The following guidance is based on the experience and learning from the Scottish National Naloxone Programme.
The following guidance is based on the experience and learning from the Scottish National Naloxone Programme.
Investigate the legal situation for providing naloxone to people who use drugs and others likely to witness an overdose.
Identify project lead – this person will be responsible for managing and coordinating the implementation of the THN programme.
Identify key partners – could include the following; relevant govt dept, prison headquarters, prison operations, prison healthcare, prison pharmacy, data collection dept, people who use drugs, prisoner rep, family support.
Establish Working Group – this group will have multi-agency responsibility for the strategic coordination of the programme.
Determine funding stream – main cost will be for the product itself and consideration should be given to additional staff required for the implementation phase (project lead and training leads).
Identify suitable product – this should be in line with the legal framework of each country and affordability based on budget.
Devise data collection model – consideration should be given to how this can be done in the least time-consuming manner for practitioners (example of Scottish system in appendix). Data should be collected on number of kits distributed, whether it is a first supply or a repeat supply (if it is a repeat supply, what is the reason for this – used on someone, used on themselves by another, lost, confiscated, other), demographics. You may also wish to collect ‘postcode’ data to identify the area the person receiving THN will be released to, if known. In Scotland, this data is provided to managers on a quarterly basis which allows for targeted interventions if the supply rates are low.
Establish supply mechanisms – consider the easiest method for opportunistic, unplanned care. Ideally a framework will be in place with minimal restrictions.
Identify ‘master’ trainer – this person(s) will be responsible for training the workforce as trainers. They should have an excellent knowledge of overdose prevention, intervention and naloxone. They should read good quality information and receive some training themselves to ensure they are fully equipped to deliver.
Devise training plan – identify those who will require training. The master trainer(s) should deliver ‘training for trainers’ to staff who will be training those likely to witness an overdose. Anyone can be trained as a trainer and can then also go on to deliver awareness sessions. The main ‘training for trainers’ should remain the responsibility of the master trainer to ensure continuity and quality.
Design peer education model – it would be sensible to have a ‘go-to’ model that could be adapted to local needs if necessary.
Produce materials – leaflets and posters for awareness raising of the programme are important.
Communication – ensure that all partners, particularly those who will have a role in the delivery, are aware of the programme from the development stage so that people can prepare and feel part of it.
Deliver training – training should be delivered once all the practical processes are in place so that once a staff member has received training they can immediately start to deliver training to people likely to witness an overdose.
Monitor programme – the working group should continue to meet once the programme is up and running to address any issues that arise and monitor its progress.
