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Take Home Naloxone: best practice in preventing fatal opioid overdoses for prison leavers

Best practice guidance on Take Home Naloxone (THN) for prison leavers from the Forward Trust presented as part of their ‘Pulse’ series of briefings.

Executive Summery

  • Every year, Forward empowers over 10,000 prisoners with drug and alcohol problems to break the cycle of crime and addiction and to achieve transformational change – from initial advice, harm minimisation and clinical treatment, to intensive programmes that instil and sustain recovery, and access to networks of support upon release to the community.
  • Drug-related deaths in England and Wales are at record levels: 3,756 deaths in 2017/18, of which 53% involved an opioid (e.g. heroin) overdose. Death rates among prisoners (especially those on post-release supervision) are many times higher than in the general population. There were 955 deaths of offenders in the community in England and Wales in 2017/18. The few weeks immediately after release from prison is a particularly high-risk period for drug-related death.
  • In response to these findings, and as part of our commitment to continually improve services and to deliver the best care possible, Forward have instigated a highly-targeted initiative to increase the number of service users being released from prison with Take Home Naloxone (THN), a drug that can save lives by reversing the reduced breathing rate caused by an opioid overdose.
  • First piloted at HMP Lewes in 2018, and since implemented in 10 other prisons, Forward’s initiative has centred on nominating a dedicated practitioner as ‘Naloxone Lead’ to take responsibility for training prison leavers on how to use the drug (administered by injection) and for providing THN kits upon their release.
  • As a result of this initiative, National Drug Treatment Monitoring System statistics show that 42% of opioid service users across these 11 prisons have been released with THN, more than three times the national average of 12%, with many lives saved as a consequence.
  • Building on these impressive results, Forward aims to further improve take-up rates of THN in prisons where it has already been introduced and to promote the initiative in all other prisons where we operate. As part of these plans, and in line with our ethos of service user empowerment, we will upskill peer supporters so they can train service users on how to use THN.

Read guidance