By Stephen Malloy
As you’ve read on this blog, programs that train drug users to respond to opiate overdose with naloxone are expanding across the globe. An important intervention that’s often overlooked, however, is training family members and “carers” - friends, housemates, and loved ones - of drug users to use naloxone. A program in the UK is doing just that, as Stephen Malloy reports:
In July 2009 the National Treatment Agency (NTA) supported a 16 site pilot project, entitled “overdose prevention and naloxone training for families and carers.” The pilot sites, which were spread across England, recruited and trained family members/carers of people at risk of opiate-related overdose death in overdose prevention; signs and symptoms of overdose; and naloxone administration and basic life support techniques. The family member/carer was also supplied with naloxone IF the person at risk of overdose was available to give written or oral consent for the supply to be made.
A new report shows that 495 family members/carers were trained, and at the time of its writing 20 lives had been saved thanks to naloxone use (18) and basic life support (2). These results demonstrate the need a wider circle of family/carers to be engaged around overdose prevention and crucially, be supplied with naloxone.
The report does however highlight challenges in recruitment of family/carers. It was difficult to recruit parents in particular, sometimes because they said they were not around when their child was using drugs. Partners of drug users, whether they used drugs themselves or not were more easily involved in the program. Other difficulties included recruiting participants post detoxification. Some potential participants reported that they did not want to be involved as this was the end of their drug using. The program also recruited family members and carers of people leaving prison, and the report details some of these challenges.
It’s well recognized that people leaving prison are at significantly elevated risk of overdose death, and are therefore a priority group for overdose prevention and naloxone training/supply. In Scotland we have a national program covering all prisons. Prisoners are trained toward the end of their detention, and are supplied with naloxone upon liberation. Soon, a new study is due to begin in England, also looking specifically at their prison population and providing overdose prevention/naloxone to them.
The full report from the NTA pilot for families and carers, including recommendations for programs starting similar initiatives, is available here: http://www.nta.nhs.uk/news-2011-naloxone-report.aspx.