In this month’s issue of the Police Gazette

Like any difficult job, having the right tools in place to do it well is absolutely crucial from the outset. Chris Rintoul from leading charity Extern believes it's no different when it comes to voluntary and statutory agencies working together to tackle and deal with problem substance use in our communities.

"In 2017, there were 136 drug-related deaths, a rate of 75 per million (NISRA, 2019). For comparison the rate in England and Wales was 66. In the Belfast area this rate climbed to 117. This represents a 58% rise since 2007, and 63% of these deaths involved an opioid."

Chris Rintoul , Manager of Extern's Drug and Alcohol Consultancy Service (DACS), is not only talking about statistics when he refers to the above increases in drug­ related deaths. He is also talking  about the very real impact on people's lives that he, and his colleagues in Extern, along with the emergency response services here, are increasingly seeing on a daily basis.

Fearsome foursome

"Evidence also shows that most of those who suffer a fatal overdose have taken multiple drugs together", says Chris.

"In Extern, we talk about the 'fearsome foursome' - alcohol, opioids, pregabalin and benzodiazepines.

''A generation ago polydrug use certainly occurred, but it was not normalised among groups of drug users in the way it now is. In 2007, only 52% of those who died did so after taking multiple drugs; by 2017 multiple drugs were involved in 71% of deaths. "

A growing issue

He adds, "The range and availability of drugs has also increased, for example New Psychoactive Substances - aka 'legal highs' - and sedating prescription drugs. Compared to ten years ago there is also a far more stable supply of heroin available. People also binge  on  drugs for longer periods, more  so  than  they did 20 years ago. Other risk factors or characteristics linked with fatal overdosing are ageing , social deprivation, being male, having poor mental health and recently leaving prison or rehab."

According to Chris, "Such figures undoubtedly show that we are facing a growing issue. What they do not convey, however, is the number of non-fatal overdoses which are either unseen, unreported or successfully reversed - for example when the medication naloxone has been administered to reverse the effects of an opioid overdose."

Naloxone saves lives

'Today, Extern is the leading supplier of naloxone training in Northern Ireland, and we frequently attend overdose situations alongside the emergency services.

"Numerous PSNI officers have mentioned to us that they would be interested in finding out more about how to use naloxone to save someone's life. Various police forces across the UK have been trained with regards to this, but at present there is no broad agreement that PSNI officers can carry and administer naloxone to casualties where opioid overdose is suspected."

Chris believes being able to do so could be a vital tool in a police officer's toolkit of responses when faced with a challenging life or death situation.

"We believe this is a move which would save lives and reduce the trauma experienced by police officers when they find themselves unable to assist in an overdose situation until paramedics, or someone with naloxone, can get there.

"What's more, we are willing and able to pass on our skills and expertise in this area to those who are most likely to be first on the scene in such challenging circumstances.

"Extern would welcome any opportunity to see how we can move this forward with the PSNI, and how we all can work togetherto make the difference between life and death on our streets."

Click here for further information on Extern DACS