Crisis of Overdoses and Environmental Change
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In the United States, drug overdose deaths have been on the rise for several years, with the pandemic accelerating this trend. According to recent studies, most drug overdoses are linked to opioids, particularly the potent opioid, fentanyl.
Researchers in New York City found that 60% of people who inject drugs experienced withdrawal symptoms after a hurricane due to the disruption of their usual drug supply. Similarly, methadone clinics in Texas were forced to close during the worst winter storm in nearly a century, causing difficulties for people receiving medication to treat opioid use disorder.
The emergency departments of hospitals have served as backup sites for people to get methadone, but accessing these facilities during extreme weather events can be challenging. Some emergency departments were reluctant to prescribe methadone during the storm, further complicating the situation.
The link between climate change and drug overdose deaths is becoming increasingly clear. Heatwaves and high temperatures increase overdose deaths because drug use, particularly opioids, impairs the body's ability to regulate heat and respond to heat stress. Extreme weather events also disrupt drug manufacturing and supply chains, indirectly affecting drug availability and possibly quality.
Certain vulnerable populations, such as people who use opioids or methamphetamine, are often excluded from public cooling centers, leaving them exposed to heat dangers that exacerbate overdose risk. Chronic air pollution related to climate change, such as elevated ozone levels, is linked to increased respiratory mortality, which may contribute to overall worsened health outcomes for people with substance use disorders.
These environmental stressors heighten physiological vulnerability to overdose and complicate harm reduction efforts for people who use drugs during extreme weather events worsened by climate change. However, detailed nationwide epidemiological data on how climate change quantitatively changes overdose rates is not yet available.
Harm reductionists advocate for solutions such as opening safe consumption sites, pushing for a safe, regulated supply of drugs, expanding access to methadone and buprenorphine, and pushing for decriminalization, regulation, and legalization of substances. It is crucial to address these issues to reduce the impact of climate change on drug overdose deaths in the United States.
Sharing needles and drug equipment can lead to an increase in infectious diseases like HIV. Providers who prescribe drugs like methadone and buprenorphine are often subject to cumbersome regulations, making it difficult to get people their medication, especially during a climate-induced emergency. Similar barriers were reported by health providers in New York City in the aftermath of Hurricane Sandy and by providers who were dealing with new patients who had been evacuated from New Orleans in the aftermath of Katrina.
In conclusion, climate change is exacerbating environmental factors that increase the risk of drug overdose deaths in the United States. It is essential to address these issues by implementing harm reduction strategies and improving access to medication and resources for people struggling with substance use disorders. The overall goals of ending the drug war and addressing climate change require a similar expansive imagination and are often met with derision from status quo politicians.
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