Naloxone

The need for increased availability

and accessibility in England

“In October 2015, legislation is expected to

be enacted that will allow wider access to

naloxone. But this should not delay the

provision of take-home naloxone to at risk

individuals now, using existing provision for

prescriptions and PGDs…”

Take-home naloxone for opioid overdose in people who use drugs

Public Health England

Who are NAG?

The Naloxone Action Group is

made up of a number of agencies

and individuals who have come

together to promote the wider

availability of naloxone in

England.

Scan this to visit

For more details:

nagengland.wordpress.com

What is naloxone

Naloxone is a medication

that reverses opiate

overdoses (eg heroin,

methadone or prescription

pain medications)

– Prescription only

– Safe to use

– Injected or intra-nasal

use

Why we need naloxone

There has been a 32% rise in UK heroin and

morphine related deaths

765 deaths in 2013

Monthly ambulance call outs in London responding

to heroin overdoses

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Heroin Overdoses Linear (Heroin Overdoses)

Source: http://data.london.gov.uk/dataset/monthly-ambulance-service-incidents-borough/resource/d1fdc814-fa13-4bda-b4f7-f258afd2b3b3

“New figures show the East Midlands Ambulance

Service's use of Naloxone has increased by 73 per

cent in the last four years, with bosses saying the

drug is now saving hundreds of lives.

Paramedics used the life-saving drug on around

1,340 patients in the last financial year – a

significant rise from an estimated 978 four years

ago.”‘Miracle drug’ is a growing lifesaver

Nottingham Post, 10 May 2014

Does take-home naloxone reduce

non-fatal overdose?

53%

15%

32%

Prevalence of overdose in injecting drug users

Not overdosed

Overdosed in thelast year

Overdosed butnot in the lastyear

N= 661

• Of those who had overdosed in the past

year, 85 disclosed how many times: once

(44), two times (26), three (seven), four

(two), five (two), six (one), seven (one),

eight (one), and 12 times (one): a total of

168 survived overdoses.

• For the 308 most recently survived opiate

overdoses, naloxone was given by

paramedics (58), by non-paramedics

(49), or by both (6)—ie, in 113 out of 308

overdoses.

• 284 of 308 respondents disclosed

whether they were alone at the time of

their most recent overdose: 245 were

with someone else.

Does take-home naloxone reduce non-fatal overdose? Bennett, Trevor et al. The Lancet , Volume 383 , Issue 9912 , 124 - 125

Naloxone is just part of a response

Naloxone is an addition

to a greater set of

overdose interventions,

you should still:

– Check ABC

– Dial 999

– Stay with them

Why do it?

Potential 100s of lives

can be saved

Prevents brain damage

in non-lethal OD

Reduces stigma

Keeps OD a priority

Engages at risk groups

“People likely to witness an opioid overdose

should have access to naloxone and be

instructed in its administration to enable

them to use it for the emergency

management of suspected opioid overdose.”

Community management of opioid overdose

World Health Organization

1. Prescribe or issue naloxone via PGD(Patient Group Direction) or Patient Specific Direction (PSD) for everyone who uses opioids or is at risk of relapse to use of opioids

2. Hence issue to all starting OST or visiting NSP

– Everyone visiting GP or A+E if using opioids

3. Can use FP10, PSD or PGD

4. Make OD management training available to all people who might be present at OD, GP, drug services, police, hostels, community services, family members, carers, prison, probation service

5. Improve understanding commissioners on it’s importance

What you can do now!

What can can’t do (sort of)

Issue to non-health care workers: hostel staff, rehabs, outreach workers, police stations, family members

This is what the October 2015 regulations will change

Although…

People carrying naloxone can use ‘public service decision’ to use hence will be protected

One of the formulations currently available (Prenoxad) can be supplied to a patient’s representative as long as we have the written permission from the patient

Naloxone e-module

Already available

Free to access

Comprehensive training

resource

Takes about an hour

Assessment + certificateScan this to visit

smmgp-elearning.org.uk

Key messages

Go out and do it!

Prioritise supply to people who use drugs

(including those not in treatment)

Ensure people on OST have it

Normalise it in services

Dispel myths

Make training brief, and to everyone

Involve peer trainers

Save hundreds of lives

“I didn’t know that he was using until I got

the call from the hospital. He had

accidentally overdosed on heroin and valium

and was technically dead. Three shots of

Naloxone saved his life. I’d never heard of

Naloxone before. It doesn’t bear thinking

about what life would be like if it hadn’t been

available that night.”

Thank you

Visit NAG England:

nagengland.wordpress.com

Save some naloxone