Author: A/Prof Shalini Arunogiri.

Trigger warning: this article discusses overdose and trauma.

More than 2,000 people in Australia lose their lives to overdose every year. Many of these deaths are preventable.

31 August is International Overdose Awareness Day – a day of remembrance, reflection and mixed emotions: grief, anger, shame and love. It is a day to honour those we have lost, and to stand with families, friends and communities who live with that loss every day.

Behind every statistic is a person. Someone’s child, sibling, partner, friend. The tributes on Penington Institute's International Overdose Awareness site are heartbreaking reminders of this.

For many, overdose is not simply about drugs – it is also a story of trauma, silence and missed opportunities for support. People living with mental illness face a much higher risk of drug-related deaths, yet this intersection remains poorly understood and often overlooked. For people with co-occurring disorders and their families, stigma and siloed service systems still mean being bounced between services – hearing again and again, “We can’t help you here.”

When it comes to opioid use, we know what works to prevent overdose:

• Widespread access to naloxone (opioid reversal medication) - this is gradually changing in Australia with an expanded Take Home Naloxone program.

• Access to harm reduction and peer support.

• Access to evidence-based, person-centred opioid pharmacotherapy services, such as buprenorphine or methadone treatment (ODT - opioid dependence treatment). This is a critical issue in many parts of Australia, where access can be severely limited and people are often waiting days or weeks to see a prescribing doctor or driving hours to reach a dispensing pharmacy. This is just not good enough. We know opioid pharmacotherapy is one of the most researched and effective approaches for opioid use problems and significantly reduces the risk of opioid overdose. Yet in Australia, only around 50,000 people access these treatments  – just a fraction of those who could benefit.

Drug checking and early warning and response systems are also a critical part of the prevention response – this has been demonstrated time and time again across the world. The Victorian government’s investment in a fixed pill testing site, launched last week, along with the structures across emergency departments and other surveillance mechanisms to support an early warning system, are a really positive step.

Still, we could do so much more, and we must do better. We would never accept more than 2,000 potentially preventable deaths every year from any other health condition. We should not accept it here.

On 31 August, landmarks across the country will light up purple — from Melbourne’s Bolte Bridge to AAMI Park and beyond. If you see them, take a moment. Pause. Reflect. And join the call for change: to end stigma, to invest in overdose prevention, to make sure no one suffers in silence.

There is support available if this day brings up difficult feelings for you. If you're in Victoria, ring Directline for 24/7 support. Elsewhere in Australia, there is help available in your state.