Lack of focus on harm reduction and shameful failure to roll out naloxone in England is leading to needless deaths. I feel deeply sad and ashamed to be part of a system that is letting this happen.
I believe the failure of Government to roll out naloxone in England and a lack of focus on and dis-investment in harm reduction and drugs services is a factor in the 32% increase in heroin/morphine related deaths. Many people I suspect are now being encouraged to leave treatment before they are ready.
There were 765 deaths involving heroin/morphine in 2013; a sharp rise of 32% from 579 deaths in 2012. Many of these fatalities could have been prevented by the use of naloxone as an intervention.
Naloxone is a medicine that is a safe, effective, with no dependence-forming potential. Its only action is to reverse the effects of opioid overdoses, and it is already used by emergency services personnel in the UK for this purpose. Naloxone provision reduces rates of drug-related death particularly when combined with training in all aspects of overdose response
The Advisory Council on the Misuse of Drugs (ACMD) undertook a review of naloxone availability in the UK and in May 2012, its report to the Government strongly recommended that naloxone should be made more widely available, to prevent future drug-related deaths.
In Scotland and Wales, successful pilots resulted in national programmes to make naloxone widely available but there has been no similar national programme in England. Scotland has allowed naloxone to be provided to services without prescription, for use in an emergency. This enables Scottish drug treatment and homeless hostel staff to have naloxone ready for use. We urgently need the law in the UK changed to allow this.
Naloxone is available on prescription in England to people at risk of opioid overdose. However, maximum impact on drug-related death rates will only be achieved if naloxone is given to people with the greatest opportunity to use it, and to those who can best engage with heroin users.
The ACMD in May 2012 made 3 recommendations for government to take to maximise naloxone’s role in reducing drug-related deaths.
- Naloxone should be made more widely available, to tackle the high numbers of fatal opioid overdoses in the UK.
- Government should ease the restrictions on who can be supplied with naloxone
- Government should investigate how people supplied with naloxone can be suitably trained to administer it in an emergency and respond to overdoses
Over two years later in July 2014 Jane Ellison Parliamentary Under Secretary of State for Public Health wrote to confirm that Government would act on the recommendations by October 2015 in England. Not only does this shamefully push the issue into the post election long grass it also makes no suggestion of a national programme similar to Scotland or Wales. Perhaps we should conclude that English heroin users lives are worth less than the Welsh and Scottish ones. Think I’m cynical; sources in Public Health England tell me a roll of naloxone is not on their agenda and they have no current plans.