DDN CONFERENCE 2024
STAND UNITED
The first session of Stronger Together explored how people could unite to address the ever-increasing risks from nitazenes and other potent synthetic drugs .
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2021 when I first joined Turning Point there was a series of overdoses from something that we all called ‘ iso ’, because nobody could pronounce it ,’ Turning Point ’ s national safer lives lead Deb Hussey told the morning session of Stronger Together . ‘ Maybe naively , we thought it had gone away .’
Isotonitazene hadn ’ t gone away , however , and by 2023 nitazenes had fully entered the UK ’ s drug supply . ‘ They ’ re being found in everything – they ’ re crossing genres ,’ she said . ‘ We don ’ t really know the statistics of how many people have actually died , so getting those effective messages out is key .’ Turning Point had begun distributing more naloxone and warning people , she said . ‘ And we kept warning them , until there were so many warnings that it just became white noise and people weren ’ t hearing them anymore . So how can we really get those messages across ?’
PRAGMATIC ADVICE It was decided that what was needed was ‘ really pragmatic advice ’ that was applicable no matter what drug the person was using , she said – and with the same message coming from all treatment providers . The organisation brought several other providers onboard , and made sure that everyone was posting the same messages on social media in the run-up to International Overdose Awareness Day . ‘ We knew these messages had been developed with people who use drugs , and we really thought they would land . But actually we were just talking to each other – not the people who really needed to hear this stuff . And the overdoses continued to happen .’
A survey carried out by the organisation ’ s Somerset service found that three quarters of respondents had witnessed an overdose , with more than half witnessing five or more . ‘ These were the people we needed to get sharing those messages , the people who could really have an impact ,’ she said . ‘ And we already knew what works .’ An ACMD review looking at a peer project in Wales had found that for 70 per cent of people receiving naloxone it was their first kit , and almost half were not in treatment at all . ‘ These are the people we need to be getting the harm reduction messages about nitazenes to .’
A fifth had even refused naloxone , she added . ‘ I don ’ t know why that is , but maybe it ’ s because of who offered it . Maybe if they were offered it by a peer they ’ d be more likely to take it . Is that going to be the same around advice for reducing the overdose risk from nitazenes ? I suspect it is .’
Her colleague Jude Duncan , however , had witnessed first-hand what happens when nitazenes get into the drug supply . ‘ We had 18 non-fatal overdoses hospitalised and four fatal overdoses in 24 hours ,’ she said . ‘ Nitazenes were linked to all of them .’ But the actual number of overdoses was likely to have been far higher , she told delegates – ‘ we were being told about people who ’ d been saved by their peers and weren ’ t going to hospital .’ On the streets that night with a homelessness outreach team she found people were ‘ shocked , stunned , worried , scared ,’ she said . ‘ What I saw was complete devastation and fear .’ It reinforced the vital need to ‘ work
alongside , and be led by – not do to – people ,’ she stressed .
MARKET VACUUM ‘ I was raised in the synthetic opioid crisis and I ’ ve administered naloxone 48 times ,’ said drug service coordinator at Release , Shayla Schlossenberg , who uses they / them pronouns . ‘ We ’ re two years into a Taliban ban on opium production in Afghanistan and the market reacted really quickly to that before the actual supply had been hit .’ The cost of heroin had risen and the purity had fallen , creating a vacuum for synthetic opioids and other adulterants to fill . ‘ So our drug supply is poisoned – not just heroin but benzo supplies and other opiate pill supplies .’ Nor was it just limited to nitazenes – there was also the synthetic non-opioid xylazine ( known as ‘ tranq ’ in the US ), along with fentanyl and its analogues .
‘ The number of people dying continues to rise , and half of these people are still not in contact with treatment . In England we don ’ t have a national naloxone campaign and we don ’ t have a click-and-deliver service .’ Coverage was piecemeal and dependent on your postcode and who was commissioned in your area , they said . ‘ And we don ’ t have a functioning early warning system .’
Drug-related deaths in the UK were already an emergency
6 • DRINK AND DRUGS NEWS • SEPTEMBER 2024 WWW . DRINKANDDRUGSNEWS . COM