Real life angels carry naloxone – not only a tool for overdose reversal
Anyone who follows the blog regularly will now be more than familiar with the Real angels carry naloxone images that I have developed. The series of images have been among the more popular of the visual messages that I have created. The central message of the images celebrates the people who participate in programs that enable greater availability of naloxone. In a large number of instances these angels are people who use drugs themselves, which is a critical feature of programs of this type.
People who use drugs are far more likely to be present when someone overdoses on opiates.
Kerr et.al 2008 (citing Darke et.al 1996, Strang et.al 1999, McGregor et.al 1998, Darke et.al 2000), assert that, ‘Injecting drug users (IDUs) are frequently present at overdoses of others, with most having witnessed at least one heroin overdose.’
The fact that people who inject drugs are more likely to be present at an overdose is not the sole reason however to ensure the central involvement of people who use drugs and peer led organisations. Their inclusion in the planning, development and implementation of such programs can go a long way in addressing stigmatisation and disempowerment.
Stigmatisation of people who use drugs
According to the excellent resource, Why Wouldn’t I Discriminate Against all of Them?” – A Report on Stigma and Discrimination towards the Injecting Drug User Community produced by AIVL, community attitudes and stereotypes regarding injecting drug users abound.
“Injecting drug users are seen as the architects of their own downfall: they used drugs, they took up injecting, they contracted a virus, they can and probably will transmit their disease(s) through inappropriate use and disposal of syringes. Additionally, they are a threat to the wellbeing of the general community. In short, they are to be blamed.
By and large, the general public has wholeheartedly embraced the drug user stereotype, and the result is day-to-day stigmatisation of and discrimination against drug users. This has profound adverse effects on users’ health and wellbeing. They are among the most feared and disliked populations in the community.”
(Source: ‘Why wouldn’t I discriminate against all of them? – A report on stigma and discrimination towards injecting drug users.’ pg. 64)
Empowering people who use drugs
By ensuring that people who use drugs and drug user led organisations are integral to the design, development and implementation of programs that enable wider access to naloxone, we can do much to address this idea that injecting drug users are the architects of their own downfall.
According to the Open Society Foundation Factsheet, Stopping Overdose:
“Naloxone’s benefit to drug users and their communities includes more than overdose reversal. Drug users report that saving the life of a friend—or a stranger—can change the way drug users view themselves and their peers, increasing feelings of empowerment and self-efficacy. A study of the Staying Alive program in Baltimore found that post-training, 62% of participants felt that other drug users in their community had greater respect for them because they had been trained to help during an overdose.”
Naloxone programs should be at the very least something that we do with people who use drugs rather than something we do to people who use drugs. This simple distinction means that aside from the direct impact of saving lives, such programs can go some way towards addressing stigma. Centrally involving or providing opportunities for peer led organisations to be leaders in this area can very much value add to these very important programs.
Discussions in Victoria regarding how programs that provide wider access to naloxone will operate are in their infancy and the recent announcement by the Victorian government of funding to support wider naloxone is very much welcomed, however we need to ensure that attention is paid to process. There has been much interest demonstrated already in the provision of wider access to naloxone in the state with many stakeholders already weighing in. We need to ensure however that in the tidal wave of interest from a range of stakeholders that the voices of the people most greatly impacted upon by overdose, people who use drugs themselves is not drowned out in the process.
Want to find out more about Naloxone? Check out these collections of naloxone resources:
Australian Injecting and Illicit Drug Users League (AIVL) 2011, ‘Why wouldn’t I discriminate against all of them?’, A report on stigma and discrimination towards the injecting drug user community’ Canberra, Australia. http://www.aivl.org.au/database/sites/default/files/images/AIVL%20IDU%20Stigma%20%26%20Discrimination%20Report%20Nov%202011.pdf accessed 12th September 2013
Kerr, D., Dietze, P., Kelly, A & Jolley, D. (2008) ‘Attitudes of Australian Heroin Users to Peer Distribution of Naloxone for Heroin Overdose: Perspectives on Intranasal Administration’ in Journal of Urban Health: Bulletin of the New York Academy of Medicine, Vol. 85, No. 3
Open Society Foundation, ‘Stopping Overdose: Peer-Based Distribution of Naloxone’ Open Society Foundation website http://www.opensocietyfoundations.org/sites/default/files/stopping-overdose-eng-20130807.pdf accessed 12th September 2013