The continued increase in the rate of drug-related deaths in England , Wales and Scotland is a tragedy , not only for those individuals and families directly affected , but for the UK as a whole . Proactive responses are vital , and naloxone supply must be a crucial priority in efforts to reduce the death rate . At Change Grow Live , a key focus in our harm reduction work over the last five years has been increasing the availability of naloxone to those within structured treatment , as well as their family , friends , and wider network .
Naloxone penetration has accelerated since the onset of the pandemic – between 19 March and 21 July 2020 , we reached an additional 7,418 service users , meaning 70 per cent of our opioid caseload was in possession of a naloxone kit and efforts to expand our reach are ongoing . Our priorities for national naloxone supply are set out in our new Naloxone strategy for 2021 , and a key focus is reaching people who are not in structured treatment and are therefore at most risk .
The strategy identifies the need to prioritise naloxone supply and awareness in hospitals , prisons , homeless hostels / shelters , as well as within ambulance services and across regional police forces . Homeless hostels and pharmacies remain key allies in ensuring naloxone penetration within communities , and pharmacies also play a central role . Since 2015 , 19 per cent of the 3,768 kits that Change Grow Live has supplied to pharmacies have been used in an overdose situation , compared
We need to prioritise naloxone supply in high-risk settings if we ’ re going to properly tackle drug-related deaths , says Mohammed Fessal
BROADENING THE REACH
with 4 per cent of kits supplied to services and wider settings .
As part of efforts to reach high-risk groups , Change Grow Live has been running the first ever naloxone project within approved premises ( APs ). Formerly known as bail or probation premises , APs house high-risk individuals who have left prison . There are 101 APs in the UK , providing over 2,000 bed spaces , and more than half of deaths in APs are drug-related .
This project has resulted in the successful distribution of naloxone across over 40 per cent of the national network of APs and gives us confidence that , with the support of the relevant stakeholders , current gaps in provision can be rectified rapidly . Change Grow Live has worked closely with the National Probation Service to develop a comprehensive online training module , and this has now been rolled out across the 42 APs where we provide substance misuse services .
This training module provides clear , evidence-based guidance ,
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‘ My hope is that our new naloxone strategy provides a useful guide to where the gaps currently are , but also demonstrates ... that naloxone supply is not just possible , but essential .’
empowering staff to know when to use naloxone and to have the confidence to act fast . Feedback from staff shows beyond doubt that effective training , not just supply , is an essential component of successful implementation – staff want to help keep people
Naloxone kits issued by CGL services each year
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17618 safe , but the idea of administering a drug in a crisis situation raises multiple questions and concerns .
Since the project started naloxone has already been administered to reverse two potentially fatal overdose cases and the National Probation Service is now planning the roll-out of training and naloxone supply to the remainder of the AP estate . We are supporting this roll-out wherever possible , through the sharing of training resources and best practice , and the training module and approach to distribution is also informing ongoing projects with regional police forces in the West Midlands and Cambridgeshire and a planned national roll-out in settings managed by the Salvation Army .
My hope is that our new naloxone strategy provides a useful guide to where the gaps currently are , but also demonstrates to wider stakeholders working in high-risk settings that naloxone supply is not just possible , but essential . Navigating multiple systems and achieving buy-in from the gatekeepers of those systems is essential , but ultimately our strategy is calling for a joinedup approach founded upon a shared commitment to save lives wherever possible . The more that our sector can demonstrate the immediate benefits of naloxone provision in new settings , the quicker we will be able to fill the current gaps in provision .
Change Grow Live ’ s 2021 Naloxone strategy is at www . changegrowlive . org
Mohammed Fessal is chief pharmacist at Change Grow Live
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