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Help from Others: Friends and Family

Help from Others: Family and Friends

NOTE: Quotes are presented word for word apart from minor editing for readability and clarity. Identifying details have been removed. Square brackets show text that has been added or, where ellipses (three dots) appear, removed. For example, ‘Since I actually participated in this Narcan [training], I’ve administered it to two people and it’s brought them around […] I wouldn’t think twice about [doing] it. Saving someone’s life is the main thing.’

The people we interviewed for this website often spoke about the importance of their family, friends and other personal relationships. They describe these relationships as shaping their perspectives on drug consumption, overdose and take-home naloxone.

Many participants (including those who no longer consume opioids), describe take-home naloxone as a tool for ensuring the welfare of others. They speak about it as something they seek out because they don’t want to tragically lose more friends to overdose. They carry it in case they come across an overdose in a public place, and they store it at home for family members.

Those who enjoy close connections with their families often describe the ways take-home naloxone could be used to protect their parents or children, while others say their parents would be able to use it if they, the adult child, overdosed.

Some speak about sharing information with family and friends on the best ways to use take-home naloxone. This information, some say, is especially valuable because of the potential to panic when trying to respond to a loved one’s overdose.

Conversely, some participants report that they lack family and friends, and this means take-home naloxone isn’t relevant to them. For example, some wonder how it could help them given they live and consume opioids alone.

Overall, the experiences and perspectives recounted here suggest that family and friends are central to our participants’ understandings of overdose and take-home naloxone.

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Helping Others

Participants in the interviews often discuss worrying about the welfare of others. They especially focus on the importance of family and friends in their lives. They describe how personal relationships influence their thoughts about take-home naloxone in different ways. For example, some speak of it as something their partner could use to revive them, while others recount times they have saved a family member or friend. Many talk about take-home naloxone as a way of looking after other people as much as a way of looking after themselves.

Andrew (M, early 40s, Vic, non-prescribed opioids) describes carrying take-home naloxone at all times in case he needs to help someone with it. For Andrew, it’s a tool for saving his friends’ lives. (Read his personal story here)

I push it to all my friends these days. I carry it in my backpack 24/7. Everyone knows I’ve got it, so if I’m near or I’m in [a] group at the time [of an overdose], it’s there […] Mates don’t have to die any more. We can do something about it. I’m over losing my mates.

Like Andrew, Julian (M, late 40s, Vic, non-prescribed opioids) reports carrying take-home naloxone in case of an emergency. In this instance he explains that he keeps naloxone in his car in case he comes across an overdose, and that he’s told some of his friends about it. (Read his personal story here)

I’m not using [opioids] any more, no. Like, I still have the naloxone in my glove box, so if I’m driving around and see someone on the side of the road or something that [looks like an overdose], I can help. I don’t let anyone use [opioids] in my house, so that’s not a problem, I don’t need one in my house, but, yeah, I’ll still keep it for emergencies in that way […] The first time [I told my friends about naloxone], they’ve said, ‘Oh yeah, what is it?’ I just say, ‘It’s just that when you do the training, you get the little vials and the syringe and everything, and if you’ve got to use it, you just put it in the syringe and put the needle on there and jab someone on the leg and squirt it in.’ But, yeah, nothing else really.

Although Mark (M, early 40s, Vic, non-prescribed opioids) didn’t know much about take-home naloxone before his interview, he thought it was a good way of looking after others. (Read his personal story here)

I just like the idea that there could be something out there that lay people could buy, have it wherever it needs to be stored, and hopefully it lasts for a good time, and then that way, we can look after each other […] I like the idea, you know, that even in an area like [in the Melbourne CBD], where there’s a hell of a lot of drug use, you know that someone might be able to rush in [and help]. A bit like those […] defibrillators. Yeah, I know certain beaches or train stations or whatever [have them]. I like the idea that in certain areas there’s an emergency defibrillator and […] anyone can use it. It’s a first response thing, you know, and I like that.

Shelley (F, late 30s, Vic, non-prescribed opioids) explains that she brought a friend along the second time she attended overdose response training. (Read her personal story here)

I actually did [naloxone training] twice because I didn’t remember [enough information] the first time. I [also] got my friend to actually come in and do it, yeah. [And how did you find the training or the course?] […] I was interested […] in the subject […] because [the training] does help. You know, people down the track, like I’ve got two kids and they don’t touch drugs, but I mean if anything ever [happened in the future…].

