Despite the best efforts of the sector, we are all aware that deaths from drug poisoning have reached record levels in England and Wales, with 4,859 deaths registered in 2021. This is the highest number since records began, and almost 50 per cent of those deaths involved an opiate. Without the harm reduction interventions of providers like Turning Point, the situation would be significantly worse, but we see that there is still a long way to go and that we need to work differently.
On 30 November last year Turning Point hosted its first Safer Lives conference, supported with an education grant from Ethypharm. Held in Birmingham, our aim was to bring together commissioners, public health officials, third-sector organisations and our partners in the sector to join in making a commitment to addressing the drug death crisis.
We welcomed around 100 delegates from third sector and NHS treatment providers, local authority public health teams, the police, ambulance services and organisations working with people who are homeless. From across the drug and alcohol sector colleagues from CGL, With You, Humankind and Cranstoun were in attendance, and it was inspiring to see so many people from different organisations coming together for a common goal.
In my role as Turning Point’s national safer lives lead, I co-chaired the conference with our clinical director Dr David Bremner. After working in harm reduction for many years I joined Turning Point in 2020 as harm reduction manager for our Somerset service, and when I was offered the opportunity to expand this harm reduction work as national safer lives lead I jumped at the chance. The role allows me to support Turning Point in our increased focus on harm reduction while working across our services to increase naloxone awareness, distribution, and carriage. I plan to put lived experience at the centre of what I do and one of my first aims is to expand our peer-led naloxone distribution programme.
I often hear that there is too much focus on naloxone, that we need to look at benzos, people using alone, and the case for overdose prevention sites. And of course we do. But making sure naloxone is in the hands of everyone who may need to use it is vital. Professionally I’ve administered naloxone multiple times, but for me this is personal. I wouldn’t be here if it wasn’t for naloxone. I have lost friends who might still be here if naloxone had been more widely available. That’s why, at the start of the conference, I asked everyone in attendance to get trained and pick up a naloxone kit if they didn’t already have one. Turning Point staff provided this training throughout the conference and by the end of the day had issued more than 60 kits.
Speakers on the day included Professor Dame Carol Black, independent advisor to the government, Dr Ed Day, national recovery champion, and Pete Burkinshaw, alcohol and drug treatment and recovery lead at the Office for Health Improvement and Disparities (OHID). The conference gave us the opportunity to reflect on where we are as a sector, and what the future may hold, and listen to examples of innovative practice in naloxone distribution from colleagues.
Professor Dame Carol Black reflected on the progress made since she published her report on the sector. She reminded us that the current economic uncertainty means we need to be ‘bold, determined and innovative.’
The most moving presentation of the day came from Abigail Kearley, Turning Point’s national service user involvement lead. She spoke on behalf of Julie Rose, a mother who tragically lost her son to a heroin overdose. On a day when we were presented with a lot of statistical information this was a powerful reminder of the real people those numbers represent.
Julie McCartney and Lauren Sloey from the Scottish Ambulance Service discussed their role in widening the provision of naloxone (40 per cent of those receiving a kit were not in treatment) and George Charlton spoke about his own experiences of childhood trauma and drug use, the stigma experienced by people who use drugs, and how this led to his development of multiple peer naloxone programmes.
For the final session of the day, I joined the workshop presenters for a panel Q&A session. Delegates used this opportunity to ask the panel for practical tips on extending the availability of naloxone, and questions included how to engage the whole drug service team in the supply of naloxone, how to get more pharmacies on board, and why it isn’t mandatory across England, Wales and Northern Ireland for all police officers to carry naloxone.
Our aim for the day had been achieved. We had come together and shared learning and innovation, and I hope all left with ideas and inspiration to carry forward in our work. Two clear messages stood out from the day – the importance of collaboration and the sharing of knowledge, and the need to collaborate with those who are best placed to get naloxone to people furthest from treatment services. Whether that be the ambulance service, A&E departments, the police or those with lived and living experience, we need to work in partnership if we want to reduce these tragic and avoidable drug deaths.
Deb Hussey is national safer lives lead at Turning Point
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USING INSIGHT FROM PEOPLE WHO USE DRUGS TO INCREASE CARRIAGE RATES
Dr Jenny Scott, a researcher from Bristol University who also works for Turning Point as a non-medical prescriber, spoke about a project that aims to identify barriers to carrying naloxone and develop solutions to overcome them. In Somerset a group of Turning Point service users worked with staff and university researchers to look at barriers to naloxone carriage.
They identified three key areas. One was the practical issue of carrying a kit that some felt was bulky, with a possible solution widening the availability of naloxone nasal spray. Another was the risk of being identified as someone who uses drugs – they felt a campaign to widen naloxone accessibility and acceptability to the general public would go some way to address this. The third issue was availability – not everyone lives near a local provider, particularly in rural areas, and not everyone knows other places they can get a kit.
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NALOXONE AND THE POLICE
Chief inspector Jason Meacham from Durham Police gave a presentation on the introduction of naloxone in police custody suites. Asked about opposition in some forces to officers carrying naloxone, he said he felt these concerns were unfounded but that he would be happy to contact any officers to discuss their objections. Having recently implemented a police naloxone pilot for Turning Point in Somerset, I was able to share my experience of the challenges we faced and how we overcame barriers to go on to train and issue naloxone to almost 150 officers. It was such a positive end to the conference and made me optimistic that there would be very real outcomes from the day.