by Maya Doe-Simkins
Overdose education and naloxone distribution (OEND) has fundamentally changed the way that harm reduction service providers and friends and family of drug users interact -- it is a “game changer.”
Syringe exchanges, for example, have often (though definitely not always) had a tenuous relationship with loved ones of drug users -- there is a very acute response to knowing that you are frantically doing everything you can think of to entice your child/partner/family member to stop injecting heroin and find “recovery,” while someone at an exchange is giving that person clean needles, cookers, tourniquets, filters. Public health practitioners acknowledge the two events can and should happen in tandem. Some loved ones find solace in knowing that needle exchange workers are taking care of their loved ones with supplies and seeing them for the wonderfully complex people they are -- but there is no denying that it is intense to know that there are people out there handing out injection equipment to a person whose potential abstinence consumes so much of your time and energy.
Enter take home naloxone. Families and friends of drug users are acutely aware of the lurking possibility of overdose -- I met one woman who went to three wakes in one week. Possessing naloxone gives loved ones a reprieve from the nagging fear and allows people to breathe a little more easily. What parents and family members have done with the extra breath is talk -- to local health service organizations, local, state and federal elected officials, the police, the media, each other, the drug users they care about, pharmaceutical manufacturing companies, grant making organizations, and importantly organizations that provide harm reduction services.
In Massachusetts, “non-users” (friends/family/service providers) approached syringe exchange and drop in programs that were providing OEND services to train them -- in church basements, around the kitchen table, etc. In recognizing that training this group of people is different than training drug users about overdose, a “Friends & Family” curriculum was developed. (Curriculum and accompanying power point can be downloaded here.)
But that wasn’t enough -- fierce and vocal family members themselves wanted to be able to participate in spreading the training and materials to save lives. A parent group, Learn To Cope, has been approved to be trainers & some members now provide overdose education and naloxone in addition to the practical, logistical and emotional support that they had been offering families.
This graph, presented to the FDA in April 2012, shows the breakdown of “users” (self- identified current or ever) and “non-users” enrolled in four years at various sites -- about 1/3 of the people who get trained in Massachusetts to recognize overdose and administer naloxone are “non-users”. Parents, other family, and friends of drug users are incredible advocates for better overdose prevention programs.