overdose – Humankind

Pharmacy staff save two lives after timely naloxone training

Jack Keery

Wicker pharmacy staff holding naloxone kits after being trained to use them

Medication that can save the lives of people who are overdosing on opioids has recently been used by staff at Wicker Pharmacy.

Following timely training by our new local drug and alcohol service, Likewise, pharmacy staff used naloxone to revive two people. Naloxone is a medication that temporarily reverses the effects of an overdose from opioids like heroin. When administered, it buys crucial time while waiting for the emergency services to arrive.

Our new community service recently launched in Sheffield on 1 August offering support to people experiencing issues around drug and alcohol use. Likewise is a partnership between national charity Humankind and Project 6.

One aspect of this support is harm reduction, which includes equipping people who use drugs, their friends, loved ones and professionals with naloxone kits and training them to use the medication effectively in an emergency.

Staff at Wicker Pharmacy undertook training sessions with Likewise during August to ensure they were able to respond should someone near their premises accidentally overdose.

Within one week of completing this training, staff members were called upon to apply their learning in real-life situations where people had overdosed. Without hesitation, they stepped up to save their lives.

One of these staff members was Joseph Ridge, a trainee pharmacy technician at Wicker.

“A member of the public came into the pharmacy reception and said that someone had collapsed nearby,” Joseph said. “As soon as I could, I went down the street and saw three other members of the public stood around the person collapsed on the floor. The members of the public were already on the phone to the ambulance service.”

Joseph realised the person’s condition was extremely serious, so he called his colleague and asked them to bring the pharmacy’s defibrillator and their naloxone kits.

As soon as his colleague arrived, he administered the naloxone to the person in need. There was unfortunately no response at this point.

Joseph remembered from his training that further doses of naloxone can be administered if someone experiencing an overdose remains unresponsive after a short amount of time has passed. After a couple of minutes, he decided to try again and administered a second dose of naloxone.

“Thankfully, the person did then come around,” Joseph said. “They still weren’t fully with us, but they were now moving on the floor. Quite quickly after that, the emergency services arrived and continued to tend to them.”

In no uncertain terms, Joseph’s ability to effectively apply the learning from his naloxone training saved the person’s life.

A similar situation occurred the same week as this incident on Wicker Pharmacy’s premises, which also led to another member of their team administering naloxone to someone they suspected was experiencing an opioid overdose. Their life was also saved by this team member’s action.

“The naloxone training was really useful,” Joseph continued. “There wasn’t anything I felt unsure about. It was obvious the person was unconscious and the ambulance service on the phone was also very supportive. They said if there was naloxone available, I should definitely use it. There was no hesitation from anyone involved.”

All staff at Wicker Pharmacy who may find themselves in a similar situation have now been fully trained by Likewise and equipped to use it in an emergency, like Joseph and his colleague.

Jon Findlay, National Harm Reduction Lead at Humankind who led the naloxone training with Wicker Pharmacy staff, said: “Knowing people have directly saved someone’s life after engaging with your training offer is one of the most rewarding feelings I can imagine. Joseph and his colleagues are nothing short of heroes and I’m so thankful to them for carrying naloxone. It cannot be said enough: naloxone saves lives.”

Ellie Bennett, Managing Director at Wicker Pharmacy, said: “When we organised the training, I wasn’t expecting it to be put it into practice so quickly, but thanks to Jon from Likewise our staff felt confident enough to administer the naloxone when it was needed. I am really proud of the way they responded.”

Graham Parsons, Pharmacy Director at Humankind, said: “Forging strong partnerships with people and organisations in local communities is at the heart of what we do. Without those partnerships, our work to support people with their drug and alcohol use, and ultimately reverse the trend of increasing deaths due to drugs, would be far less effective.

“We want to thank Wicker Pharmacy staff for their dedication to this cause and encourage anyone who wants to engage with our harm reduction training to contact us.”

Greg Fell, Director of Public Health at Sheffield City Council, said: “The prompt actions of Joseph and his colleagues at the Wicker Pharmacy are recognised and applauded. The fact that they had been trained and were in possession of naloxone at the times of these events undoubtedly saved the lives of two people.

“Naloxone is a game-changer, it is effective and very simple to use. Training can be provided.

“Sheffield City Council, in collaboration with Humankind and Likewise, is currently reviewing and expanding the provision of naloxone across the city and together we hope to save many more lives”

International Overdose Awareness Day takes place on 31 August every year. People who use drugs, their friends, loved ones, professionals, and even members of the public who may encounter someone they suspect could have overdosed are being encouraged by the new Likewise service to engage with their free naloxone training, get a kit, and save a life.

