rugs were changing rapidly and overdoses were rising – there was no time to lose . The ‘ Stayin ’ Alive ’ plan came about from the passion and frustration of a group of individuals , transcended treatment services and ‘ came from a genuine place of care and concern ’ ( DDN , November 2023 , page 6 ).

At a breakout session at Cranstoun ’ s conference , three of the group – Maddie O ’ Hare from HIT , Chris Rintoul from Cranstoun and Deb Hussey from Turning Point gave their perspectives on progress .

‘ After recovery had been prioritised in services , it was more difficult to talk about harm reduction ,’ said O ’ Hare . ‘ So it was important to have a united front . The campaign had to happen because of nitazenes but we knew we couldn ’ t change anything without a bit of tension .’

‘ The conversations on Twitter were about ways of mitigating risks ,’ said Rintoul . ‘ It became a conversation – what messages would work ? Lynn Jeffries of EuroNPud came up with simple messages , and we elaborated on

these . We knew that a proportion of people die alone at home . But we can ’ t say with any certainty where people are going to be when an overdose occurs .

‘ So the group focused on the need for making a plan , which has to stay with you – and this was the basic concept of ‘ Stayin ’ Alive ’. It was developed with people who use drugs , particularly those using alone . What can you do ? What can you put into practice ? The ideas were theirs but could apply to anyone .’

‘ This was happening , people were dying – so we gravitated towards people who understood what was going on ,’ said Hussey . Another important result from the campaign was the added intelligence available to participants ’ own services to enable them to focus on supportive action – ‘ as my organisation has seen stuff come together , there ’ s been a shift towards harm reduction ,’ she said .

The group fully endorsed the value of working as a selfselecting group , ‘ especially with people you trust and like ’. The common purpose was much more likely to succeed , they agreed , and it felt like a hub of

creative individuals coming up with ideas .

There was plenty to do – feeding back on the overdose campaign , more work on nitazenes , and a piece of work on ketamine .

‘ People think they can ’ t make a difference ,’ said Hussey . ‘ For us in services , we need to inspire our colleagues – we have a responsibility to make our services responsive . We need to lead by example and make a lot of noise .’

ON MOVING FORWARD …

‘ The Welsh Government has given approval to nitazene checking machines . Don ’ t forget Wales ; we can each do things the others can ’ t . Martin Blakebrough , Kaleidoscope

‘ If we ’ re going to do something meaningful , we need to push the envelope .’ Peter Krykant

‘ It ’ s too medicalised – in Scotland the consumption rooms are NHS led and cost a lot . But every needle exchange should be able to offer a room – it ’ s about moving away from risk .’ Martin Blakebrough , Kaleidoscope

ON INCONSISTENCY ….

‘ In London , you can get same day prescribing in one borough but wait four weeks in the next . And how can we support each other to call out clinicians who are putting people on subliminal doses ? We have a crisis on our doorstep . What can we fix now ?’ Niamh Eastwood , Release

‘ Working in hostels we struggle to get a roof over people ’ s heads .

We need more opportunity for collaboration and shared delivery .’ Delegate

ON NALOXONE …

‘ The message is getting skewed – we ’ re getting them breathing , not bringing them back to consciousness .’ Deb Hussey

‘ Has there been any conversation about providing oxygen ?’ Lynn Matthews

‘ Naloxone works but it ’ s not something everyone wants – it can lead to miserable withdrawal . Oxygen is under used , under explored and over regulated .’ Chris Rintoul

ON HARM REDUCTION …

‘ Harm reduction can be seen as just naloxone and a few pins . But it should span all areas .’ Chris Rintoul

‘ It ’ s difficult to give harm reduction information to children and young people in case you ’ re seen as encouraging them .’ Delegate

‘ Schools are not the only way to deliver harm reduction . Social media offers a plethora of ways to get messages around .’ Maddie O ’ Hare

‘ How does harm reduction keep up ?’ ( Question sent from Anna Millington )

‘ By holding people to account ; by being a thorn in their side .’ Maddie O ’ Hare