On Sunday at a media briefing in Edinburgh, Health Secretary Jeane Freeman announced that “the Lord Advocate has confirmed that – for the duration of this crisis – it would not be in the public interest to prosecute any individual – working for a service registered with the Scottish Government – who supplies naloxone in an emergency, to save a life”.
This development aims to increase the distribution of naloxone kits by relaxing the rules around who can supply the life-saving medication. It remains the case that anyone can legally administer naloxone, to anyone, for the purpose of responding to a suspected opiate-related overdose.
UK regulations were amended in 2015. These amendments were welcomed by SDF and the broader drugs field as they widened the number of people and services who could supply take home naloxone kits and the criteria for those people to whom a supply could be made. Under the regulations a ‘drug treatment service’ can give a supply of take-home naloxone to anyone likely to witness an overdose. Naloxone remains a prescription-only medicine.
Unfortunately, there remain potential supply routes that regulations have not opened up. A lot of services who are in regular contact with people likely to witness an overdose, such as homelessness services and family support services, are not classed as ‘drug treatment services’. They therefore have to signpost people entitled to get a supply to another service, often in a different location, to receive a take-home naloxone kit.
SDF and others have worked to open up this crucial supply route to maximise the potential of naloxone to prevent drug-related deaths and harms from drugs overdoses.
The Lord Advocate was asked to provide guidelines to allow services that are not providing drug treatment to legally supply take-home naloxone kits to people likely to witness an overdose who are accessing and contacting their services.
The Health Secretary’s statement that “it would not be in the public interest to prosecute any individual – working for a service registered with the Scottish Government – who supplies naloxone in an emergency, to save a life” therefore signals a welcome change of approach from the Lord Advocate.
Unfortunately, there has been an apparent and widespread misinterpretation of what the Health Secretary was describing. What is intended is that the move sanctions the supply of “naloxone FOR USE in an emergency”.
The Minister’s statement is based in Lord Advocate’s ‘statement of prosecution policy’ which will require non ‘drug treatment services’ to register with Scottish Government to become a naloxone provider. They will be supported by their local programmes via naloxone leads in each of Scotland’s health board areas and by Scottish Drugs Forum for any training requirements.
Most agencies who will benefit from the extended distribution plan will already be very skilled in naloxone administration, as they will likely already have been trained and be carrying it for use in an emergency. Cascading this training when making their own supplies will be a natural progression in organisational development.
Currently these new rights to supply have only been made for the duration of the coronavirus pandemic but SDF will be strongly advocating for this to remain normal and usual practice until the UK regulations can be amended to ensure this supply is endorsed through the usual legal framework.
Recently, SDF was provided with a small grant made as part of the Scottish Government’s response to the COVID19 pandemic. SDF proposed to ensure and support the provision of naloxone kits via new routes and is liaising with other organisations and local naloxone leads to identify areas to deliver this.
SDF’s Strategy Coordinator for Drug Death Prevention, Kirsten Horsburgh, said “This is a very welcome development that has been needed for some time. The most important aspect of the national programme is to ensure wide, easy to access to naloxone. The more kits in circulation, the more lives will be saved.”
To find out more about naloxone and how to use it, you can access SDF’s free e-learning course, Overdose Prevention, Intervention and Naloxone.