Naloxone on-release

This course is a product of the project “My first 48 hours out – comprehensive approaches to pre and post-prison release interventions for drug users in the criminal justice system”.

It aims to promote the implementation of life-saving interventions in prison and upon release with specific reference to harm reduction, overdose prevention and the use of naloxone programmes.

Globally, overdose is a leading cause of premature death among people who inject drugs and the overwhelming majority of overdose fatalities involve opioids*. Worldwide, an estimated 69 000 people die from opioid overdose each year (WHO, 2014).

Naloxone is a medication that reverses the effect of opioids. In an emergency overdose situation, it can be a lifesaver.

In this section you will learn how it works, as well as how and when it should be used.

Examples and further details regarding Naloxone status and use in the following European countries: United Kingdom, France and Italy

Provision of Naloxone and related legislation in Norway, Denmark, Germany and Spain.

Rates of drug-related deaths in Scotland are among the highest in Europe. In 2016, 867 people lost their lives to preventable overdose deaths, the majority of which were accidental (National Records of Scotland, 2017).

In response to the rising number of opioid-related deaths, the Scottish Government introduced a National Naloxone Programme in 2010, which was launched in 2011.

The aim of the prison naloxone programme is to train prisoners in overdose prevention, intervention and naloxone during their sentence and to provide them with naloxone-on-release. It is delivered by NHS staff and peers, facilitated by the Scottish Prison Service.

There are many steps along the ‘prisoner journey’ through their sentence where they have access to training. The steps listed here describe potential barriers and solutions to each phase.

The primary outcome for the effectiveness of the Scottish naloxone programme was to show a reduction in the number of opioid-related deaths within 4 weeks of liberation from prison.

These deaths decreased by 36% from 9.8 to 6.3% during the evaluation period. 

The following guidance is based on the experience and learning from the Scottish National Naloxone Programme.

This comic booklet was produced in the framework of the EU co-funded project “My first 48 hours out” – comprehensive approaches to pre and post prison release interventions for drug users in the criminal justice system”, implemented by the University of Applied Sciences in Frankfurt.

List of recommended resources on the topic of overdose prevention and Naloxone.

Example form to be used as a brief guide to follow up on Naloxone use cases.

Example of promotional materials produced in Scotland

Example of an evaluation form for an "Overdose Prevention, Intervention and Naloxone Awareness Session"

An example of a certificate to confirm completion of an overdose prevention, intervention and Naloxone training for trainers.

Sample form of an overdose awareness or overdose intervention training session.

A brief one-page overdose prevention programme implementation checklist.

This course should provide an overview of drug-related deaths (DRDs) nationally and locally with an emphasis on overdose prevention, intervention and naloxone.
It should explore the causes of DRDs, risk factors, high risk times, myths and how to identify the signs and symptoms of an overdose.
There should be a focus on naloxone, its actions, kit assembly and administration with specific attention to the inclusion of naloxone in basic life support.

Checklist for a One-to-One Naloxone Training Session