Be prepared! Train with naloxone

pulse-main-600x400Train your staff to empower service users with life-saving naloxone, says David Swain

In the 1838 report to the House of Commons on causes of death, the coroners in England and Wales for the preceding year recorded that a third of all deaths were shown to be attributable to laudanum and other opium preparations. These were either by accidental overdose or substitution for another medicine, and needless to say, caused a ripple of concern among politicians.

In 2014 the Office for National Statistics recorded a total of 3,346 drug-related deaths across England and Wales, 1,786 of which were attributable to opiates and which sadly represented an increase from the previous year. However, the figures for Wales revealed a slightly different story, with drug-related deaths in Wales falling by 16 per cent from the previous year.

Why were things different in Wales? The reasons might include a greater acceptance of harm minimisation as the first step to recovery, thereby encouraging users not yet ready to embrace abstinence to engage with services. However, one major factor has undoubtedly been the national take-home naloxone (THN) scheme. Started in 2011, it has systematically trained service users, their families and professionals (such as hostel staff) to identify signs of opiate overdose, apply basic life support and administer intramuscular naloxone. Its take-up has been huge and THN is now an established part of the Welsh treatment landscape. Its ethos continues to be, in the words of Sarz Maxwell, consultant psychiatrist in Chicago, a desire to ‘flood the streets with naloxone’.

Of course, there are always naysayers: ‘Surely naloxone will encourage users to engage in more risky behaviour knowing that the antidote is available?’ There is no evidence that this is the case. ‘What if they give it to someone who isn’t in opiate overdose?’ In the absence of an overdose, the medication is inert. ‘Aren’t we just condoning drug use?’ Oh, please.

If handing out naloxone challenges the sensibilities of some, let’s look at what we’re achieving. Of course there is the obvious gain in lives saved, but there’s the sense of control being handed back to people who feel they have none, and the power to save a life.

Gearing up services to be able to train clients and their families to understand and be able to use naloxone is a simple matter, but it requires trainers who are able to deliver properly. Pulse Addictions provides take-home naloxone training for staff, either as a standalone session or as part of its course on risk management in substance misuse. This comprehensive training will enable staff to empower their clients to respond in emergency situations, reducing the tragedy of drug-related deaths.

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