Naloxone is safe and easy to use. So let’s get lots more people trained up and carrying it, says Deb Hussey.
I’m passionate about service user involvement, so the DDN conference is always a highlight in my calendar. For this year’s conference I was delighted to showcase our Carry Naloxone co-production campaign alongside providing naloxone training to almost a hundred attendees.
Our Carry Naloxone campaign started back in 2021 after an international review highlighted the low numbers of people carrying a naloxone kit on a daily basis. Most overdoses are thought to occur with someone else in the room or nearby, making early intervention possible – but that person needs to have a naloxone kit. Alongside colleagues Jennifer Scott and Jo Kesten from the University of Bristol – and funded by Somerset Council – we aimed to develop a project to increase awareness and carriage of naloxone.
We started by running a short survey with people who use Turning Point services in Somerset, to see if the numbers reported in the 2021 study were borne out locally. The results were sobering – 87 per cent who responded said they had a naloxone kit but only 26 per cent carried one. Forty-six per cent had experienced an overdose, with more than half having overdosed between two and five times.
For this project to be a success we knew that we needed to actively involve the people we wanted to reach, and we recruited five people who were using our services to work alongside us as part of a co-production team.
We held our first focus group last summer. Recruitment had initially been challenging – people thought it was a tick-box exercise, that their opinions wouldn’t be listened to, and it probably wasn’t until the second group meeting that they began to see their ideas were being taken seriously.
That’s my favourite part of co-producing projects – the moment when you see people start to understand that their contribution has meaning. Entering this project, I fully expected that our focus would be on making naloxone easier to carry. That’s why it’s so important to come to the table with a willingness to adapt, and why people with lived experience should always be consulted in projects that affect them.
Ease of carriage was raised as an issue, but as the consultation progressed a larger issue emerged – stigma. The co-designers felt that carrying a naloxone kit identified them as someone who uses drugs, so the need to challenge public perceptions and normalise naloxone as a first aid medication became our primary objective.
Working with artist Michael Linnell, the co-designers’ ideas were developed into three posters – there’s also an app to direct you to the nearest naloxone supplier that can be accessed via a QR code on the posters, an idea from one of the co-designers. The app is currently only available in Somerset but we have a set of posters without the QR code that can be used nationally. Getting to showcase the posters at DDN’s conference was a great opportunity to introduce them to a wider audience.
At a concerning time for the sector with the increased overdose risk from synthetic opioids, this Carry Naloxone campaign is part of Turning Point’s wider commitment to increase naloxone training and carriage rates among family members, friends, people who inject drugs (whether they’re in treatment or not), and people working in services and across key parts of the public sector including health, housing and criminal justice.
At present, under the Human Medicines Act 2015, only those ‘employed or engaged in the provision of drug treatment services’ are able to issue the medication without prescription. While we wait for policy to shift, we’re doing all we can to develop more joined-up approaches and increase training and carriage rates across all groups.
Click and deliver
A new naloxone click and deliver service available through the Turning Point website launched on International Overdose Awareness Day in Somerset. This allows people to order naloxone kits online and have them delivered straight to their homes, and will be particularly beneficial for those who may be reluctant to collect a kit from the pharmacy. Following a trial period, we hope to roll the scheme out across Turning Point services nationally.
At one of our services, HMP Thameside in south-east London, as well as running drug and alcohol rehabilitation programmes, we train prisoners and prison officers in how to use naloxone. Seamus Tobin, Turning Point’s senior operations manager at the service, has been stressing the need for naloxone for prison leavers for almost a decade. Even if someone leaves prison and dies within six weeks, it’s still classed as a death in custody. After securing a six-month naloxone pilot through NHS England in 2020, the Turning Point team at HMP Thameside trained and handed out around 450 naloxone packs in that period.
The programme at HMP Thameside is now permanent thanks to funding from NHS England. ‘The people carrying the naloxone packs – it’s not their lives they’re going to be saving, it’s someone who’s using in their community and overdoses,’ said Seamus.
(Features September 2023): As Overdose Awareness Day approached, the millionth kit of injectable naloxone was distributed. DDN looks back at the story of this lifesaving intervention.
(Features February 2023): Turning Point hosted its first Safer Lives conference in Birmingham making a commitment to addressing the drug death crisis.
(News August 2023): An app to highlight places such as pharmacies and needle exchanges that offer free naloxone has been launched by Turning Point and Somerset Council.
(The DDN Conference 2023): Cranstoun’s Worcestershire service talk about their peer-led naloxone team, PACKS – ‘peer-assisted community knowledge and support’.