Drug users being trained to prevent overdoses
Dublin Nitazenes Linked Weeks Of Synthetic Been Have To Deadly And And In Potent In Overdoses Cork Opioids Spate Recent A
Active drug users are being trained by the HSE to prevent and treat overdoses after highly potent synthetic opioids were found in Ireland.
The new Circle Peer to Peer programme is to begin for a six-month pilot phase in 16 locations from January.
It will see drug users and people who are often with drug users trained to prevent and treat overdoses with naloxone, a drug used to reverse or reduce the effects of opioids.
Thirty staff members have been trained across 16 hubs countrywide and up to 128 peers are now being actively recruited, with many anticipating to start the programme next month.
Potent and deadly synthetic opioids nitazenes have been linked to a spate of overdoses in Dublin and Cork in recent weeks, making the programme’s launch particularly timely.
To date there have been 17 suspected overdoses associated with nitazene drugs in Cork and 57 in Dublin. The HSE said it could not comment on any deaths until confirmed by toxicology results.
Nitazenes are up to 30 times more potent than fentanyl, the much-feared synthetic opioid which has caused death and destruction in North America.
Fentanyl has not yet appeared in the Irish drugs market but nitazene drugs have HSE clinical lead in addiction services Professor Eamon Keenan said.
Prof Keenan said peers were in a unique position to be able to intervene in overdoses. They are trusted by other drug users, who share similar lived experiences.
“It's not just responding to the overdose. It's talking to people about risks, about the identification of harms, about prevention.”
Promoting self-esteem among drug users is another function of the programme, with peers empowered to respond to overdoses and to work with other users.
Research suggests four lives are saved for every 100 naloxone administrations, Prof Keenan said.
“Naloxone can reverse an opioid overdose. It does save lives. But with the new synthetic opioids that are appearing on the market, you may need to administer more naloxone to get a response because it can wear off."
“Nitozenes are actually in the Irish market and are causing overdoses.”
“We need to be vigilant over the Christmas period now that these new drugs are circulating in the Irish drug market," Prof Keenan said.
“People need to be aware of that, services need to be informed about it and people who use drugs need to be supported through this period.
“Although we're not seeing a big tranche of overdoses at the minute, it hasn't necessarily gone away."
The Circle Programme is to be launched by the HSE National Social Inclusion Office in collaboration with partner support services.
Circle represents the circle of peers who through shared lived experience understand each other and through participating in this peer programme can help increase peer skills, understanding of overdose prevention and management of overdose including peer administration of naloxone if they witness someone overdosing.
The Circle Programme is a countrywide rollout of the Topple Programme, which was developed by Novas, a voluntary organisation providing services to people who are homeless and disadvantaged, in 2014.
Naloxone project lead with the HSE addiction services Jenny Smyth
said training of 30 staff was completed in November and peers were being actively recruited..
Many of the 16 programmes should be operational in January, she said.
Two staff will facilitate each programme, with six to eight peers recruited for each of the 16 hubs.
“They're all very keen to start that programme,” Ms Smyth said.
There is at least one programme operating in every HSE community Healthcare Organisation, with operations in Cork, Waterford, Limerick, Wexford, Dublin, the Midlands, Galway, Sligo and Donegal.
“The peers that we're recruiting, they are either active opioid users or they're in regular contact with active opioid users,” she said.
“They'll be trained up in how to administer naloxone and with information about maybe nitazenes if they're around.
“They learn how to prevent an overdose, how to reduce risk of overdose and how to respond when one happens — with naloxone, CPR, interacting with emergency services. There is also training on how to cope after an overdose.
“It really is about empowering peers.
“They're experts by experience and they can help others.”