In recent years we’ve seen a rise in drug related deaths across the globe, but what if we could be doing more to prevent such tragedy? Two people working on the frontline of the war on drugs and trying to prevent drug-related overdoses are Kirsten Horsburgh and Nigel Brunsdon.
Kirsten Horsburgh – the National Naloxone Coordinator at Scottish Drugs Forum – is a mental health nurse who holds responsibility for the coordination of the Scottish Government’s National Naloxone Programme.
What exactly is naloxone?
Kirsten Horsburgh: “Naloxone is an essential component of any overdose death prevention strategy. It is an extremely safe medication that is administered by injection to people who are experiencing a suspected opiate overdose. In an overdose situation, where someone is experiencing respiratory depression, it can be a life-saver. Its only function is to reverse the effects of opiates, restoring the person’s ability to breathe. It does not induce any kind of intoxication”
What’s the history of this life-saving drug?
“Naloxone has been around and used in clinical settings for over 50 years now however, since the late 90s, in some countries it has been provided to people who use drugs to be peer administered. Rates of drug-related deaths continue to rise and the majority of these deaths involve opiates. Tragically, and appallingly, the overwhelming majority of these overdose deaths are accidental and therefore preventable. Despite this, the availability of take-home naloxone is not always widely available to people most likely to witness an overdose.”
Kirsten also draws attention to the importance of an inclusive dialogue, taking care to reach everyone that could be faced with an overdose:
“Alongside other evidenced-based interventions to reduce overdose fatalities, the provision of naloxone - which incidentally is an inexpensive medication - should be a core element of overdose prevention training delivered by all drug services, we also need to include those at risk of overdose and their families.
“In 2005 in the UK, naloxone was added to a list of medications that can be administered by anyone for the purpose of saving a life. Stigma and discrimination towards people who use drugs is an obvious barrier. I cannot imagine us having this conversation about any other life-threatening scenario when an antidote is available at low cost.”
Who should be included in the awareness of Naloxone and its practical application?
“People who have seen naloxone being administered are fantastic advocates, and their experience should be harnessed. Peer educators should be supported to deliver training and broaden the reach of naloxone programmes, and training should not be limited to drug services. All services that come in to contact with people who use drugs should be informed – police, ambulance service, GPs, prison staff, social workers, hostels, homeless services...the list goes on.”
Where do we go from here? How do we continue raising awareness to this relatively inexpensive, easy administered, life-saving drug? Kirsten concludes,
“There is much work still to be done. Despite radio campaigns, media input, national conferences, local events and social media presence, it is important that we do not become complacent and ensure that naloxone remains firmly on the agenda. There are not many opportunistic interventions that we can provide to people that can literally save their lives.”
Whether it’s themselves, family members, or their respective social circles, making sure naloxone is accessible is an area that Nigel Brunsdon takes a big interest in. As Director of Injecting Advice, and Deputy Chair of the National Needle Exchange Forum, Nigel is well placed to spot just how important naloxone is to the national and international conversation around drug overdose prevention, so where do we go from here?
Nigel Brunsdon: “We need to ramp up supply of naloxone. We currently have the highest levels of opiate deaths for the fourth year running, so the risks for people using opiates are greater than ever. Now that we have the added risks of the drug fentanyl popping up in the supply chain we really need to start being more proactive in making sure that there is enough naloxone in the community - that means supplying people with multiple kits and helping peers to be supplied as well.”
Currently, who has access to naloxone?
“Over the last few years we've increased awareness of the existence of naloxone. And the number that keeps getting shared is nine out of ten areas in England have naloxone programmes, but what isn't clear is the extent of those programmes and the restrictions that they place on who can be supplied, without some kind of formal national programme we may never know.”
As Nigel concludes, there is another reason why we need to have this conversation.
“Naloxone is also important because it shows a heavily stigmatised group that it matters if they live or die, the easy availability of naloxone could encourage people to engage with services at a far earlier stage as well as helping them gain a level of control over their own and their peers risk levels.
“Over the next year or two we are likely to see alternative routes of administration for naloxone becoming available in the UK, including nasal naloxone that may be more attractive to family members who would feel nervous around injecting someone. Naloxone is a powerful tool for us to save people’s lives and to show people they matter.”
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