Q. How did Harm Reduction Victoria’s Overdose Training Program Develop?
When I started the DOPE program in 2013, you needed a prescription to get Naloxone. Every time I ran an overdose training, I would have to organise a GP or nurse practitioner to write scripts for each of the trainees. Someone else would get the Naloxone during the training so it was ready for the trainees to take home with them. It wasn’t exactly legit, but it was worth it.
I was adamant I wouldn’t do it unless they get Naloxone at the end.
Q. Are there things that you would like to see change in relation to overdose and Naloxone?
Lots of people still believe you’ll put someone into withdrawal if you give them Naloxone, and that they’ll get up and punch you. It can be a big barrier for some people doing the training and getting Naloxone. I tell people this is a myth in my training, but I also worry about people relying too much on Naloxone. We managed overdoses for decades without Naloxone. There’s always something you can do to help. So I always teach people rescue breathing in training and encourage people to do it even if they have Naloxone.
Q. Do you have ideas about how we could make our overdose programs more effective?
I’ve often thought we (People Who Use Drugs) need to find a way to let people know we have Naloxone on us. Like those medi-alert bracelets we have for people who have allergies, or a badge we could put on our bag, something like that. If we have Naloxone on us, we need something to tell bystanders who might find us that it’s there, and they can use it.
I once found a person overdosed and I’d trained them a couple of days before. I was doing rescue breathing for them and I was thinking, “I bet that Naloxone I gave them is in their bag”, but I was in a public place, with people watching. After they woke up, they pulled the overdose kit out of their bag and told me I could have used it, but I didn’t know what would happen if I started going through their stuff. If we had a badge or something that said: there’s Naloxone in my bag and you have permission to use it, I would have felt way more comfortable going into their bag.
Q. Do you know if many of the people you’ve trained to respond to overdose have used Naloxone?
Oh yeah. DOPE has trained thousands of people in our community to respond to overdose. Heaps of them have used it (Naloxone). There’s been at least 5 times where people I’ve trained told me they used the Naloxone within the first couple of days. One guy I trained came running up to me as I was still packing the car. He had already used his Naloxone on someone he’d found as he was leaving the building after the training. It always makes you feel good when you hear something like that.
Q. What do you think has changed in the 10 years you’ve run overdose training?
In over 10 years of training people to respond to overdose, I have seen and heard a lot. There are the people who think coloured syringes will make people who’ve never injected a drug, especially children, suddenly want to inject drugs, and people who worry giving drug users Naloxone will make them less afraid of overdose so they’ll use more heroin and deliberately overdose knowing someone will give them Naloxone. It’s crazy, no one wants to be injected with Naloxone. But people believe it.
There are also GPs and pharmacies that don’t know much about overdose. Like the time I trained a mother. She was prepared to get a prescription for Naloxone and pay for it herself because she was worried her son would overdose. Her first hurdle was the GP who wanted her to bring her son to the appointment when she didn’t want him to worry she was going to give him Naloxone and hide his using from her. The second hurdle was the pharmacies. It wasn’t until she got to a hospital pharmacy, the 4th one she’d tried, that Naloxone was available, and there the pharmacist asked her when she was going to use it because the Naloxone didn’t have long before it would expire. She tried to explain she didn’t know when she would have to use it and hoped she wouldn’t have to use it. There are still a lot of pharmacies that don’t have Naloxone on the shelves and other barriers to getting it. I don’t know why they get so uptight about it. It’s literally saving people’s lives.
Q. What have programs like DOPE achieved that have made the most difference for our community?
If we hadn’t made sure we gave people Naloxone right from the start, even though it was really hard to organise, people would have had to do the training, then go to a GP and convince them to write a Naloxone script, and then go to a pharmacy to buy Naloxone. Almost no one would have ended up with it. That’s how most overdose programs used to run it in the beginning. We made sure people got it (Naloxone). We didn’t just tell them how wonderful it was and then say now you’ve got to jump through 27 other hoops to be able to get it.
I think giving Naloxone to the thousands of people we trained has really changed the communities’ attitude to it. Users used to be afraid of it and believe all sorts of things about Naloxone. I’ll never forget the girl I gave Naloxone and when she came round, she was really grateful, and said: “thank god you didn’t give me that Narcan s%@t” because she thought she was allergic to it. One of the things I’m most proud of is the number of people who now come to us asking for Naloxone. In the beginning, no one would ask for it. I think people in our community are a lot more onto it now and want to have it.