Tony (M, mid 40s, NSW, non-prescribed opioids) says that he isn’t sure carrying take-home naloxone is relevant to his own drug use and worries that it could create negative interactions with police. However, he argues that it’s a good idea to keep it at home since he keeps prescribed opioids in the house and worries they might be consumed accidentally by a visitor. (Read his personal story here)

I try not to keep very much drug paraphernalia on me because it just starts the ball rolling for [police] searches. Every time they bump into you, it all goes down on their files nowadays. I was [also] a bit reluctant about getting the [take-home naloxone] because I was by myself and using by myself. One of the main things [though, are relatives], like, I couldn’t cope if [they] accidentally or inquisitively took some of my [prescription] medicine that was at home [and overdosed], you know.

Contemplating take-home naloxone also prompted our participants to reflect on times when they were not able to intervene in overdoses.

Karen (F, early 30s, Vic, non-prescribed opioids) describes how take-home naloxone affects her emotionally. As she explains, it makes her grieve overdoses she wasn’t able to reverse, and worry about the overdoses that may happen when she’s not present to reverse them. (Read her personal story here)

It affects me a lot though, because, like, two of my mates have died and I sit there and think, ‘Well if I’ve saved these [other] people, why couldn’t I [save them]?’ You know what I mean? But I wasn’t there to administer it […It’s good] to know that I have done it [in the past], and they’re still around for another day. I would like to think that they would [then] go on to help someone else too […] That’s my biggest thing: feeling left alone, isolated and not being able to do anything. So that’s the only thing I carry with me is the grief and worry about what I can’t do.

Similarly, Jamie (trans-woman, early 30s, NSW, non-prescribed opioids) explains that losing her partner to an overdose prompted her to complete overdose response training. (Read her personal story here)

Well, because I have had people die from overdoses and stuff, and that’s why I decided to do [the training] and, yeah, I pretty much [now] know how to do intramuscular injections. My last partner […] died of an overdose, so yeah, and I was helpless, I couldn’t help him […] It’s affected me a lot. It kind of woke me up a bit. I’ve got depression from it […] I was pretty distraught at the time, so yeah, I was just a mess.

According to Julia (F, mid 50s, NSW, non-prescribed opioids) take-home naloxone may give family members the confidence to help during an overdose. (Read her personal story here)

I think [take-home naloxone] would give somebody’s mother a big dose of confidence to be able to help in that way, especially if she has been through [an overdose] before and had to call an ambulance. To be able to do it herself and still call the ambulance would make a huge difference. That would be a great idea, you know. Your sisters and brothers or everybody in the family who sees this person, you know. If they know, and if they’re still lucky enough to have family contact, you know.

On one occasion Ghassan’s (M, mid 30s, NSW, non-prescribed opioids) mother called an ambulance to respond to his overdose, so he thinks keeping an intra-nasal naloxone product at home is a good idea. (Read his personal story here)

Like, for me, it would be good at home because, like, my mum has found me in the bathroom and she’s had to call an ambulance. So if there was naloxone at home, then she could just administer it herself. […] I reckon the nasal spray [would be the best product], 100%. Yeah, I think people using it, they [might] start freaking out with the needle. Whereas if you just stick it up someone’s nose, how easy is that? I know [my mum might think] ‘Oh, do I need to do it in the vein or do I need to do it in the muscle?’ That kind of stuff, so with [the nasal spray], you just go up the nose.

While Andrew (M, early 40s, Vic, non-prescribed opioids) recounts a number of times he revived people with his take-home naloxone, here he describes a recent event when his friends used his naloxone to revive him. (Read his personal story here)

Some time ago I was working with my friend, Thomas, doing mowing and landscaping, and one day we decided to share some heroin. We’d done this before, and we were both using the same amount as usual, but this time I overdosed. Thomas later told me he caught me before I hit the bathroom floor, and screamed out to his girlfriend and his mum, telling them to bring my backpack from the lounge room.

They brought my backpack, phoned the ambulance, and got out the pack of naloxone that I carry with me 24/7. Thomas injected me with the two naloxone Minijets [prefilled syringes] from my bag and that brought me back. I came to and was all right. Thomas had never had any naloxone training himself, but because we regularly used heroin together, I’d explained to him how to use it. After that experience, I preach to all my mates to do the overdose response training.

As soon as I heard about naloxone and the overdose response training, I did the program straight away, and since that time, I never leave home without my naloxone kit. The Minijets are easy to use, you just put a tip on them, so it’s quicker than using the glass vials [ampoules] of naloxone, but they’re both the same thing. It doesn’t worry me either way.

