by Baden Hicks

According to Harm Reduction International, ‘harm reduction’ refers to policies, programmes and practices that aim primarily to reduce the adverse health, social and economic consequences of the use of legal and illegal psychoactive drugs without necessarily reducing drug consumption. Harm reduction benefits people who use drugs, their families and the community.

Celebrated each year on 7 May, International Harm Reduction Day aims to promote evidence-based public health policy, practices and human rights.

This year on International Harm Reduction Day, I organised and ran overdose prevention training for the members of the Australian Psychedelic Society and their loved ones. I am very passionate about overdose prevention training and advocating for the importance of naloxone being available to the public, as I have lived experience of overdose and having to have naloxone administered to myself. I might not be alive today if people didn’t know how to respond to an overdose and administer naloxone. I have had to respond to overdoses and administer naloxone to other people as well, and it makes it a lot less stressful if you do know what to do to save someone’s life.

The overdose training that we did online on International Harm Reduction Day was focused on opioid overdose. It was facilitated by myself and the training was run by the wonderful Brittany Chapman who works at Harm Reduction Victoria. Some of the things we went through in the overdose prevention training were how to recognise an overdose, how to respond to an overdose and how to administer naloxone.

What are opioids and opiates?
Opioids include any drug that acts on opioid receptors in the brain, and any natural or synthetic drugs that are made from or related to the opium poppy. Opiates are a type of opioid. They’re drugs which are naturally derived from the opium poppy plant, and are not synthetic. Opioids bind to opioid receptors which depress the central nervous system – meaning they slow down messages between the brain and the rest of the body. On opioids, your breathing and heart rate slow down. Dopamine is released, causing sensations of pleasure and pain relief.

What is an opioid overdose?
An opioid overdose happens when too much of the drug overwhelms the brain and interrupts the body's natural drive to breathe. During an overdose, breathing can be dangerously slowed or stopped, causing brain damage or death if not responded to appropriately in time.

What is naloxone?
Naloxone is a medicine that rapidly reverses an opioid overdose. It is an opioid antagonist. This means that it attaches to opioid receptors and reverses and blocks the effects of other opioids. Naloxone can quickly restore normal breathing to a person if their breathing has slowed or stopped because of an opioid overdose. But naloxone has no effect on someone who does not have opioids in their system. It can be administered by an intramuscular injection or also comes in a nasal spray that is called Nyxoid, which is sprayed up the nose. Nyxoid can be a good option for those that are a bit uneasy about using needles and injecting someone, although does have its downsides, as each spray only contains one dose which is reasonably high and can put someone in precipitated withdrawal a lot easier. Whereas the intramuscular injection contains five doses and you can do what’s called step dosing, which is giving a little bit at a time to bring someone out of an overdose without putting them into much of a precipitated withdrawal. People will only go into withdrawal if they have been using opioids for some time and have developed dependence.

I thought it would be a good idea to organize opioid overdose prevention training for The Australian Psychedelic Society because opioids like fentanyl and nitazines among a few others are making their way into more and more different types of substances these days, like ketamine, MDMA and Xanax. It can be really dangerous when people don’t know what their drugs have been cut with and cause overdose, so it’s very good to know how to respond when you are with someone who is experiencing an overdose. I think it’s really important to get as many people trained in overdose prevention and naloxone administration as we can. This is because we don’t always know 100% what is in some of the drugs that people take because we don’t have a regulated safe supply of most drugs due to prohibition, which I believe is the most dangerous thing about drugs.

One thing people worry about if there are any adverse reactions to drugs or someone is experiencing an overdose is calling for an ambulance. Some people worry about the legal ramifications, but police have been told not to attend ambulance call outs for an overdose and generally only the ambulance officers or fire brigade will turn up because they don’t want to discourage people from calling for help. The police will only show up if they think that it might be dangerous for the ambulance officers.

If you would like to be trained in overdose prevention and naloxone administration, the drug user or harm reduction organisation in your state will be able to direct you to where you can get trained in person or online. The training is usually free and you are usually provided with a free naloxone kit as well.

I’d like to thank the Australian Psychedelic Society for giving me the opportunity to be able to organise the great event that we had on International Harm Reduction Day, as well as Brittany Chapman from Harm Reduction Victoria. I’d also like to thank those who came along to the training and learned how to respond to an opioid overdose and save a life.

Baden Hicks is a senior drug and alcohol lived and living experience peer support worker at Turning Point, one of the chapter leaders for the APS Melbourne chapter, part of the “Keep our city alive” campaign advocating for the second overdose prevention site in Melbourne, and an overdose prevention trainer. He is passionate about advocating for the rights of people who use drugs, for harm reduction, and decriminalization of all drugs, and believes the most dangerous thing about drugs is prohibition.