Harm reduction is seen as one of several key tools in plans to reduce drug related deaths across England and Wales, which hit their highest levels on record in 2021 according to ONS data.

Visit www.likewisesheffield.org.uk to learn more about the services Likewise provide and contact them for more information.

Drugs contaminated with synthetic opioids: an updated collective message

Jack Keery

To anyone that uses drugs or cares for someone who does:

The drugs available in the UK seem to be changing lately. As services that provide support to people who use drugs and their loved ones, we have come together to issue a shared statement about some of the new drugs being used by the people we support and the risks they present.

Today is International Overdose Awareness Day, and in honour of all those who have been affected by overdose and in light of new information about synthetic opioids, we have updated our joint statement.

In the last two years, new opioids called “nitazenes” have arrived in the UK. They have recently been found mixed with heroin, with some being sold as illicit oxycodone pills and illicit ‘Xanax’ powders.

Nitazenes can be at least as strong as fentanyl and can be hundreds of times more potent than heroin. They are known to have led to accidental overdoses and the deaths of people across the UK in recent weeks.

If you use drugs, this information could help you and your friends to stay safer. If you know people who use drugs but do not use drugs yourself, the following information could help you to keep people alive.

Because of how dangerous these contaminated drugs are, the way you use drugs may need to change to avoid overdose. We have updated the following information, in line with harm reduction guidance issued by EuroNPUD, with additional information provided to aid those living in the UK:

1. Carry naloxone

  • Always carry naloxone. It’s available from all drug services.
  • If you live in Scotland: Scottish Families Affected by Alcohol and Drugs offers a ‘click & deliver’ service.
  • If you live in Wales: Barod offers a ‘click & deliver’ service.
  • Nitazenes have been found in non-opioid drugs (like illicit Xanax), so even if you or your friends don’t normally use opioids,  it is still worth carrying naloxone.
  • Carry extra naloxone – in some cases, it has taken multiple doses of naloxone to reverse  overdoses involving heroin contaminated with synthetic opioids. Carry two yellow cases of intramuscular naloxone or two double packs of nasal naloxone. More advice is provided in point six (overdose response).

2. Don’t use alone

  • Try not to use drugs alone, and don’t let your friends use them alone either. Watch out for signs of overdose in others. The signs include difficulty breathing, blue colouring to the lips or fingertips, unresponsiveness, and limp limbs.
  • If you are going to use drugs, reach out to someone to let them know your plans and ask them to check up on you.
  • If you are using with others, avoid all using at the same time. More advice on this is provided in point five (stagger your dose).

If you don’t have people to stay nearby or check on you, consider using the BuddyUp app.

3. Check your drugs

  • Submit an anonymous sample of the substance to the WEDINOS Project for analysis. It will take a few days to get the results back, so go easy in the meantime.
  • Fentanyl strips do not test for nitazene.

4. Start low, go slow

  • Start with a lower dose and wait for the peak effects to pass.
  • If you’re using illicit pills, consider splitting them and starting with a fraction of the pill. If you can’t split the pill, you might want to consider using the crush, dab, wait method. This was designed for MDMA users and is more applicable to powder or crystal form drugs, but could also keep you safer when using other pills.

5. Stagger your dose

  • Make sure you are with a friend and one or both of you have naloxone.
  • If one person takes their hit first, wait until the peak effects have worn off before the other person uses. This makes it much more likely that there is someone who can respond in the case of an overdose.

6. Overdose response

  • If someone overdoses, administer naloxone and call an ambulance.
  • Recent overdoses have required multiple doses of naloxone. You do not need to give doses at a faster rate, but you might need more than one naloxone kit. Continue to administer naloxone as you were trained to, and do not give multiple doses at once.
  • Aim to restore breathing rather than consciousness. As well as synthetic opioids, drugs may be contaminated with other substances such as benzos or xylazine, which can lead to heavy sedation.
  • Overdose symptoms returning is more likely with nitazenes, so make sure you observe someone for longer than you would with a normal heroin overdose.
  • Naloxone only works on opioids. It’s best to use naloxone if you think someone has overdosed, even if you’re not sure what they’ve taken –  naloxone will not harm them.
  • While mixing different drugs is common, it is more likely to cause an overdose. Try to use one drug at a time. If you are going to mix drugs, use less of each.

