Current status and challenges of peer support for young people who engage in over-the-counter medicine overdose in Japan: Practice-oriented perspectives

Over-the-counter (OTC) medicine overdose among adolescents and young adults is an increasingly visible concern in Japan, intersecting with suicide prevention priorities and unmet psychosocial needs. In this article, we share frontline perspectives from a semi-structured group interview with five peer supporters (women in their 20s-30s) who provide street outreach, social networking service (SNS) consultation, and drop-in place-making for young people, including those who overdose on OTC medicines. Using an inductive, data-driven thematic approach to organize participants' accounts, we highlight practice-relevant insights: <i>i</i>) an ecology shaped by offline isolation, SNS normalization, and easy access to OTC products; <i>ii</i>) low-threshold, non-judgmental engagement as a first door to care grounded in peer support principles; and <i>iii</i>) fragility and safety risks as complexity escalates, underscoring the need for structured professional backup, supervision, explicit escalation criteria, and reliable referral and crisis pathways.