Keeping it together

Handy naloxone pouches containing everything needed to make administration risk-free are a potential game-changer, says Alistair Bryant.

peer led naloxone distribution

It would be cool if I can just explain our naloxone pouches and how we rolled them out. Everyone loves a backstory, right? So how did these pouches become a thing? 

Chris Rintoul, our harm reduction and innovation lead, brought the idea to the table when he joined Cranstoun, and there’s a very real reason why these kits have been made the way they have. And that is that the reality of administering naloxone can sometimes be different to what you see in basic training. 

Quite often naloxone administration happens in quite tough environments – alleyways or waste ground, cramped hostel bedrooms, or squats. It could also be dark, there could be glass on the floor, or even uncapped needles. All of these added risks for someone who is already responding to an opioid overdose can make the situation ten times harder. 

naloxone pouchesSo what we decided to do at Cranstoun was create a pouch that contained enough equipment to support the person administering naloxone in one of these risky situations. We decided that our pouches should contain a number of useful items, which are kept together for ease of access. 

There’s a high-powered LED torch, a face shield for giving rescue breaths, instructions on how to administer naloxone and naloxone itself. We have two types of pouch, one containing nasal naloxone, and the other injectable.

One of the best things about the project was the big team effort. Chris Rintoul brought the original idea, our service commissioners supported the funding of the pouches and kits in a number of areas including Worcestershire. Ethypharm also kindly donated to wider distribution with 2,000 naloxone kits, which means 1,000 people will have access to a fully stocked pouch. Our Worcester peer harm reduction team, PACKS (peer-assisted community knowledge & support), helped get them all packed up for distribution – it was really special for PACKS to be involved in this as they had all lost someone to overdose and really enjoy being part of the bigger picture in preventing drug related deaths. 

naloxone outreachThe passion the peer team bought to the table was quite amazing. You could really tell these pouches meant something personally to them. Without them, 2,000 would still be sat in boxes and I would be facing a telling off! So from me and all the people who now have a pouch, nice one PACKS – you did a mighty fine job on these! 

I see these pouches as part of a shift towards ensuring that harm reduction is right at the forefront within Cranstoun services. We’re not only reducing harm by providing the ability to prevent overdoses, we’re also reducing the harm that our workers or other professionals could face when administering the naloxone. It was also the first project at Cranstoun Worcester where we worked with people who have lived experience and had them on complete equal footing as staff members, paid above the real Living Wage.

As always, we made sure we had some fun while we were packing the naloxone pouches – we’d get some pizzas in, get some music on and have a big factory line to get them packed. We also decided to make a TikTok video about them, and it was one of the videos that helped us go viral and reach over 1m views on our work. Such a high social media view count shows that harm reduction messages are very much here to stay – check out harmreduction_al on TikTok. 

harm reduction and naloxone videos
You can view more of Cranstoun’s naloxone and harm reduction videos on their site

It’s been incredibly refreshing to talk about keeping people who use drugs safe, and not having to focus solely on encouragement into abstinence or pushing them into recovery. 

naloxone kits being put togetherOne thing we did notice when we were doing the naloxone training in public with the peer team was that sometimes people were interested in naloxone but didn’t have time to do the full training. So Deb from our Sutton service, the PACKS peer team and myself designed a Z-CARD which would contain all the key naloxone training information that could be given to someone with a kit. We know that if they read it they’ll have all the information needed to use the kit successfully. 

Steve from the PACKS team came up with the quote we used – ‘I can’t save my friends, they’re gone. But you can save yours’. That always sticks with me and reminds me daily why we need to keep bringing harm reduction practice back. We need to bring care and compassion to the people who need it the most, wherever they are and whatever their need is.

Alistair Bryant is media and harm reduction content creator at Cranstoun.


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