Peer-to-peer naloxone training
A mixed methods evaluation of peer-to-peer naloxone training and supply in Scotland
(2020-2022)
Drug-related deaths are at their highest levels in Scotland since records began, and opioids are implicated in the majority of those deaths (89%). Naloxone is an opioid antagonist which temporarily reverses the effects of overdose giving a vital window in which emergency services can attend. The Scottish Drugs Forum and NHS Greater Glasgow and Clyde collaborated in 2017 to create the Naloxone Peer Training and Supply Programme (NPTSP) which recruits people with lived experience of problem drug use (peers) and trains them how to use and supply naloxone to others.
This study aimed to develop an understanding of the impact of the NPTSP and develop good practice learning to inform scale up of similar programmes across Scotland and beyond. Qualitative data were gathered in interviews between January and July 2021 with NPTSP programme facilitators (n=5), peers (n=8) and recipients (n=6) in order to understand strengths and challenges within the programme, and develop recommendations. Data were analysed thematically in NVivo.
The main strength of the programme was the shared experience between peers and recipients resulting in rapid development of relationships of trust, leading to authentic communication around drug use. The approach also had benefits beyond naloxone training and distribution including: peers as examples of successful recovery; advice and signposting based on personal experiences and lived realities; and development of an engagement approach free of stigma. There were a variety of challenges in carrying out the programme, including: stigmatising attitudes within partner organisations; potentially risky environments; self-inflicted pressure within the role; training challenges due to peer diversity; peer attrition; and barriers to scale up across Scotland. Participants also identified a range of improvements that they thought should be core to future programmes: paying peers; expanding targets to include dry blood spot testing, direct referrals and other services; and scale up across the UK.
The NPTSP has shown an innovative and successful approach to naloxone distribution, particularly to those who might otherwise not have access due to lack of service engagement. Peers represent a wealth of knowledge and experience, and a unique opportunity to connect with people who use drugs, that cannot be replicated by those who do not have such experience. With these advantages, there is no reason that peer to peer naloxone efforts should not be adapted across the UK and more broadly.
Project team
Matt Smith (Principal investigator, GCU), Andrew McAuley (GCU), Hannah Carver (University of Stirling), Kirsten Horsburgh (Scottish Drugs Forum)
Contact: matt.smith@gcu.ac.uk
Findings published in the Scottish Drug Deaths Taskforce Final Report: https://drugdeathstaskforce.scot/news-information/publications/reports/final-report-evidence-paper/
Funded by the Scottish Government
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