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Five things we did to help more people carry naloxone

Putting naloxone at the forefront of everything we do has saved lives

Image via Flickr.

By Caroline Liney, Operations Manager at Addaction Cornwall

The opioid overdose reversal drug naloxone saves lives. It’s vital that anyone who’s at risk of overdose, or who interacts with people who are, carries naloxone and is trained in how to use it. But during 2017 and early 2018 people who used Addaction’s services in Cornwall were much more likely to reject carrying the drug than accept it.

Since then we’ve ripped up our old methods. We’ve put naloxone at the forefront of everything we do, resulting in our highest acceptance rate ever. Based on what we learnt along the way, here are our five tips for any drug treatment service looking to do the same.

Naloxone offered and accepted (blue), offered and declined (red)

Make people opt out rather than opt in

Previously we treated naloxone as an added extra to treatment. Staff would ask clients and family members questions like, ‘would you like naloxone?’ or ‘would you like naloxone training?’.

Now anyone who’s at risk of an opioid overdose, or knows someone who is, is given naloxone when they interact with us. Staff say, ‘here’s your naloxone and this is what you do with it’, rather than waiting for some to ‘opt in’. Recently, a staff member joked that our slogan should be — ‘naloxone, naloxone, naloxone’- a testament to how it’s now an essential part of our service.

Shorten the training and reduce the paperwork

Naloxone isn’t complicated to use, however, people need to complete a brief training session before they’re able to carry it. If someone said they wanted naloxone training we used to book them a slot to come back and receive it. But, for whatever reason, a lot of people weren’t returning.

Now staff give the demonstration to people on the spot, covering key advice such as how to recognise an overdose and how to open and administer naloxone. They also incorporate the tear-off leaflet which reminds people how to administer which is covered in picture and word form. We also streamlined the paperwork so staff have more time for practical work and clients can take a naloxone kit and get on with their day.

Appeal to people’s sense of community

Some of our clients are slightly offended when they’re offered naloxone. They often haven’t used an opiate besides buprenorphine or methadone for years. They’ve distanced themselves from drug using communities and can feel the offer implies they’re likely to relapse at some point. For them, accepting naloxone can feel like an admission of failure.

Instead, staff ask them to imagine walking down the street and seeing someone who’s overdosed. Questions like ‘wouldn’t it be great if you could save their life?’ helps reframe naloxone as a way of helping the community.

Be proactive

One huge lesson we’ve learnt is don’t wait for people to come to you. We used to hold events where people would receive naloxone training in groups, but this wasn’t bringing many people through the door. Cornwall is a huge geographical area so people often struggle to travel long distances to events.

Now we focus our efforts on promoting naloxone in every interaction rather than waiting for people to come to us. This applies to people both inside and outside of treatment. For example, the staff who run our outreach needle exchange program tell everybody who phones up about naloxone and they’re able to pick a kit up with their needle pack.

Make sure naloxone is in people’s homes

We know that a lot of overdoses take place in people’s homes. Yet many housing projects don’t have naloxone onsite. So we’re developing relationships with multiple housing projects, training staff and making sure they always have naloxone on site in case of an emergency.

We also make sure that client’s next of kin are always offered naloxone as they’re often the first people to respond to an overdose. This offers another layer of protection and also helps normalise naloxone. Reading through client notes and seeing incidents where family members have used it to save someone’s life makes it all worth it.

As told to Nye Jones

If you or someone you love needs help or support, reach out. You can chat to a trained advisor at addaction.org.uk.



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