Police often stop me on the street and look through my backpack to see if there is any contraband. They ask if I am carrying any sharps, so I tell them straight out, ‘Yes, and I have the naloxone kit’, and they have a quick look.

I know a guy who has saved 12 people with naloxone at different times in his own home, and I’ve used naloxone to help other people twice. I have a bit of confidence now, because I know I can do it and it worked. Sometimes I worry whether I am going to have enough ampoules though.

The importance of interpersonal relationships appears again in Karen’s (F, early 30s, Vic, non-prescribed opioids) account of how she and her husband talk about the best ways to respond to overdose. Like her, he has used take-home naloxone a number of times. (Read her personal story here)

If someone says ‘Someone dropped’, we all instantly go, ‘So did you bring the Narc [naloxone] out?’ That’s where other people wouldn’t really talk about it. I suppose that’s one good positive thing about being with a bloke that has saved people too. We can talk about it and figure out which way does best for others.

Participants also suggest that personal relationships affect how recipients respond to revival with take-home naloxone.

Dylan (M, early 30s, Vic, non-prescribed opioids) notes that he’s ‘well regarded’ in his community, and it’s known that he only intervenes in situations in order to ensure the person’s ‘health and well-being’. (Read his personal story here)

It’s easier if you have some sort of relationship with the person that you’re administering it to, or if you’re at least known to each other. I’m quite well known and quite, I don’t want to say the word ‘popular’, because that sounds like high school, cliquey kind of [thinking] … but I’m quite well known and […] well regarded within the [inner Melbourne] community. So if I come across somebody that’s having an overdose situation and I respond to it, people generally know that I’ve done it for their health and well-being. It’s not something that I just do for the sake of doing.

While Ghassan (M, mid 30s, NSW, non-prescribed opioids) says administering take-home naloxone is easy, he often consumes heroin alone and knows he wouldn’t be able to give it to himself if he overdosed. (Read his personal story here)

Like, [giving naloxone is] not hard. We use needles anyway. I know how to use it. It’s pretty self-explanatory. For me it is, anyway. But, like, my head tells me I know better and it says, ‘You’ll be careful, you won’t need it.’ And I always, I use [heroin] alone [and] that’s the scary part too. I’ll go by myself […] and it’s dangerous, it’s really dangerous because if something does happen, I’m not going to be able to snap out of it and give myself the injection […] I don’t know, I’m really weird too, like, it depends how much I have. If I have a lot, if I score a big amount, I’d go to the injecting room. If I don’t, if I’m doing a little bit, I’ll do it at home. I don’t know, it’s just weird.

Attitudes to heroin consumption among family and friends are also mentioned by some of our participants in thinking about take-home naloxone.

According to Lewis (M, mid 40s, Vic, non-prescribed opioids), his father wouldn’t be interested in keeping or using take-home naloxone. (Note: strong language) (Read his personal story here

I guess if you’re in a situation where there are non-using people that are around you and would recognise that situation [overdose], it would take a certain degree of acceptance on their behalf. You know, I’m sure if I mentioned [take-home naloxone] to my father or something, he’d be like, ‘Well how about you just don’t fucking use heroin,’ and that would be the end of that. But I understand […] that there are different degrees of acceptance [of heroin consumption within families…] I wouldn’t ask someone, or my son’s mother, to do [overdose response training because] it’s just a bit of the same: ‘How about you stay off the fucking heroin?’ But yeah, once again, I’m hiding it from her, so she’s the last person who’s going to find me overdosed.

Focusing on the family unit has a whole, Ken (M, mid 30s, Vic, prescribed opioids), speaks about why he might keep naloxone at home. Ken consumes opioids to manage a health condition.

I’ve been sick with immunological diseases, or disease, for a long time, since about year ten, and that has meant that I’ve experienced varying levels of pain over the years. And I was never really … I guess I was never really worried about opioids. I’d used them in the past, but recently I’ve had a couple of surgeries, like, I’m talking in the last four years, couple of surgeries that required some pretty serious sort of post-operative, in-hospital pain relief.

