NNA - To mark the International Overdose Awareness Day that takes place on 31 August of every year, Skoun releases its map of “safe hospitals” listing hospitals that do not report cases of overdoses to the police as per the Ministry of Public Health’s circulars of 2016 and 2019. The map’s aim is to allow people who use drugs to safely access hospitals in cases of emergency in order to safeguard their right to life and health.

The mapping shows that only 40 hospitals in Lebanon abide by the directives of the Ministry of Public Health.

Skoun calls on the Ministry of Public Health to reiterate the content of its circulars to ensure that all hospitals are aware of the circulars’ content, and to monitor their implementation by all hospitals in order to ensure the right to life and health of all patients, including those who use drugs. 

Skoun calls on the administration of private and public hospitals across Lebanon to refrain from reporting drug-related emergencies to the police in commitment to the circulars issued by the MOPH, and to inform concerned staff of their duty of care towards patients who use drugs, and include the restriction to inform the police of overdose cases in their internal policies.

Although there are two circulars from 2016 and 2019 (attached) issued by the MOPH that remind the hospitals to protect patient's lives and refrain from calling the police when receiving cases of overdose or drug-related emergencies, the vast majority of hospitals across Lebanon still report overdose cases to the police; a practice that puts people's lives at risk by delaying or hindering their recourse to emergency medical care because of fear of arrest, therefore increasing the risk of death.

-        Of the 91 hospitals that answered the survey, only 40 hospitals have confirmed that they do not report overdose cases to the ISF: 8 governmental hospitals and 32 private hospitals.

- 7 of the hospitals previously marked as “safe” or non-reporting in 2022 are now out of the “safe hospitals” list: They were either unreachable or answered by saying that they report overdose cases to the police.

-20 hospitals that were previously marked as reporting hospitals have now joined the “safe hospitals” list.

- The staff of  57 hospitals reported having no knowledge of the circulars, 12 of which are governmental hospitals. 

- As a result of repeated mappings, the number of safe hospitals has increased from 27 in 2022 to 40 in 2023, showcasing the importance and impact of reminding hospitals of the circulars and their content.

During the months of July and August, Skoun contacted all hospitals listed on the Ministry of Public Health’s website to inquire about their practices when receiving overdose cases in the emergency room.

A total of 91 hospitals across Lebanon responded: 15 governmental hospitals and 76 private hospitals.

The calls targeted ER Doctors or the ER Head Nurses who were asked whether:

1-       The hospital reports overdose cases to the Internal Security Forces (ISF) upon their reception or not

2-       The hospital is aware of the Ministry of Public Health’s circulars of 2016 and 2019 which inform hospitals that they should not report overdose cases to the police and remind them of their duty of care towards patients.

Hospitals that responded that they do not report cases of overdose to the police were marked as “safe hospitals” whether they don't report as a result of the MOPH circulars or as a result of their own policy.

Background

-        An overdose is the consumption of doses of a substance (legal or illegal) beyond the recommended dosage or beyond the body’s tolerance. Overdose can lead to death if not treated in a timely manner. Overdose deaths are preventable.

-        The practice of informing the police of such cases discourages individuals who are suffering from symptoms of overdose or their family/friends from seeking urgent medical care due to fear of arrest. Delaying emergency medical care in cases of overdose puts the person at risk of death.

-        In 2006, the Ministry of Interior issued circular 55/1 requiring hospitals to inform the ISF of incidents they receive in the Emergency Room that result from harms caused by others. This circular created confusion and led to hospitals reporting incidents that resulted from any illegal activity such as the use of drugs.

-        In 2016, the Ministry of Public Health issued circular 44/2016 in view of protecting persons suffering from overdoses, from arrests while seeking medical assistance. The circular clarifies that circular 55/1 does not apply to overdose cases, as they do not result from harms caused by others, and that these cases should therefore not be reported to the ISF. The circular further links directly the practice of reporting overdose cases to the police with an increased risk of death in cases of overdose.

-        Despite the circular 44/2016, the vast majority of hospitals continue to report overdose cases to the police.

-        In 2019, and as a result of Skoun's efforts, the MOPH reiterated in  circular 76/2019 that hospitals should refrain from reporting overdose cases to the police.

-        In 2019, The Ministry of Interior also issued its own circular addressed to ISF officers reiterating the right of people who use drugs to seek medical care and reminding them of the text of the MoPH’s circular.

- Globally, more than 100,000 people die every year from overdoses.

About the international Campaign

International Overdose Awareness Day is a global campaign held on 31 August each year to raise awareness about overdose and call for  evidence -based policies and overdose prevention measures. The campaign remembers without stigma those who have died or had  permanent injuries as a result of drug overdose and acknowledges the grief felt by families and friends left behind. The campaign spreads the message that drug overdose is preventable.

Skoun, Lebanese Addictions Center is a harm reduction center that provides outpatient treatment services for people with substance use disorders as well as a full range of protection and prevention services for  people who use drugs and communities at risk, and advocates for drug policy reform in line with health and human rights principles.

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