Increasing awareness of Take Home Naloxone to prevent opiate overdoses
The UK is the largest reported opioid using population in Europe with rates of opioid overdoses increasing both locally and nationally.
Our addictions directorate and dual diagnosis team identified a need within the Trust to work toward identifying the people who are at risk and provide them with the life-saving drug, Naloxone.
Naloxone is an opiate antagonist that is a safe and effective way to reverse overdoses and if administered in time, can prevent fatalities. Until this project, only those working in substance misuse services and doctors could issue prescriptions for this drug, leaving a “hidden population” of people at risk but unable to access Naloxone.
What were the project aims?
Given how effective the take-home Naloxone schemes are in preventing opioid related deaths, the team had big aims for the project.
With the help of the Improvement Service, the team aimed to train one third of nursing staff in the trust in the use of take-home Naloxone, demonstrate a positive impact on service users and carers, and offer the drug to 100% of the patients who should be given it.
How was it done?
The first step of the project was to reduce the steps needed to access Take-Home Naloxone. Working with pharmacy colleagues, they created a patient group directive, a policy that allows for identified populations to administer the kits without a prescription.
Once this was done, the team needed to raise awareness in the workforce around not only the risks of opiate overdoses, but the fact that there is a safe, easy and effective way to treat overdoses.
The patient group direction began to be implemented in 2020 and training was being offered to nurses and pharmacists to raise awareness. However, the project was halted due to Covid and the Trust’s shifting priorities. It was picked up again in 2022 which resulted in another round of training across the trust and publicising that it was available.
The face-to-face training for teams became very labour intensive and difficult to monitor and follow up. The team proposed an e-learning package and worked with the Trust’s learning and development team to take the content and transform it into a package on leap.
The learning package is now compulsory training for all nurses and pharmacists within the Trust – a first for London NHS mental health trusts.
What were the results?
Before 2020, a maximum of two kits were issues per year. Between June 2022 and August 2023, this number rose to 71 – an increase of 3450% comparatively. In Southwark, 90% of relevant patients were offered a take home Naloxone kit, of which 70% accepted and the kit was issued upon discharge.
In the last 12 months, there has been a huge uptake with 206 kits issued between November 2023 and November 2024.
For one service user, they said:
I carried it around for a while just in case I came across someone that was overdosing, because it talks about how it could save somebody else’s life and my life.
In terms of the e-learning and workforce development goals, over 1,200 members of staff have completed the learning, equating to 75% of all nurses and pharmacists employed by the Trust.
What next?
The team will continue to push for the kits to be given to the service users who need them to work toward curbing the increasing number of opioid overdoses in the UK.
The team has been exploring sharing the training and learnings across other trusts, with the eLearning package potentially being shared with other organisations to ensure more clinical staff are trained on these life-saving kits.
The team are hoping to produce a new version of the training to align with new UK legislation that will allow all healthcare professionals, who are adequately trained, to issue lifesaving Naloxone kits to patients at risk of opiate overdose.
