Four years after it began in humble circumstances, an ACT program is helping to save the lives of Canberra's opioid-dependant community one at a time.
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The program, now one of several across Australia, has been training users and their support network in first aid, CPR and using naloxone; an injectable drug that reverses the effect that many opioids, including heroin, have on the brain.
Started by the Canberra Alliance for Harm Minimisation and Advocacy in 2012 without funding, the program trains and supplies people with "take-home" naloxone packs to help reverse drug overdoses, with some 335 such packs supplied to the injecting community since it began.
It was one of several initiatives, as well as a 1996 decision in Italy to make naloxone available in chemists, that prompted Melbourne pharmacist Angelo Pricolo to apply last year to the Therapeutic Goods Administration to make the drug available over the counter.
While it was already available more cheaply through doctor prescriptions, the TGA in February this year approved the application.
Community pharmacists and general practitioners have been getting up to speed on the drug and how best to advise people on safe administration.
There have been some complications – it is understood stocks of the most easy-to-use formulation (a mini-jet) have run out in many areas.
But a second preparation, with separate ampoule and syringe, remains available through the program and a growing number of pharmacists.
CAHMA naloxone trainer David Baxter said that the more of the injections that were available, the better, although he was concerned many dependant people were reticent to go to a GP for a script, and the take-home program was one he knew was supported by Canberra's injecting community.
While he knew many GPs were learning more about it, Mr Baxter said there were still concerns in the community that some doctors were also reticent to provide the drug, for fear it might be used an "insurance policy".
"The reality is the evidence shows it isn't being used like that, but it is helping to save lives," he said.
"It's really hard to know how many people might have been saved from naloxone, especially when people call the ambulance as well as administer it.
"But we have heard anecdotally of up to 100 'reversals' in Canberra over the past few years, so clearly that's a strong signal it is doing the job."
Mr Baxter said he had also been contacted by friends and family of opioid-dependant Canberrans who had thanked him for the training.
"I have gotten texts from people, one father particularly who had texted me to thank me for the training because he believed it had helped save his son's life," he said.
"It's really great to know that there are people out there who are gratified for this program being here – it does make it all worth it."
CAHMA manager Chris Gough said one of the key things people were told during training was that they were not medical experts, and they should always call an ambulance if they suspected someone was overdosing.
"The first thing people need to do is to check for danger to the person and themselves," Mr Gough said.
"Then check whether the person is unresponsive, if they are not responding, they should call an ambulance on Triple 0 immediately.
"Then they should get the person into a recovery position if possible, and make sure their airways are clear, then perform CPR and administer the naloxone."
Mr Gough said ACT Health gave the program one year of funding, to provide for a full-time trainer last year, and earlier this year CAHMA signed a three-year contract to keep the service running.
"I joined a few months ago as manager, but I was told the first manager basically did the job for nothing, and slowly the program has grown," he said.
"Now we've been able to get three years of funding that will help it continue, and it's really being treated as a core part of the [ACT] health system."
