HARM REDUCTION
Reaching out
Now that naloxone is
officially ‘out there’, CGL are
among those searching for
the people most in need of it.
DDN reports
uy Phillips is preparing for his nightshift as an outreach worker in
Newham, east London. In his rucksack he will carry needles, a
first aid kit, condoms, information leaflets – and four naloxone
kits, plus a training kit. His mission is to give naloxone to
‘anybody that needs it’ and to offer friendly advice and a route to
further help.
Phillips is employed by CGL but coordinates his shifts to do joint outreach with
East London NHS Foundation Trust and homeless charity Thames Reach, to find
the people in most need.
‘I’ll have my lists of people I want to see and they’ll have their list of people
they want to see, so we’ll form a plan before we go out,’ he says.
Shifts vary to try to cover all hours within a fortnightly period, and can be as
early as 4am to 8am. Many of those they will be trying to reach will be rough
sleepers ‘who might be walking around, about to bed down somewhere’; others
will be tuned into the night-time economy – sex workers, who don’t keep hours
that fit in with regular drug services.
Some of the people they meet are glad of a friendly face and interested in
hearing about naloxone – particularly if word has already reached them of this
life-saving drug. Others are more difficult to engage – the sex workers for
example, who may be earning £400 a night, can buy as much heroin as they
want, don’t need methadone, and can’t see the need to talk to a drugs worker.
Looking at those most at risk, ‘It’s difficult to say who’s most likely to
overdose, but imagine the effects of rough sleeping on people, in terms of being
out in the cold and not having the facilities we normally have, plus the likelihood
of having a lowered immune system,’ says Phillips. So the night’s schedule
focuses on rough sleepers.
‘I’ll ask them if they want to have naloxone, and if they say no, I’m going to
have to persuade them it’s a good idea,’ he says. He might get the reply ‘I’m only
smoking’, and will have to dig deeper to find out if they are taking anything else.
‘Most people who die of overdose die because they’ve used more than one
substance – and each drug can multiply the effect of the other substance,’ he
says. A brief chat will often reveal they are taking ‘all sorts of drugs at all sorts of
times – methadone, buprenorphine, alcohol, anything that suppresses the
central nervous system’.
Then there’s ‘quite a bit of persuasion to do, because people think they don’t
necessarily need naloxone, and I have to explain that they do’. When he’s got
their attention, Phillips runs through what an overdose can look like and what
can happen throughout the course of it.
G
14 | drinkanddrugsnews | November 2016
www.drinkanddrugsnews.com