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Scottish Naloxone Network (ScoNN)

Take Home Naloxone Programme

Drug Treatment Centre

Standard Operating Procedure (SOP) Recommendations

In 2015 legislation was passed to allow the supply of naloxone, a Prescription only Medicine, by non-clinical staff without the need for a prescription or Patient Group Direction. The legislation is specific to services which provide drug treatment i.e. Opioid Replacement Therapy (ORT) or Injecting Equipment Provision (IEP).

The Take Home Naloxone programme aims to reduce the incidence of drug related deaths due to accidental opioid overdose. By raising awareness of overdose prevention and providing education on the signs and symptoms of overdose, calling an ambulance, basic life support and the administration of naloxone, it is hoped to reduce the number of fatal opioid overdoses.

The following points are for consideration by services in developing an SOP relating to the delivery of the Take Home Naloxone Programme. It is recommended that the drug treatment centre has procedures in place which cover but are not limited to: staff training; ordering; storage; supply; recording; risks; emergency use in the service.

Training

  • Staff must have completed locally approved training in naloxone prior to participating in the naloxone programme.
  • Staff will be provided with access to a copy of the Take Home Naloxone Supply Competency Framework.
  • On completion of training and demonstrating an understanding of the Framework, the name and signature of each member of staffwill be recorded on the staff training record.
  • Refresher training should be undertaken every three years as a minimum.
  • It is the responsibility of the drug treatment centre manager to ensure that staffwho are trained are competent and to maintain and monitor the staff training record.

Ordering

  • Prenoxad® Injection (Naloxone hydrochloride 2mg/2ml Pre-filled Syringe for Injection)must be supplied. Generic versionsDO NOT contain needles or the appropriate patient information leaflet (PIL) and are not licensed for use in non-clinical settings.
  • Supplies should be obtained by...... INSERT LOCAL PROCESS......

Storage

  • Stock should be segregated from other medicines which may be held within the service to minimise the risk of any potential picking error.
  • A storage area should be identified which can be locked and is not accessible to the general public or service users. It should be kept locked when not in use.
  • Packs should be stored as per manufacturer’s recommendations.
  • Packs must remain sealed.
  • Stock should routinely bedate checked and stock rotated. The stock with the nearest expiry date should be used first.

Supply

  • Supply must be made in accordance with the Take Home Naloxone Supply Competency Framework.

Recording

  • The individual receiving a supply of naloxone must consent to ....INSERT LOCAL INFO......
  • Supply to individuals must be recorded using the recommended paperwork and/or database.
  • Client data is confidential and as such procedures should be in place to ensure data protection and information governance requirements are met.
  • Where supply is not made for any reason, this should be recorded.
  • Monthly submissions should be returned to ...... INSERT LOCAL PROCESS......

Potentialrisks/Points of note

  • If the generic naloxone product is supplied instead of Prenoxad® the individual will not have the necessary needles or PIL if faced with an opioid overdose.
  • If naloxone is supplied without checking the person’s awareness or understanding of the training elements they may not be equipped to take appropriate action if faced with an opioid overdose.
  • The serviceis unable to offer naloxone supply due to trained staff beingunavailable. Aim to have sufficient staff trained to allow access during opening hours and be aware of other local services offering the intervention if signposting is required.

Emergency Use of Naloxone

Drug treatment centres will come into contact with individuals who are at risk of opioid overdose and there may be occasions when a patient or service user will overdose within the vicinity of the service. It is an expectation that staff will be trained how to respond to an overdose situation within the drug treatment centre and be familiar with local procedures.

NHS Services – refer to local policies and procedures for administration of emergency medicine.

Non-NHS Services – further guidance is available from the Care Inspectorate

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