September 2013

COPE signals statewide naloxone education and distribution

A multi-sector community overdose prevention program involving naloxone distribution and training has been announced by the Victorian Coalition government.

Minster for Mental Health, Ms Mary Wooldridge, chose the lead-up to International Overdose Awareness Day to declare that a state-wide strategic plan of action would begin this year.

The Minister announced that the program would be called Community Overdose Prevention and Education, or COPE.

It would involve engaging existing peer-based overdose education programs, needle and syringe programs, drug treatment agencies including Opioid Substitution Therapy, general practitioners, pharmacists and in future, may also involve pain management specialists.

Minister Wooldridge said: “With more than one Victorian dying each day as a direct result of drug use, we are committed to supporting programs that prevent the use of, and reduce the harm from illegal drugs for individuals and the community.”

The policy change that led to the actual roll-out of a network of specific interventions across Victoria was announced early in the year as part of the whole-of-government strategy known as “Reducing the alcohol and drug toll: Victoria’s plan 2013 – 2017”.

The COPE program aims to:

  • increase GP knowledge of naloxone, to support increased prescribing of naloxone to people at high risk of an opioid overdose;
  • increase the knowledge of pharmacists and other primary health care providers about naloxone, its availability and use;
  • provide at-risk drug users and potential witnesses to overdose (particularly family and friends) with the knowledge and ability to respond to and administer naloxone in the case of an overdose;
  • provide training (train the trainer model) for frontline service personnel (police, pharmacists, primary care providers, Medicare local staff and potential witnesses) about opioid overdose risk factors, how to recognise the signs of an opioid overdose, and how to respond to an overdose including how to administer naloxone; and
  • link into other primary care services and harm reduction settings to mainstream the use of naloxone as a standard opioid overdose prevention tool.

Anex has been tasked by the Government to coordinate the program, which will seek to leverage the widespread needle and syringe programs and the community-based opioid replacement therapy system.

A high level reference group has been convened and includes the Australian Medical Association, Ambulance Victoria, Harm Reduction Victoria, the Department of Health, the Pharmacy Guild, General Practice Victoria, Hanover welfare services and others.

The first frontline service workers naloxone planning forum was held in Melbourne on September 4, bringing together staff from needle and syringe programs, pharmacotherapy outreach, overdose prevention workers, dual diagnosis workers and alcohol and other drug programs more generally.

Under the COPE program, local-area interventions will initially be established in some metropolitan sites, as well as regional areas and possibly also rural towns.

“Our whole-of-government plan sets out how we will work with the community to bring down the alcohol and drug toll,” Ms Wooldridge said.

The COPE project is a prime example of how we can implement innovative, clinically effective and cost-effective measures that save lives.

Mary Wooldridge

“The COPE project is a prime example of how we can implement innovative, clinically effective and cost-effective measures that save lives.

“The project will benefit city, regional and country Victorians, particularly heroin users and people who are at risk of overdosing on opioid-based prescription medicines.”

In particular it will target staff in health care settings that have significant involvement with targeted population groups including health care providers that have:

  • needle-syringe programs;
  • alcohol and drug treatment service;
  • opioid pharmacotherapy program providers;
  • prison post-release programs;
  • primary health care providers likely to have significant interaction with target groups; and
  • specialist homeless services targeting the needs of opioid users.

Anex CEO Mr John Ryan said it was exciting that another jurisdiction had endorsed concerted efforts to target opioid overdose mortality and morbidity.

He said: “There is substantial latent capacity for naloxone promotion and distribution to be integrated into existing health systems. Existing capacity can be leveraged in a cost-effective manner.

The COPE approach is to draw upon existing State and Commonwealth investment, such as the Pharmaceutical Benefits Scheme and Medicare.