7. Seek substitute medication and other prescribing support

  • If you use opioids every day, your local drug service can support you and prescribe alternatives such as methadone or buprenorphine. Abstinence does not need to be your goal; these alternatives can help to keep you much safer.
  • “The best way to reduce your chances of an overdose is to be on an opioid substitution treatment. Even if you are still taking drugs, if you are on methadone or buprenorphine, you are less likely to overdose, and you are less likely to die… If you are on a script, you are less likely to overdose and if you do, you are less likely to die” (Streve Brinksman, Cranstoun).
    • The above quote is from a recent Cranstoun Tiktok. You can hear the rest of the message on TikTok.
  • If you are already in treatment for opioid dependence and you don’t want to use on top, speak to your prescriber and make sure you’re getting the right dose for you.
    • Check out the SODA tool to help you determine if your dose is right.
  • If you do still want to use on top, that is okay too, but be aware that there are higher risks now of overdosing.
  • If you don’t use opioids but are worried about your drug use and you take illicit benzos every day, you can also talk to your treatment provider about how they can support you.

Signed:

  • Jon Findlay (National Harm Reduction Lead, Humankind)
  • Deb Hussey (National Safer Lives Lead – Turning Point)
  • Peter Furlong (National Harm Reduction Lead – Change Grow Live)
  • Chris Rintoul (Innovation & Harm Reduction Lead – Cranstoun)
  • Kate Blazey (Interim Medical Director – With You)
  • Dr. Judith Yates (International Doctors for Healthier Drug Policies: IDHDP)
  • Shayla S. Schlossenberg (Drugs Service Coordinator, Release)
  • Mat Southwell (Project Executive, EuroNPUD)
  • Roz Gittins (Director of Care Standards and Practice Improvement, Via)
  • Rob Barker (Campaigns and Communications Lead, Barod)
  • Justina Murray (CEO, Scottish Families Affected by Alcohol and Drugs)
  • Prof Adam Winstock (Consultant psychiatrist & addiction medicine specialist)

Drugs contaminated with synthetic opioids: a collective message

Jack Keery

A red graphic with the text "Overdose alert". An orange warning sign appears to the right of the text and the logo the Humankind logo appears below.

Important information for anyone that uses drugs.

The drugs available in the UK seem to be changing lately. As people services, we have come together to make a shared statement/clarification on some of the new drugs the people we support use, and the risks they present.

New opioids have arrived in the UK in the last two years, called “nitazenes”. They have recently been found mixed with heroin, with some being sold as illicit oxycodone pills or even Xanax powders.

Nitazenes can be at least as strong as fentanyl and can be hundreds of times more potent than heroin. They are known to have led to accidental overdoses and deaths of people in several areas across the UK in the last few weeks.

The vast majority of people taking drugs do not expect to die from an overdose. If you use drugs, this information will help you and your friends to stay alive.

Considering new information around contaminated drugs, the way you use drugs might need to change to avoid overdose:

  • Mixing different drugs is common, but it is more likely to cause an overdose. Try to use one at a time. If you are going to mix drugs, use less of each.
  • Try not to use drugs alone, and don’t let your mates use them alone either. Watch out for signs of overdose in your friends. The signs include difficulty breathing, blue colouring to the lips or fingertips, unresponsiveness, and limp limbs.
  • Always carry naloxone. It’s available from all treatment providers. If someone overdoses, give naloxone to them and call an ambulance.
  • Naloxone only works on opioids. However, if you suspect someone has overdosed give them naloxone even if you’re not sure they have taken an opioid. It will not harm your friend.
  • If you use opioids every day your local drug treatment service can support you and prescribe alternatives such as methadone and buprenorphine. Even if abstinence isn’t your goal these alternatives can help keep you safe. You will know what you are taking and your risk of overdose may be reduced.
  • If you are already in treatment for opioid dependence and you don’t want to use on top, speak to your worker and make sure you’re getting the right dose.
  • Use WEDINOS Sample Testing to test your drugs if you can spare a bit, but it takes time to get the results back so go easy in the meantime.

Signed

Humankind – Jon Findlay, National Harm Reduction Lead

Change Grow Live – Peter Furlong, National Harm Reduction Lead

Cranstoun – Chris Rintoul, Innovation and Harm Reduction Lead

Turning Point – Deb Hussey, National Safer Lives Lead

Drug related death analyst, Birmingham – Dr Judith Yates, Data Collector & Analyst

You can download a printable poster containing this important information.