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Stephen Malloy

on 2 June 2016

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Transcript of #EuroNPUD:

10-20 000
Someone is there to save a life! We can help!
Most overdoses occur when others are present, and most
injecting drug users
have witnessed or experienced overdoses. Therefore,

drug users
themselves, or their
friends and family
, are likely to be both
bystanders and potential first responders in emergency overdose situations

Trends show opioid overdose rates are increasing
Overdose is the leading cause of death among People who useDrugs (PUD), accounting, in Europe, for more than 3.5% of all deaths in males under 40 years of age
1.4 million
'Take home' naloxone
World Health Organisation*
Advisory Council on the Misuse of Drugs (UK)
Center for Disease Control and Prevention US,
Drug Policy Alliance,
Open Society Foundation,
Global Fund to fight Aids

..many many more...
Competitive opioid antagonist
temporarily clears opioids from brain receptors, allowing overdose casualty to breath again

ONLY effective at reversing effects of opioids

No 'street value' or abuse potential

Awareness raising and capacity building
Drug user networks and organisations
Needle and Syringe exchanges
Treatment services providing OST
Prison release supports such as probation services
Drug Consumption rooms (where available)
Rehabs and 12 step programmes
Family support organisations
Hospital discharge (where patient was in hosptal because of overdose)
Police custody leavers
Community pharmacies
.....and MORE
National Strategies to combat opioid related overdose deaths

Legislative support

Amend national medicine control laws- Enable the possession and administration of naloxone - an EMERGENCY medicine -by trained bystanders/witnesses of overdose

Legislation to support program development. Remove legal barriers and restriction to availability of naloxone, for use by non medical facilities such as hostels and shelter providers
The situation
in Europe
What we Need
Overdose deaths in Europe & access to naloxone under the microscope

Estimated number of 'problem' opioid users in Europe
The estimated number of opioid users dying each year from opioid overdoses, infections related to drug use, violence and other causes
~ 6 500- 7 000 deaths every year caused by opioid related OVERDOSE
It is estimated that over 70 000 lives were lost to drug overdoses in Europe in the first decade of the 21st Century
Research conducted:
Are peer programs with naloxone distribution for opioid users (in combination with first aid training) effective in reducing the numbers of drug-induced deaths?

A Systematic Literature Review

 Epidemiological and Medical Background
 Systematic Research in Medline, Eric, Psycinfo, Embase and the Cochrane Library
 Limited methodological quality of studies; only self-reported experiences, self-selection bias, low follow-up rate
 No systematic results on mortality
 One quasi experimental controlled cohort study, 12 evaluation studies, 5 overviews

Naloxone is a safe drug to use (no effects in the absence of opioids), no reports on increased riskier use of drugs, generally no decrease in the use of emergency services, bystanders present at most ODs

Scottish prisons cohort Study PROVED IT REDUCED MORTALITY
Recommendations and supporting statements on take home
*the Word Health Organization recommends that people likely to witness an opioid overdose should have access to naloxone — an effective antidote that can reverse opioid intoxication — and should be instructed in its administration

Evidence shows that educational and training interventions for peers and family members, complemented by take-home naloxone, help decrease overdose-related mortality (EMCDDA, 2015).

Examples of good practice can be found in the UK, Ireland, Denmark, Norway, Italy, Estonia, Germany
and a few other European countries..
'Take home' naloxone is becoming available, but it's still VERY limited
But Hundreds of thousands of people who may need naloxone, still have no access to naloxone!
National and local resources
to fund take home naloxone
What you can do

Do some local research, learn about
opioid overdose deaths in your country
Strategic issues
Conduct situation assessment
Analyze legal framework for the provision of naloxone
Garner support from potential project partners...

Choose a model for procurement, storage and distribution of naloxone
Prepare for staff training and individual consultations
Develop informational materials
Determine how many first-aid kits are needed
Add technical support components
Develop the project’s advocacy strategy
Make a budget .
Document cases of naloxone administration
Monitor impact indicators
Eurasian Harm Reduction Network
Support. Dont Punnish
hvala tak aitäh kiitos merci danke efharisto köszönöm
grazi paldies ačiū nirringrazzjak dziękuję obrigado
mulțumesc ďakujem hvala gracias
The European Network of People Who Use Drugs

Full transcript