INTERNATIONAL DOCTORS FOR HEALTHIER DRUG POLICIES

Action Summit on Naloxone

Increase the use of Naloxone in reducing opioid deaths

Dr Chris Ford, Clinical Director IDHDP

October 27th 2015

Physicians globally unite for health based drug policy

10:00 Introduction to summit Chris FordSetting scene10.05 History of naloxone use in UK John Strang10.15 Where are we in England now John Jolly10.25 Update from PHE Steve TaylorExamples of good practice10:35 How Scotland did it Kirsten Horsburgh10.45 What can we learn from Wales Rhian Hills 10.55 Birmingham – how achieved & lessons learnt Judith Yates11.05 Discussion11:30 CoffeeAction Plan11.45 Role of user activism Kevin Jaffery11.55 Role of training Elsa Browne12.05 Using legal challenges Kirstie Douse12.15 Discussion and formulating the Action Plan12:55 Summing up, electing action group to take forward and timeline13:00 Close main meeting Meeting action group >14.00

Agenda

1. What is the availability of naloxone in your area?

•Marked variation

–total provision (Scotland, Birmingham, Leicestershire)

–Minimal informal through peers

–nothing

2. What have been the main drivers for

the availability?

• Reducing DRD’s– Reducing DRD is a Scottish Government priority

• Belief in the evidence that it works and that lives are being lost which could be saved

• Need to provide for PUDs safety• Tenacity of individuals• Working together e.g. monthly naloxone meeting with service

leads

• For unavailability: – ambivalence from the commissioners and prescribers

3. What have been the positive outcomes in the community of the naloxone

programmes?• Hundreds of lives potentially saved

• Avoid brain damage following non-lethal OD

• PUD’s proud to be part of the solution

• Reduces stigma, increases self-worth

• All involved, working together: Drug workers, GPs, police

• Improves relationships with health services

• Keeps overdose prevention a priority

4. What are the main barriers locally and nationally?

• Locally– Lethargy, stigma, lack of understanding and knowledge– Staff willingness, competing priorities– Lack of GP prescribing – Confusion on who holds medication

• Nationally– Postcode lottery being allowed to develop– Lack of clear guidelines or instructions from the center– Confusion about the MHRA consultation and the October

2015 date– Awareness and funding

5. Have you found something that needs to be improved or could be managed better?

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

• Prescribers of OST – need to prescribe naloxone

• Better understanding from PHE and commissioners on its importance

• Need access naloxone to those not in drug treatment

– Need to be make this standard practice in PC and secondary care

– Needs widespread availability through Needle Exchanges/Pharmacies

• Ambulance service – need to change operator script via NHS Pathways nationally, happening locally, need nationwide

• Better presentation of the evidence, the arguments for and against (including dispelling the myths that remain), and the costs.

• Co-ordination needed between community services, with prison programmes

6. What do you hope might be outcomes from the day?

• Formulate an “Action Plan” as to how things can be taken forward so we can get national coverage for naloxone

• Clear actions / steps at a national level – with PHE and DoH buy-in

• Promote much wider provision in England• Promote training and provision to all• Leave feeling confident that lots can be done now to

provide naloxone and it doesn’t need to be resource intensive

• Get it as part of normal practice in our areas and better directive of what is possible

Runs the biggest drug survey in the

world.

• GDS 2012 : 15,500

• GDS 2013 : 22,000

• GDS 2014 :

78,800

• GDS 2015

target 130,000

12 languages

9 languages

Injecting drug use section in GDS2015

• Developed in collaboration with the

international injecting community

• Will map the following around the world

Access to naloxone

Groin and neck injecting

Being injected by others

Access to clean injecting equipment

Last year overdose experience

Launches Nov 10th

https://www.globaldrugsurvey.com/GDS2015

INTERNATIONAL DOCTORS FOR HEALTHIER DRUG POLICIES

Now time to do the work!

Dr Chris Fordchris.ford@idhdp.com

www.idhdp.com

Physicians globally unite for health based drug policy