The day saw repeated calls for life-saving, and cost-effective, naloxone to be made more widely available.
‘The case for take-home naloxone is quite clear,’ activist Kevin Jaffray told the morning’s Naloxone – keeping up the campaign session. ‘So why isn’t it in the hands of the people who need it?’
While take-home naloxone programmes in Scotland and Wales had led to a fall in opioid-related fatalities, England saw a 32 per cent rise in deaths in 2013. ‘That’s because we have no national programme,’ said Jaffray. ‘It’s disgraceful. I’m not saying it’s a magic wand, but the fact is we could have saved at least half of these people.’
Naloxone had ‘been around since 1961’ he told the conference, and endorsed by the WHO, NTA and ACMD, among many others. ‘This medicine saves lives,’ he stated. ‘So why are we still having to fight?’ Many of the arguments against naloxone – that it encouraged people to take more drugs, or deterred them from seeking support – were myths, he said.
‘The arguments that come up time and time again when we’re campaigning in local areas are comical. Naloxone will bring people into services, not the opposite.’ In fact it had the power to act as a turning point in people’s lives, he stressed. ‘When I OD’d and was brought back by naloxone, I accessed services. Because it scared the shit out of me.’
An overdose situation could add up to £20,000 per person in costs to the emergency services, while an overdose prevented from becoming fatal by naloxone cost around £400. ‘Not only is that a £19,600 saving, you’ve still got a human being breathing and a family kept together,’ he said. ‘We want the Medicines and Healthcare Products Regulatory Agency (MHRA) to publish draft regulations on naloxone now, and we also want Public Health England to be more active in local direction around take-home naloxone programmes.
‘We have to work with what we’ve got,’ he told the conference, which meant user activism was vital. ‘You’re out there on the frontline. Form naloxone action groups in your local area, get trained and pass the training on in whatever capacity you can. Lobby your local commissioning boards, MPs and health and wellbeing boards. Anywhere you can get this out there, do it.’
Take-home naloxone guidance had just been published by PHE, Rosanna O’Connor told the conference. This would act as a ‘nudge to local authorities and partners’ to promote wider availability in advance of the change to medicines regulations – which currently only allow naloxone to be supplied on a prescription basis – expected in October.
Meanwhile, the lunch break saw an Action on naloxone session chaired by Niamh Eastwood of Release and Mat Southwell of CoAct, looking at what could be done to challenge lack of availability. Delegates were handed a list of local authority areas that were not providing naloxone – a substantial number.
‘How far is it being rolled out?’ asked Niamh Eastwood. ‘It looks like even in a number of areas where they’re saying “yes, we’re providing it” they’re not doing it sufficiently.’ And for those local authority areas that had stated they were not providing it, she said, ‘we need to find out why. Whose decision is this? There’s no reason why it shouldn’t be available. It’s cheap, and it saves lives’.
Release now intended to challenge non-provision through legal action, she stated. ‘We need to find someone for a test case, and then what we can do is look at taking a judicial review. There’s no guarantee we’ll win, but it’s one of the ways we can push the boundaries on this. There are very strong right-to-life and human rights arguments here. People who use drugs have been stigmatised for years. This approach of taking legal action is one way of giving people a voice again.’
The day also saw naloxone training delivered by outreach worker and activist Philippe Bonnet. ‘The turnout was fantastic,’ he said. ‘I showed how you can train people very quickly, so those people can now go out into their communities and spread the message.
In terms of those areas not providing naloxone, the vital thing remained perseverance, he stressed. ‘Identify champions and knock down doors, and make use of the service user groups and advocacy groups that can do that on your behalf. But absolutely, don’t take no for an answer. One thing’s for sure – it’s not rocket science.’
PHE’s advice for local authorities at www.gov.uk