A crucial conversation

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Peter Furlong, North West harm reduction lead and development manager at Change Grow Live
Peter Furlong, North West harm reduction lead and development manager at Change Grow Live

Change Grow Live’s National Naloxone Conversation event was a vital opportunity to keep up the momentum for widening access, says Pete Furlong.

Our sector is very aware of the crucial need to increase naloxone access and availability nationally. Last year’s ONS figures on drug-related deaths showed 4,359 fatalities related to drug poisoning in England and Wales, the highest number and annual increase – at 16 per cent – since the data set began in 1993 (DDN, September 2019, page 4). More than 2,200 had an opiate specifically implicated.

To address this need, Change Grow Live hosted a National Naloxone Conversation event in Manchester in January, bringing together professionals, activists, and naloxone peer educators to collaborate on new thinking and solutions to widen the availability of naloxone across the UK. Attendees also included Change Grow Live staff and clinicians, service user reps, Addaction (now We Are With You) clinical representatives and Red Rose Recovery staff, and all contributed to wide and varied discussions and planning for further development of naloxone interventions.

a meeting about naloxone distribution

As harm reduction lead for Change Grow Live’s North West region, it fell to myself and Zac McMaster – head of services for Change Grow Live Mersey and Cheshire region – to welcome more than 35 delegates from across the country. To set the scene, I outlined the journey our sector has been on over the last decade regarding take-home naloxone (THN).

Many of us have had to address the concerns of those who feared that the supply of THN would increase risk-taking behaviours among opiate users, but today we’re able to point to a continually increasing global evidence base that naloxone saves lives. This, coupled with the need to urgently address the growing number of drug-related deaths, means that THN is now a core component of most new tender specifications and the majority of commissioners welcome more innovation in widening the availability of naloxone for those most at risk of opiate overdose.

We heard from Kirsten Horsburgh from the Scottish Drug Forum (SDF) about how Glasgow’s peer supply programme, originally headed up by Jason Wallace and Steph Kerr, had not only had a significant impact on the numbers of naloxone kits issued across the city but had also reached new cohorts through peer supply and peer-to-peer education, with hugely impressive results. Kirsten also gave an overview of Scotland’s priorities for harm reduction and naloxone supply, including the welcome news that paramedics are now set to issue kits to overdose casualties who refuse transport to hospital for further treatment and monitoring.

Last year I was asked to identify a service in the North West to pilot a peer-to-peer naloxone pilot, and I didn’t have to think too long before recommending the St Helens Integrated Recovery Service, given their positive energy and the passion of the staff. On top of that, I was made aware that peer mentor John Pilkington had recently been alerted to a nearby overdose incident and had rushed from a waiting area where he was welcoming people with tea and coffee to successfully administer naloxone to a man in a state of respiratory failure. A powerful reminder, if ever one was needed, that naloxone saves lives.

It was therefore a proud moment for St Helens service manager Rachel Fance and local service user involvement lead Amanda Taft when naloxone peers from the Change Grow Live St Helens service presented the initial findings and data from their pilot supply programme. Rachel outlined the programme’s structure and delivery, including the training and governance framework that had been developed, and described how the pilot had resulted in naloxone being used to save lives in the town centre on multiple occasions. The pilot is now looking to expand the recruitment of peer naloxone educators in the coming year, as well supporting and training them through increased education opportunities and the potential for secondary needle and syringe provision interventions.Naloxone activists pose with a sign

The event also coincided with the end of Change Grow Live’s six-month nasal naloxone pilot, which ran from August 2019 in Manchester, Knowsley and HMP Risley. As project lead, I was able to share a brief presentation of some initial findings and raw data. In overarching terms, the supply of nasal naloxone had been overwhelmingly popular with people using our services, with a significant increase in kits issued and interest from key stakeholders including hostels and law enforcement.

The potential for the local neighbourhood policing team in Manchester to be trained in the use of nasal naloxone is now under consideration following a successful pilot in Birmingham, and Change Grow Live’s national research manager Zoe Welch will be working with myself and the leads from each pilot area to further evaluate the feedback, data and associated costs from the six-month delivery.

Zac McMaster led the afternoon session, which focussed on harnessing the potential of open source technology, while discussions also centred on what’s needed for the development of effective peer-to-peer initiatives that can co-exist with statutory provision, with attendees identifying critical issues, concerns and new ideas to formulate actionable solutions.

The content of the day encapsulated the core principles of Release’s best practice guide and the innovative work of EuroNPUD, with special emphasis on the importance of peer-to-peer naloxone initiatives involving people who use drugs and those with lived experience. Twitter helped in promoting the event, with great traction around the #naloxoneivegotmine hashtag, and we continue to strive for increased awareness of the need for naloxone to be available without barriers or restrictions in all areas of the UK.

There was a clear commitment from all involved to continued collaboration, starting with sharing the resources that have been developed in St Helens as well as all the material from the event. Our hope is that by maintaining this national community for ongoing naloxone conversations we will be able to help organisations to continually innovate. This community of practice will be unified by a shared commitment to meeting the ambitious but achievable target of 100 per cent of opiate users – as well as friends, family and loved ones – having easy and unimpaired access to life-saving naloxone as standard practice.

Any organisation or group that wants to be part of future events is welcome contact me at Peter.furlong@cgl.org.uk

Find out more about peer-led naloxone distribution, get trained and get a kit at the DDN conference on 18 March.