Last summer, EuroNPUD worked with our UK partners to undertake a peer designed and delivered Naloxone Access and Advocacy Project to coincide with International Overdose Awareness Day
This page describes the Naloxone Access and Advocacy Project - On it you will find...
The Naloxone Access and Advocacy Project - Process and Findings Report; A detailed report on the practice, processes and advocacy aims of Naloxone Access and Advocacy Project in the UK.
Peer 2 Peer Distribution of Naloxone - (P2PN) A current look into a range of Peer 2 Peer naloxone projects around the global, in particular looking at Scotland & UK, MyanMar , United States, and Australia.
Peer 2 Peer Naloxone Distribution: Saving Our Friend’s lives! - A Technical Briefing. A Powerpoint presentation of the UK based Naloxone Access and Advocacy Project
A summary of the complete UK project (including links to blogs and pictures) -In 5 clear steps, find out how the project was delivered in the UK and read about the experiences of our UK peer partners in carrying it out.
The Naloxone Access and Advocacy Toolkit - A How To Guide Everything you need to know to start your own Naloxone Advocacy and Access Project (in production, check back soon)
Also see bottom of page for all resources - free but please credit EuroNPUD.
The experiences of our UK partners, the legal and local environs of naloxone distribution, and generating local naloxone advocacy.
BLOG: Our Peer Partners in Blackpool, UK - Area Coordinator Emma Daggers click image for more on their experience of the project.
Prenoxad: The naloxone kit available in the UK manufactured by Martindales -click image for Prenoxad website with all the HOW TO info you need to use naloxone in this 5 dose kit form.
BLOG: Peer Partners in Burnley, Area Coordinator: Peter Yarwood Click image for more info on project
Naloxone
There is a safe, fast acting, inexpensive and reliable antidote for opioid overdoses: naloxone. It has a long history of effective use as an opioid antagonist (i.e. it reverses the effects of opioids), effectively ‘bring a dying person back to life' in minutes.
The United Nations Commission on Narcotic Drugs (CND) has formally recognised the need to expand naloxone access to reduce overdose related mortality. Naloxone is also included in the World Health Organisation (WHO) Essential Medicines List.
The Naloxone Access & Advocacy Project - UK
“Any recognised drug service in the UK can now provide naloxone and volunteers or subcontractors can distribute from the service. However, UK opioid overdose rates continue to climb and naloxone coverage remains unacceptably low. ”
Members from Lancashire Users' Forum in BlackPool, having their focus group prior to their mystery shopping exercise.
The project included peer led focus groups, mystery shopping exercises around naloxone accessibility, advocacy briefings on the findings, next steps, and the benefits of peer 2 peer naloxone distribution, all held with local service delivery partners and peers. The milestone to complete the project by International Overdose Awareness Day on Aug, 31st 2018, was important in the life of this project as it helped to consolidate much of the urgency around completion, and promote the issue of overdose prevention and naloxone access and delivery. Each of the selected sites were chosen for their strong local peer leaders and for having strong peer forums/groups who had the requisite capacity, community links and professional connections in their area to take a project like this to completion within the short time frame of four weeks. This ensured it would coincide with International Overdose Awareness Day, 2018.
EuroNPUD went to Liverpool, Burnley and Blackpool in the UK, where overdose rates are some of the UK's highest, to find out more about why, and how to get naloxone out into the community -using a Peer 2 Peer access and delivery model.
Concerned that access to naloxone remains unnecessarily restricted, EuroNPUD utilised an educational grant from Martindale Pharma, an Ethypharm Group company, to undertake a project aimed at improving naloxone access and advocacy in the UK.
The focus of the project was to highlight the role of naloxone in responding to opioid overdose, to describe the existing response and barriers to accessing naloxone in the UK and to advocate for expanded peer-to-peer access to this life saving intervention.
EuroNPUD designed and coordinated the project, working closely with peer leaders from the 3 sites selected for the project; Burnley, Liverpool and Blackpool.
All three areas share double or more the national average of opioid overdose deaths and typify many of the wider issues that are associated with overdose and naloxone access in the UK.
BLOG: When Peer Partners met with area managers and commissioners in Burnley, UK (click on image to read about their own experience of the project)
BLOG: Peer Partners meet area commissioners and service delivery managers in Blackpool, UK -read all about it in their blog!
The Legal Environment for P2P Naloxone in UK
Since 2005, various amendments to the UK Human Medicines Act and regulatory exemptions have also sought to expand access to the lifesaving Naloxone.
