Dr. Jo-Hanna Ivers

Opioid Use Disorder (OUD) is characterised by a loss of control over the use of opioids, resulting in physical, psychological, and social harm. Examples of opioids include heroin, morphine, codeine, fentanyl, and oxycodone. The misuse of prescription and illegally obtained opioids are major public health issues and are associated with significant mortality and morbidity (WHO, 2009). Across Europe, it is estimated that there are 1.3 million people with high-risk opioid use, with opioids being found in up to three-quarters of overdoses. In Ireland, it has been estimated that in 2019 there were 19,875 problematic opioid users. In addition, opioids are the main drug group implemented in poisoning deaths, with more people treated for opioids than any other drug. As opioid users age, they also experience co-morbid health problems requiring treatment.

Stigma can affect self-esteem, physical and psychological health, and relationships with others, directly affecting an individual accessing the necessary support services and resources. The social disadvantage and stress people experience can lead to inequalities and impact health and life expectancy.1 The hidden element of those living with active drug use disorders due to the stigma associated with their condition means the wider public has no opportunity to hear from them and no opportunity to reflect on their prejudices, such as the opinion that addiction is a moral failing or a form of deviance. Research has consistently shown that interacting with members of a stigmatised group and listening to their stories has a profound destigmatising effect on listeners. It is far more powerful than merely educating the public about the science underlying a condition. However, while a growing number of people in recovery are sharing their stories, there is still a significant stigma attached to illicit drug use. Thus, speaking openly about a history of drug use carries a fear of public stigma and, in some instances, the threat of legal retribution. An effective public health response to substance use and substance use disorders must consider the policy landscape of criminalising substance use, which constitutes a primary socially sanctioned form of stigma. In addition, there is a pressing need to develop the research on the outcomes associated with alternative policy models that prioritise treatment over punishment, such as health diversion programmes, that reframe drug use as a health need rather than a criminal act. The current study aims and objectives set out in the tender call, namely, to develop a strategy for reducing drug-related stigma.

Non-fatal opioid overdose is a significant cause of opioid-related morbidity globally. As the number of non-fatal overdoses continues to grow, and it is crucial to understand the short and long-term consequences. There is a dearth of literature on non-fatal overdose in Ireland, with no published studies exploring the experiences of persons who use drugs and who experienced a non-fatal overdose. Timely data can help enhance coordination among service providers, community members, healthcare providers, public health, law enforcement, and government agencies. Timely, robust data can enable readiness for increasing change and response to overdose. For example, evidence suggests individuals who have had at least one overdose are more likely to have another. However, if an individual who has had an overdose is seen in the ED, there is an opportunity to intervene and prevent further overdose by individual care that can improve their health outcomes. The current study will use a mixed methods approach to examine data and capture the experiences of relevant stakeholders for the last decade.

To advance the evidence in the area of youth substance use, we plan to combine measures of multiple risk factors into a cumulative measure of substance use vulnerability that could be used to identify specific thresholds or unique combinations of risk factors (e.g., substance use risk profiles) associated with substance use initiation and associated harms.