and how to respond to a suspected overdose – including the use of naloxone.
Naloxone is an FDA-approved opioid overdose reversal medication that, when administered properly, can reverse the life-threatening effects of an opioid overdose. Opioids include prescription and illicit substances like oxycodone, heroin, and fentanyl. Naloxone is available as both a nasal spray and intramuscular injection and can be used without medical training or authorization. Because opioids may be present in any illicit drug, there is an enhanced need for overdose prevention, recognition, and response - including access to naloxone at the community level. Learn more about naloxone here.
It is important to note that naloxone only helps in situations where opioids are involved. Drugs such as stimulants (ex. Methamphetamines) and chemical adulterants (ex. Xylazine) cause complications that are not reversed by naloxone. In Iowa in 2022, 30.5% of unintentional overdose deaths involved methamphetamine with no other stimulants or opioids while 20.1% involved illegally made fentanyl with no other opioids or stimulants (SUDORS, 2022). In overdoses where naloxone cannot be used, the best response is to call 911.
Iowa HHS has implemented multiple programs for free nasal-spray naloxone distribution.
Local organizations across Iowa are also working to expand access to naloxone, including:
You can learn about additional strategies organizations are implementing to address substance use across the state by reading through Healthy Iowans’ Partners in Action document.
If you would like to share your community efforts, or if you have questions, please reach out to sor@hhs.iowa.gov