In 2012, the Advisory Council on the Misuse of Drugs (ACMD) advised that Naloxone should be made more widely available as a way of reducing deaths from heroin overdoses.
Given the substantial body of international evidence regarding naloxone efficacy and safety, in 2015, the Human Medicines (Amendment) (No. 3) was amended to allow Naloxone to be supplied by: Persons employed or engaged in the provision of drug treatment services provided by, on behalf of or under arrangements made by one of the following bodies a) an NHS body; (b) a local authority;(c) Public Health England; or(d) Public Health Agency.
“Naloxone can now be supplied to anyone in the course of lawful drug treatment services [in the UK] and only where required for the purpose of saving life in an emergency.”
Prenoxad: A naloxone kit from Martindales Pharmaceuticals that is now available across the UK, having been especially developed for use by opiate users themselves (and their loved ones). EuroNPUD's own Stephen Malloy was instrumental in making this kit become a reality for opiate users up and down the country.
The above PreNoxad kit by Martindales is the predominant one available in the UK today. Naloxone P2P delivery - is essentially one trained opiate user training another in how to recognise an overdose and administer naloxone - and then giving them a kit like the one above - in a ten minute training exercise, monitoring data collection to record P2P outputs, scope and usability. EuroNPUD is developing a Naloxone P2P Technical Guide for peers everywhere. The UK research showed us that by being able to get it into the hands of our peers -out in the community - we can reach 10 times the amount of Naloxone distributred, than drug agencies alone. (See EuroNPUD Report below).
Resources for Use
NOTE: The Process Report and the Naloxone Access and Advocacy Toolkit are undergoing completion so please check back soon, however the Technical Briefing (slide presentation) and 5 stage Summary are available below. Free for use although we do ask that you credit appropriately.
NALOXONE ACCESS & ADVOCACY PROJECT (UK) SUMMARY BRIEFING
PEER 2 PEER DISTRIBUTION OF NALOXONE (P2PN) TECHNICAL BRIEFING
NALOXONE ACCESS & ADVOCACY PROJECT (UK) PROCESS & FINDINGS REPORT
NALOXONE ACCESS & ADVOCACY PROJECT -TECHNICAL BRIEFING SLIDES
The Naloxone Access and Advocacy Project’s Toolkit - A How To Guide is under is currently under development but please check backsoon, over summer 2019.
"EuroNPUD underscore the centrality of the involvement of people who use drugs; drug users must be regarded as the primary target group for naloxone distribution and administration. EuroNPUD believe that unless we prioritise peer access to naloxone, the roll-out of naloxone will remain sub-optimal and preventable loss of life will continue at this artificially high rate". EuroNPUD Naloxone Access and Advocacy Project Process Report, August 2018
Dedicated to Dan Bigg of Chicago Recovery Alliance
Dan Bigg, was an inspiration to thousands around the world and trained thousands of peers and professionals to use and carry naloxone, all over the world. Our project is dedicated to Dan, who died just 3 short days before the end of this project on 31st August 2018. We will carry your torch.
To donate to the Chicago Recovery Alliance in Dans’ Memory, please click here. To learn more about Dan and his incredible life’s work, click here,
During the implementation of this project, the international community of people who use drugs suffered a great loss in the passing of Dan Bigg, an award winning Chicago-based activist who undertook pioneering work on expanding peer-to-peer naloxone access. Due to Dan’s efforts, thousands of lives have been saved. EuroNPUD dedicate this project to Dan. The toll of this loss and every preventable overdose death continues to traumatise our community and confirms the importance and urgency of this project. To hear more about the Chicago Recovery Alliance, click here.
Thank You's to all who made this amazing project happen in just 6 short weeks!
With a huge amount of thanks going to the amazing area coordinators, Emma daggers, Peter Yarwood and Francis Cook along with all of the committed activists who shared their knowledge such as the peers in Glasgow doing Peer 2 Peer naloxone and Martin McCusker of Lambeth Service User Council taking naloxone into the community, where it belongs. Thanks also to all the peers that attended the focus groups and mystery shopping exercises. and a special mention to the members from Lancashire Users Forum and all the commissioners, service managers and interested parties that took the time to take part. This project displayed some terrific teamwork and smooth delivery to a tight timeline -thanks to EuroNPUD's own Stephen Malloy, Mat Southwell, Amy Massey and Erin O'Mara and Ruth Birgin in Australia.