International Overdose Awareness Day 2018: Blog from APCC Drugs Lead on using naloxone to #EndOverdose
International Overdose Awareness Day is an annual event held on 31 August to raise awareness of drug overdose and prevention, and to commemorate all the lives lost to an overdose.
PCC Hardyal Dhindsa, APCC Lead for Alcohol and Substance Misuse, shares his thoughts on our responsibility to put reducing drug-related deaths at the heart of the policy response to serious drug misuse:
On International Overdose Awareness Day, bereaved friends and families, drug support workers and communities around the world come together to remember those who lost their lives to an overdose, to tackle the stigma against those who have died in this tragic way, and to work together to prevent further deaths.
The grief of everyone who has lost a loved one will be particularly hard to bear today, and my thoughts are with them. Many frontline workers in public services will recall people they have met, helped and lost to drugs; many police officers will look back on those heartbreaking times they have come across someone when it was too late to help.
The latest figures on drug-related deaths in England and Wales highlight the true scale of the problem; 2,310 deaths from overdoses in 2017 alone. The comparisons are stark. More people are dying from drug overdoses than die in road traffic accidents, more than twice as many as are murdered in Britain, and more than ten times as many as there are victims who lost their lives to knife crime.
Every one of these fatal overdoses is a terrible and preventable tragedy. It is incumbent on everyone involved in shaping the policy response to drug misuse, both locally and nationally, to put saving these lives at the heart of what we do.
More than half of the overdoses in 2017 involved opiates, and they have been critical in driving the increase in drug-related deaths over recent years. The increased threat of super-strength opiates such as Fentanyl and Carfentanyl, which can cause an accidental overdose even for those with a higher opioid resistance, further highlights how providing an effective first response to these overdoses is only going to get more important in the coming years.
A key tool to preventing these deaths from overdose is the opioid-suppressant naloxone. This drug is used to inhibit the effects of opiates, such as heroin and morphine, and can stop an overdose in its tracks, providing a crucial window for getting medical assistance to the patient.
There is little doubt about the safety and effectiveness of naloxone in an emergency. It has been listed by the World Health Organisation as an essential medicine, and is recommended by health experts at the Advisory Council for the Misuse of Drugs and Public Health England on the basis of the difference it has made and the lives it has saved both at home and abroad.
That is why the Government supports extending the availability of naloxone, through drug treatment services and elsewhere, and so do I. This can be done by maximising our impact with hard-to-reach communities through existing channels, such as hostels and shelters, and by exploring new avenues such as police custody suites.
The guiding principle has to be to that we need to meet people using drugs where they are, not where we think they should be. This is vital for ensuring this emergency response reaches people at risk of overdose in time to save their life.
Naloxone is increasingly being used by enforcement agencies in the United States to prevent loss of life from opioid overdose. This has been helped by the introduction of intranasal naloxone; a nasal spray application of naloxone, which has more commonly been administered by injection.
In the UK, discussions are underway around the potential of the intranasal naloxone spray here, and I am keen to explore how this approach could help to save lives as well as allaying the reservations of some about the use of this medication.
It is my view that the option of providing naloxone to police officers needs to be on the table for these discussions. We should be doing everything we can to make sure we don’t get to the stage where people are suffering overdoses, but we also need to make sure that the first person who finds them is able to administer that emergency response which can save their life. Police officers have always been on the frontline of public crises, and policy makers need to make sure they have the tools to protect the public. In cases where time is critical, this can mean ensuring that every first responder has access to the necessary life-saving equipment, including police officers.
I know that operational representatives have raised concerns about this in the past. I will be reaching out to meet with the Police Federation to begin the process of talking through these concerns, as we need to ensure that police officers on the frontline are comfortable with the approach. There will also be questions about how we can practically facilitate the training to administer naloxone, and where the funding will come from. However, now is the time to be having these discussions and it is my hope that the shift towards using a nasal spray in the UK can be an important step change.
At the end of the day we all want to help those who are in danger or vulnerable. That is why I will be working closely with my opposite number in the National Police Chief’s Council, and my counterparts across the policing family and the drug treatment sector, to take this forward.
This isn’t about pretending that providing naloxone to police officers is a silver bullet. There are many necessary ingredients of an effective response to drug misuse; we need policies aimed at prevention as well as treatment, and delivering harm reduction as well as recovery. The common needs of those vulnerable to drug overdose, including housing, mental health support and a welcoming community, needs to be provided for, and any strategy will falter if we don’t have a strong and responsive drug treatment system.
However, we owe it to the people we represent to explore measures that could reduce the appalling high numbers of drug-related deaths. That is our responsibility to everyone grieving today, and I will do all I can to put them front and centre of our debate on naloxone provision.
The NHS Substance Misuse Provider Alliance has produced a blog outlining what to do if you think someone has overdosed, which can be accessed here.
For friendly and confidential drugs advice on drugs, you can Talk to Frank.
If you live in England, a service directory can be accessed here to help you find support and treatment services in your area. If you live in Wales, the Dan website provides information on available services here.