Drugs 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 self-selecting 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