‘We have no budget for training.’ We heard this plenty of times at previous NNEF events – when budgets get tight, one of the first casualties is staff training. Yet training is essential for this sector. We often have relatively high staff turnover, and staff need to be empowered with the knowledge and confidence to provide the best advice to our clients.
The National Needle Exchange Forum (NNEF) is a voluntary network that promotes and supports the provision of high quality needle and syringe programmes. In June, we organised our first ever free training event for needle exchange workers, with parallel courses offered on safer injecting, overdose prevention, peer distribution, and bacterial infections. Trainers from across the country were brought to Liverpool to deliver to more than 80 participants – and the event was kept free of charge thanks to the generous support of Frontier Medical Group, Liverpool John Moores University, and a number of exhibitors.
The feedback from the event was overwhelmingly positive: all of those who left feedback said that they would recommend future NNEF events to their colleagues, and that they were able to access training that they would otherwise not have been able to. As a result, the NNEF will look to provide more training events in the future – at locations across England – to support needle exchange staff as much as possible in their important, lifesaving work.
To find out more, join the forum at www.nnef.org.uk/nnef_join.html – membership is free.
I was lucky enough to be asked to run two half-day workshops on promoting overdose prevention at the NNEF’s free training event. Although drug services and needle programmes have always had a duty to reduce drug-related deaths, this often has in practice involved little more than asking someone if they have overdosed in the last four weeks, with very little in the way of follow-up. Some services do go further, but staff training around this is often just a small aspect of a wider training programme rather than intensive overdose prevention work.
Training people in promoting overdose prevention messages has to include a large amount of ‘myth-busting’; both workers and people who use drugs can have fixed ideas learned from their peers and the media. Challenging these ideas requires sensitivity and understanding.
For example, explaining to a group that walking people around when they’ve overdosed won’t help them. You’re likely to come across someone who has done this in the past, and the person lived. They may have gone though years believing they saved someone’s life, and you have to explain that not only did this not help, but that they might have put the person at a greater risk of injury from falls as well as increasing the overdose risk by delaying the process of getting help. Imagine how you might feel in that same situation.
Overdose prevention also has to be practical and realistic; take for instance the recovery position. Almost everyone I’ve trained has some idea of how to put people into the ‘correct’ position. But how often does this kind of training include coming across people who are not flat on their back with their hands by their sides. Unfortunately people don’t always fall to the floor in a neat and tidy way, they might be slumped over, face down, or even wedged between furniture. If all we do is talk to people about artificially ‘tidy’ scenarios then they won’t be confident responding in real life situations.
During the training at the NNEF, one exercise was for people to develop their own overdose education plans that could be incorporated into the kinds of programmes they worked in. This might be a formal one-hour one-to-one session, a group situation or even just small bite-sized chunks of information that can be delivered while supplying sterile injecting equipment. When developing this kind of plan, think about the resources you have – are you going to give people handouts? What practical exercises can you run (have you got access to a resuscitation doll?) and, of course, are there partner agencies you can work alongside to deliver this?
Both the sessions at the NNEF event were very well attended, showing that there is a real need for this kind of work from the point of view of the workers involved. The last drug-related deaths figures showed more than 500 people died from heroin use. With other drugs added the figures are more than 1,000 people, so this needs to be more of a priority than a couple of questions on an assessment.
Overdose prevention is something that should be done at every stage of drug service work, from brief interventions during needle sessions, right though to relapse prevention overdose work in rehab situations.
Nigel Brunsdon is community manager at HIT and a harm reduction trainer, www.injectingadvice.com