Naloxone in Homelessness Services

Naloxone Saves Lives! By Sunny Dhadley

With drug-related deaths at the highest number since comparable statistics began, why aren’t more homelessness services using naloxone to prevent overdose deaths?

Naloxone is the emergency antidote for overdoses caused by heroin and other opiates/opioids. It temporarily reverses the main life-threatening effect of these drugs, which is the slowing and stopping of breathing, providing more time for an ambulance to be called and treatment to be administered.

In 2005, a change in the UK Medicines Act allowed naloxone to be administered by anyone for the purpose of saving a life in an emergency. From 1st October 2015, new legislation came into force that enabled ‘take-home naloxone’ to be supplied to individuals by drug services, without prescription – including hostel staff. Naloxone has since played an integral part in preventing opiate-related fatalities.

Certain groups in society are much more likely to suffer a potentially fatal overdose, including (but not limited to) people leaving prison, those that have recently detoxed and people experiencing homelessness. However, there is a postcode lottery as to whether local authority areas have: a) a naloxone programme in place, and if so, b) sufficient coverage. While evidence for the effectiveness of naloxone is well established, in the context of local authorities trying to balance their books, even life-saving interventions like take-home naloxone can easily be overlooked.

Naloxone Action Group

The Naloxone Action Group and others have made concerted efforts to raise the profile of naloxone, but there is still a need to create a greater movement of passionate people across the country who can lobby and campaign for this life-saving antidote to be within comfortable reach of all those able to administer it. The prospect of a nasal variation to replace injections may lessen some of the stigma and make it easier to influence availability (as a less intrusive method), but there is a way to go before this may be considered a viable alternative to the Prenoxad Injection currently prescribed.

Homelessness is associated with many risks and continues to be a growing issue in England. Although naloxone is not the antidote to tackling the current surge in homelessness, it does have the power to keep people who have overdosed alive in order to take opportunities to change their situation for the better.

We need to work towards changing the way that much of society sees problematic drug use. It can often be a route out of pain and suffering, with the person using the drug/s able to escape the harsh realities of their life – there is a need to see beyond the drug, to the human being behind. To then further punish that individual, either through stigmatisation or incarceration, for seeking solitude in such a way, often distances them from receiving the health and social care that they need and deserve. Homelessness services have a key part to play in re-balancing this view and linking people with appropriate services.

Provide a lifeline

Homelessness services provide a lifeline to those who have fallen on difficult times. The relationships that are formed within these environments demonstrate the good that inherently exists within society. Ensuring that naloxone is readily available within each homelessness service, outreach service and other contact points (such as the Police), will reinforce a commitment to ensuring that everyone is given an equal opportunity to protect and succeed in their lives.

If your service can’t access naloxone yet, there are steps you can take:

• contact your local drug service and work with them to see if, with the support of commissioners, a naloxone programme can be started.
• raise the issue of naloxone with your commissioning team
• put naloxone on the agenda of your local multi-agency meeting or homelessness forum
• use the checklist in our guidance to take action and start saving lives