The aim of this evaluation was to establish whether the current model of naloxone provision and training across all Health and Social Care (HSC) Trusts in Northern Ireland is sufficient and to identify areas for development.

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This report was prepared for the PHA. Please cite as:
Shorter, G.W. & Bingham, T. (2016). Service Review: Take Home Naloxone programme in NI. Consultation with service users and service providers. Belfast: Public Health Agency.

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This report, which is based on data provided by countries for reporting on the Dublin Declaration, summarises key issues related to HIV and people who inject drugs (PWID) in Europe and Central Asia. It identifies priority options for action to improve the HIV response for this population.

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This publication describes general fundamental elements of nutrition and training required for safe and effective muscle building. By putting this advice into practice and adhering to a personal training and nutritional plan for a sustained length of time the desired result should be seen.

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The Government has been accused of adopting a “head in the sand” approach to the problem and criticised for a continuing delay in introducing laws controlling the supply and possession of legal tranquillisers.

Garda sources said that organised crime gangs have moved in to control the supply of the lucrative trade in benzodiazepines (tranquillisers) and so-called z-drugs (hypnotics), while health researchers report that a third of all overdoses involve benzodiazepines.

Official statistics show a rise of almost 25% in the total number of people treated for illegal drug use between 2009 and 2013, increasing from 6,668 to 8,259.

Figures gathered by the Health Research Board for the main drug of abuse-level users show that the biggest increases are for benzodiazepines (up 175%, from 261 in 2009 to 719 in 2013), and cannabis (up 61%, from 1,531 to 2,460).

Opiates — in most cases heroin — rose by 4% from 4,013 to 4,189, but this reflected a fall in Dublin (from 2,360 to 2,100) and a 26% rise outside Dublin (from 1,653 to 2,089).

A geographical breakdown on treatment shows:

Dublin: 3,302 people were treated in 2013 (3,039 in 2009, up 9%), 233 were treated for benzodiazepines (115, up 103%), 528 for cannabis (224, up 136%), and 2,100 for opiates (2,360, down 11%)

Cork: 1,008 people were treated in 2013 (687, up 48%), 132 for benzodiazepines (46, up 187%), 460 for cannabis (333, up 38%), and 332 people for opiates (217, up 53%)

Waterford: A total of 418 were treated in 2013 (256, up 63%), 62 for benzodiazepines (8, up 675%), 140 for cannabis (64, up 119%), and 173 for opiates (113, up 53%)

Kerry: 236 people were treated in 2013 (122, up 93%), 21 for benzodiazepines (less than five), 127 for cannabis (65, up 95%), and 59 for opiates (35, up 69%)

Tipperary: 353 people were treated in 2013 (267, up 32%), 40 for benzodiazepines (8, up 400%), 142 for cannabis (118, up 20%), and 140 for opiates (96, up 46%)

“Heroin in Dublin is static, but outside Dublin, in the likes of Athlone, Limerick, Waterford, Carlow, Galway and Cork, heroin unfortunately is spreading,” said a senior Garda source.

“Benzos are a major problem, with a huge increase in organised crime involved in the supply and manufacture of benzos and z-drugs.”

The Garda source said many people addicted to cannabis were spending €300 to €400 a week on the drug and that this was resulting in “drug-related debts and intimidation”.

Cork City Sinn Féin TD and drug activist Jonathan O’Brien said there was “no doubt” that heroin had spread, including in Cork.

He said addicts were using a range of drugs, including benzodiazepines, and that there had been an increase in mental health issues and homelessness.

“The Government has its head stuck in the sand,” said Mr O’Brien.

Tony Geoghegan, director of Merchants Quay Ireland, said they had seen a rise in the number of people outside Dublin using their residential detox facilities. He said benzodiazepines and heroin were the main drugs.

Cormac O’ Keefe Irish Examiner 13/4/2015

The demonstration project involves 600 patients receiving take-home Naloxone within the current legislative framework.  The product (Prenoxad 1mg/ml injection) is a licensed injectable administered via the parenteral route and formulated in a specific overdose pack. This allows for lay administration. The product is currently available inWales and England.

A key element of the demonstration project is the provision of training for drug users and those close to them, on the use of Naloxone and on recognising and dealing with overdose events.

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