Local authorities failing to provide sufficient naloxone

The amounts of naloxone being provided by local councils and prisons are ‘extremely limited’, warns a new report from Release. While all but three of the 152 local authorities who responded to Freedom of Information requests now supply the overdose-reversing medication – up from 90 per cent a year ago (DDN, February 2018, page 4) – the amount being dispensed is still ‘drastically insufficient’, says Release.

Zoe Carre from Release: ‘This life-saving medication is not reaching those who most need it.’ (pic: Nigel Brunsdon)

Just 16 take-home kits were provided for every 100 people using opiates in 2017-18, equating to 16 per cent coverage, with many areas also failing to provide kits to ‘key populations most likely to experience or witness’ an overdose. Almost 60 per cent failed to provide kits to clients accessing opioid-related treatment or services at community pharmacies, a quarter did not provide them to people in contact with outreach services for homeless populations, and more than 10 per cent failed to supply them to families and friends of people who use opioids.

While Darlington was the only local authority in England that did not report either having a take-home programme or plans to introduce one, low levels of coverage elsewhere were ‘particularly shameful’ given record rates of opioid-related deaths and the fact that naloxone is ‘cheap to acquire and has no potential for misuse’, says Release.

Many prisons were also failing to provide naloxone despite the acknowledged high risk of overdose in the first two weeks after people are released, the report says. Just over half of the 109 prisons that reported on take-home naloxone had a programme in place, and only one in five young offenders institutions. Failing to provide kits to people upon release meant that prisons were not fulfilling their duty of care, the charity states.

Release is calling for each authority to provide at least one kit to every person in the community using opiates, as well as making kits available to anyone else who requests them. People not in contact with treatment should be able to easily access naloxone through distribution points like community pharmacies, GP surgeries, ambulance services and peer networks, it adds, while every adult prison should also offer kits and training to everyone prior to release on an ‘opt-out’ basis.

‘There is a crisis of drug-related deaths in this country and many local authorities are failing to protect people from fatally overdosing on opioids,’ said policy researcher at Release, Zoe Carre. ‘The amount of take-home naloxone given out nationally has been abysmally low. This life-saving medication is not reaching those who most need it. People who use drugs are an extremely stigmatised group in society, facing significant health risks which are exacerbated by the government’s ideological abstinence-focused approach to drug use. If any other group of people were needlessly facing barriers to accessing a cheap and effective life-saving medication, there would be widespread public outrage.’

Meanwhile, the number of men dying from drug-related causes in Northern Ireland has doubled in a decade, according to figures from the Northern Ireland Statistics and Research Agency (NISRA). More than 100 of the 136 drug-related deaths registered in 2017 were males, compared to 51 in 2007. Female drug-related death rates have remained unchanged.

Finding a needle in a haystack: take-home naloxone in England 2017/18 at www.release.org.uk

Drug-related deaths and deaths due to drug misuse in Northern Ireland 2007-2017 at www.nisra.gov.uk