Peer-to-peer naloxone initiatives are proving an effective way to tackle overdose risk. Lee Collingham describes how SCUF are grasping the opportunity in Nottingham.
The latest release of worsening statistics has kept drug-related deaths (DRDs) at the forefront of everyone’s mind, whether treatment providers, family members, friends or peers.
In May Nottingham’s user-led campaign group, SCUF, was approached by the European Network of People who Use Drugs (EuroNPUD) to discuss the possibility of a partnership. The suggestion was to work together for a three-month period to promote peer-to-peer distribution of naloxone.
The initiative started on International Remembrance Day on 21 July, when drug using communities across the world come together to remember those we’ve lost during the year and highlight the war on drugs – especially with budget cuts and services being decommissioned.
Local service users came together for action, and through working with neighbouring specialist support services, the P2POD (Peer to Peer Overdose) group was formed. We have the firm belief that it will be beneficial to all in reducing the unnecessary deaths of our friends and peers by ensuring all users, as well as their families and carers, have access to naloxone – the drug that temporarily reverses the effects of opioid overdose and buys time for medical professionals like the ambulance service to arrive.
A lack of knowledge around naloxone has meant that there has often been confrontation when the ambulance arrives, and we believe by informing service users properly we can avoid this.
P2POD group have met a number of times this year. We arranged events for International Remembrance Day on 21 July and Overdose Awareness Day on 31 August, as well as organising naloxone training for our local harm reduction week at the end of August. We have been able to raise awareness, distribute naloxone to peers, and cement future working relationships for peer-to-peer distribution of naloxone in Nottingham. This also demonstrated once again how important engaging with service users is to the success of any project and the annual release of DRD figures only cemented the group’s commitment.
Local service providers and commissioners came along to the events, where service users were trained in basic overdose response. Participants were shown how to administer naloxone by one of their peers and issued with a naloxone kit before leaving, and were told exactly what happens when it is administered. It’s our firm belief that if people understand what’s going on, and that it momentarily reverses an overdose, they are less likely to hit out at the person administering it. This information also prevents the person from running off to score again, only to collapse as the effects of the naloxone wear off.
We are grateful to the team at EuroNPUD and local service providers, not only for their support, but for backing the possibility of peer-to-peer distribution of naloxone in Nottingham.
Peer to peer
Mat Southwell shares EuroNPUD’s strategy to spread the initiatives far and wide.
The European Network of People who Use Drugs (EuroNPUD) has undertaken a project to understand barriers to accessing naloxone in the UK. The project has been funded by an unrestricted educational grant from Martindale Pharma, which has also enabled us to explore peer to peer overdose prevention training and naloxone supply.
We began by selecting three areas with at least twice the average number of opioid overdoses and where we have strong local peer partners – Liverpool, Burnley and Blackpool. The partners in these areas initially undertook a mapping exercise identifying local planners, service providers and community stakeholders.
EuroNPUD and our local peer partners then ran a focus group in August, with eight to ten local community stakeholders in each area. This involved a range of drug users and family members with different experiences of drug use and drug services. We also trained the local peers to deliver a mystery shopper activity, testing access to naloxone for drug users and family members.
Drawing on case studies from London and Glasgow in the UK, Kachin in Myanmar, Minnesota in the USA, and Canberra in Australia, EuroNPUD has researched and written a technical briefing on the peer-to-peer distribution of naloxone. This gave examples of drug users distributing naloxone to their peers and shared good practice tips from the peer experts that have been interviewed for the project.
The peer-to-peer technical briefing provided the focus for a second local event in on 31 August, International Overdose Awareness Day – a lunchtime briefing that targeted peers, families and professional partners. Its purpose was to engage stakeholders in hearing the findings on local drug users’ assessment of access to naloxone. This also supported an advocacy planning exercise to design a peer-led advocacy initiative, which has been backed up with a £1,000 local advocacy grant.
The EuroNPUD project team has also produced a report describing the methodology and learning, launched at a media event alongside the naloxone technical briefing, where peer experts from across the UK showcased peer-to-peer distribution of naloxone. We are now producing an open source standard toolkit, supporting the delivery of this activity in other areas or national settings.