New pilot initiative designed to save lives and promote harm reduction

Marking International Overdose Awareness Day 2023 on Thursday, 31st August, the HSE in collaboration with St James’s Hospital is introducing Nalox-Home: a new pilot initiative designed to save lives and promote harm reduction among people who use drugs.

Nalox-Home provides free naloxone kits to patients who attend the St James’s Hospital Emergency Department (ED) and have experienced or are at risk of an opioid overdose. The pilot is a collaborative effort between the St James’s Hospital Emergency Medicine Department and Inclusion Health Service, and the HSE National Social Inclusion Office.

What is Nalox-Home?

Nalox-Home includes a brief overdose awareness intervention delivered to patients at risk of opioid overdose, both upon discharge from the emergency department or after an inpatient admission. Central to the project is the prescription and provision of take-home naloxone, a medication that temporarily reverses the effects of opioids, providing a vital lifeline while awaiting medical assistance.

Speaking at an International Overdose Awareness Day webinar organised by the HSE, Professor Eamon Keenan, HSE National Lead, Addiction Services, said: “With opioids implicated in 7 out of 10 poisoning deaths identified by the Health Research Board’s (HRB) latest figures in 2020, and 57.5 per cent of those individuals accompanied by someone who may administer naloxone, the availability of naloxone can be crucial while waiting for medical care to arrive.

“By removing barriers to naloxone access, Nalox-Home offers hope through overdose awareness interventions and take-home naloxone for patients with a history of opioid use, as well as reducing stigma, supporting harm reduction and ultimately it will save lives.”

Hildegarde Naughton, Minister for Public Health, Wellbeing and the National Drugs, said: “International Overdose Awareness Day gives us the opportunity to remember those who have lost their lives through drug overdose, and highlight actions we can take to improve our responses to this critical and pressing issue. Developing integrated care pathways for high-risk drug users in order to prevent drug overdose deaths is a strategic priority for the National Drugs Strategy. I therefore welcome the Nalox-Home initiative as a practical, appropriate, and lifesaving response to drug use overdose.

“I am also committed to enhancing access to and delivery of drug services in the community, as this is also a preventative factor for drug overdose. I want to convey my support and solidarity with families who have been impacted by drug overdose. As a society, we need to strengthen our resolve to reduce the harmful impacts of illicit drugs. I look forward to the report and recommendations of the Citizens’ Assembly on Drugs Use in this regard.”

Jess Sears, Inclusion Health Clinical Nurse Specialist at St James’s Hospital added: “This pilot has the potential to improve the relationship between hospital staff and the patients we treat, which in turn may result in them returning for follow up care and improving their overall health outcomes. I am privileged and excited that St James’s Hospital is the first hospital in Ireland promoting take home naloxone. I hope we can follow Scotland in making take home naloxone available through the ambulance services, providing the intervention to people who decline a transfer to hospital, and widening the reach to the Gardaí and other emergency services.

“We wouldn’t hesitate to provide an EpiPen to someone with a severe allergy or a glucagon injection to a diabetic at risk of severe hypoglycaemia. We should follow the same approach for opioid users by training their family and friends on how to identify an emergency and respond with Naloxone, a potentially lifesaving treatment.”

In 2020, Ireland experienced 409 poisoning deaths, a concerning trend that has been on the rise since 2016. Tragically, these are preventable deaths caused by overdoses. Each statistic represents a life lost, leaving behind grieving families, friends and peers. The HSE urges all services that may encounter opioid overdoses to support the provision of naloxone and training on how to administer it.

As part of the global campaign to raise overdose awareness, the HSE National Social Inclusion Office is hosting a free webinar (at 1.30pm on Thursday, 31st August 2023) under the theme "Recognising Those People Who Go Unseen." This event stands as a poignant acknowledgement of the unsung heroes within our society, including families, healthcare professionals, and spontaneous first responders who play a pivotal role in combating overdose-related tragedies.

The event is being hosted by Dr Denis O'Driscoll, Independent Chair of the National Naloxone Oversight Quality Assurance Group and includes an opening address by the Minister of State with Responsibility for Public Health, Wellbeing and the National Drugs Strategy, Hildegarde Naughton. Topics covered include impactful drug harm reduction campaigns, living with bereavement by drug-related death in Ireland and advancing addiction recovery.