’ ve created an underclass ’, said George Charlton , who works across the UK developing peer-to-peer naloxone training and supply programmes . Media headlines about ‘ junkies ’ had caused a disconnect between ‘ some of the most socially excluded and disenfranchised people in our communities ’ and the general public , he said . ‘ People who do care for drug users are other users , which is why peer-led projects are so important .’

Drug-related deaths were ‘ needless and avoidable ’, he stated , and the most important people he worked with were those with ‘ lived and living experience of addiction ’.

‘ The best way to get this out into the community is for drug users to go into the community .’

LEE COLLINGHAM

Naloxone provided a ‘ wonderful opportunity to keep people alive . It ’ s not the whole solution , but it ’ s part of the solution .’

PRIVILEGED ACCESS One of the key strengths of peerto-peer naloxone programmes was that people who use drugs have privileged access to drugusing venues , supply systems and markets , he said – ‘ they have instant trust and credibility .’ However it was vital to ensure that all organisations involved in a project were ‘ fit for purpose ’, he stressed . ‘ We won ’ t recruit any peers until we ’ ve made sure that we ’ ve addressed any of the bureaucracy that could get in the way ’, with everyone needing to be fully aware that lived experience often meant active drug use . ‘ These aren ’ t recovery projects , they ’ re harm reduction projects .’

Community mobilisation involved asking people to ‘ own and be part of ’ the projects , which often meant building trust as many had been let down in the past . ‘ As providers , we have the assets , the naloxone , the governance , the frameworks for peers to work within – the rooms , the teas , the coffees , the expenses . Let ’ s give them access to all of that , and let ’ s give them the project . Let ’ s see what the peers are doing with our support , not what “ our ” project is doing .’

‘ The best way to get this out into the community is for drug users to go into the community ,’ agreed Nottingham-based harm reduction activist and longtime DDN associate , Lee Collingham . ‘ Unfortunately , the other side of my work is seeing drug users being exploited and not being paid for the work they do .’

‘ We firmly believe that we cannot continue with this process of only having peers on

a voluntary basis ,’ stated Kirsten Horsburgh , who leads SDF ’ s work on drug-death prevention and is coordinator of Scotland ’ s national naloxone programme . ‘ We absolutely need to drive home the importance of paying peers for the work they ’ re doing – it ’ s utterly crucial .’ Criminal record checks could be an unnecessary barrier for many of those eligible for doing the work , however , and while services were often able to work around this it still needed to be urgently addressed .

Scotland ’ s drug death situation had been described as a ‘ public health emergency ’ for many years without the major action to address that , she continued . ‘ And then something like COVID comes along and you see how quickly things are put in place when a public health emergency is taken seriously – immediate access to resources , changes to practice , fasttracked law changes , all the things we really require for addressing the drugs death crisis .’

PROGRESSIVE The country ’ s naloxone programme had been in place since 2011 , however , supplying more than 100,000 take-home kits . ‘ Scotland has been fairly progressive in a number of areas around distribution ,’ she said , despite legal restrictions , and with a national awareness campaign in place since August ( DDN , September , page 4 ). ‘ The focus for the campaign we were commissioned by the Scottish Government to deliver is about a wider societal response ,’ not just targeting people who use drugs or their families – ‘ every single person can do something .’ More than 30,000 people had visited the Stop The Deaths website in ten weeks , with much of the feedback – especially from family members and

‘ People who do care for drug users are other users , which is why peerled projects are so important .’

GEORGE CHARLTON

people who use drugs themselves – emphasising that ‘ just seeing that on such a public platform , on mainstream TV and across the country , was really powerful – that recognition that these lives matter .’

In the first year of Nottingham ’ s naloxone programme ‘ we spent less than £ 2,000 and over 100 overdoses were reversed ’, said Collingham . ‘ That ’ s 100 families that still had loved ones .’ As one of the faces of the national naloxone billboard campaign ( DDN , May , page 12 ), he was able to choose his own message to go alongside his image . ‘ As someone who ’ s carried both it was clear to me that carrying naloxone is easier than carrying a mate ’ s coffin . Let ’ s have our loved ones at home , and let ’ s carry naloxone .’ DDN www . stopthedeaths . com

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