[…]

And I think about overdose, like accidental overdose, more than anything I’m using very measured, you know, pharmaceutical grade Endone, but I use it in conjunction with sleeping tablets and things, so I’ve never really asked anyone, like “how much of this is safe?”. And I’m sure the response I’d get, you know, from people in the medical fraternity, is “just take what your doctor tells you to take and you’ll be cool”. So I religiously do, but, you know, I’m sure there’s nights that I go out and I might have a couple of beers and a couple lines of coke or something and then I’m like … I’m still taking what the doctor tells me to take … but I’m sure I wouldn’t be the first person to take [what you] were supposed to take and have some sort of accident. So that’s sitting in the back of my mind, you know what I mean?

[…]

And if I was to have an accidental overdose, the ramifications for the people I know, family, like, it would, yeah, it would destroy people, you know.

[…]

So yes, there would be an absolute argument for me to have a Narcan pen in the cupboard, like someone would have an EpiPen for anaphylaxis. That argument would be that it wouldn’t matter how much someone seems like they’ve got it together on the surface. To my friends, family and work, I’m cruising along pretty well. I’ve got a job, steady income, wife, family, but here I am having this interview and it’s pretty crystal clear that I’m, as well as all those things, at risk of overdose. And if there was Narcan at home and I could bring the people closest to me up to speed, then that would certainly perhaps save my life.

As with Ken, many other participants also draw parallels between the use of take-home naloxone and the use of EpiPens® to counter serious allergic reactions.

Olive (F, early 70s, NSW, prescribed opioids) describes take-home naloxone as a safety ‘backup’ for use by partners of people who consumes opioids, just like an EpiPen®.

I think people with chronic pain usually have [a] multidisciplinary […care team who should teach them how to administer naloxone]. It also should be with a partner or friend, someone who’s close, and for safety reasons for them. It’s just backup safety, just like they do for anaphylaxis […] I know I take different number of tablets every day [and] I know it’s very easy to mix them up. You think you’ve taken one, but you’ve taken something else. My husband takes a lot more than I do and a few times I’ve found one of his tablets still sitting on the plate that he’s [forgotten to] take […] I know how easy it would be to accidentally take a double dose, an overdose, and that worries me [so] I have to think [carefully] sometimes. So I just think anyone who takes opiates should have [naloxone], just like anyone who gets anaphylaxis should have an EpiPen.

Some participants don’t feel that take-home naloxone is relevant to their current situation.

Even though Adam (M, late 40s, NSW, prescribed opioids) says he isn’t sure if take-home naloxone is relevant to him at present, he says it could be useful if a medication mix-up happens or if his regime of pain medication changes in the future, especially since he lives far from medical care.

If I was on OxyContin tablets, for example and, for whatever reason, I took too many of them, whether it’s deliberate or by accident, it’d be handy if my wife had access to something on those lines [… In the past] it wasn’t uncommon for me to forget what [medications] I’ve taken and that sort of thing. One time I doubled up on pretty much my entire day’s dose of all different tablets and, basically, I was off my face for the whole day. At least, I didn’t have any bad side effects from that, but, yeah, [overdose is] something I could see easily happening to some people. If you’re in a rural area like [I am], sometimes you might be looking at half an hour or more for the ambulance to get to where you are. If you don’t have that initial aid, you know, I can see that being potentially fatal in some cases.

Participants also talk about the ways their relationships with others affect their thoughts and actions during an overdose.

Cameron (M, mid 40s, NSW, prescribed opioids) explains that the experience of dealing with overdose varies depending on the person you are helping. In his view, administering naloxone needs to be as simple as possible so it’s easy to ‘concentrate’ when trying to save the life of a loved one.

I think it all comes down to who the person is. If I came across someone on the street, I would be reacting differently to coming across a loved one or someone I knew, you know. You’ve got that disconnect with the average person, so you can concentrate more on doing rather than worrying about ‘that’s my cousin’, ‘that’s my wife’, whatever it is. I think, in those situations, you’ve got to make it as simple as possible. So it’s got to be idiot-proof […] basically.

However, in contrast to some of the perspectives described so far, many of our participants explain that they don’t have the right relationships for take-home naloxone. They aren’t sure whether take-home naloxone is suited to them or whether it would be as helpful for them as it is for others.

While Charlie (M, mid 40s, Vic, prescribed opioids) explains that take-home naloxone would have been a useful ‘safety net’ when he was living with his wife, he questions whether it would help to him now that he’s living alone.

While [other] people were living with me, [such as] my wife at the time, [take-home naloxone] would have been a useful safety net for her. And she was a [health practitioner] so she would have been quite confident in administration. But there was a lot of time in my life […] where I’ve been alone. So I need to question whether [keeping take-home naloxone] would help.