Introducing naloxone in your service

Hostel culture, policies and procedures, local networks, recording and reporting.

Hostel culture

The culture in a hostel is shaped by organisational policies and procedures, management and staff and other environmental factors. Developing a ‘no blame’ culture in hostels, with high tolerance policies towards on and off site drug use will impact on engaging residents in harm reducing initiatives like naloxone.

Overdoses often take place behind closed doors, out of view of staff and volunteers. It may not be clear to those present if the person has overdosed or not, especially if other people are also intoxicated and/or have not completed the training. Users and others present may not want to get into trouble or may be embarrassed about what has happened. 

Conversations in one-to-one sessions with staff, group sessions, informal conversations, posters in the hostel (see example PDF), drug-tolerant policies and procedures, will all contribute to creating an open, harm reducing environment. It’s important that residents feel comfortable and safe in alerting the appropriate person that someone may have overdosed.

Local Policies and Procedures

Local policies and procedures can provide a framework for creating a safe and open culture, supporting harm reduction and preventing drug related deaths. Policies and procedures such as drug use and evictions can be an important part of this: making clear that residents should feel comfortable talking to staff about their drug use and raising the alert if they have concerns that someone has overdosed, without the fear of punitive measures or putting their or other tenancy at risk.  

Hostels should have procedures in place for the procurement, storage, administration and disposal of naloxone supplies.  The service should ensure a needle stick injury policy is in place. In light of the regulation changes in 1st October 2015 allowing hostel staff to be supplied naloxone, policies relating to the wider storage and handling of medications may also need to be reviewed.

Local networks

If naloxone is already available in your area, your local drug treatment service should already be liaising with a wide local network in order to make them aware that people will be carrying naloxone, the reason why and that people are trained to use it. The hostel manager should speak to the drug service manager to see if anyone needs to be informed about the hostel’s intention to provide, or that you are providing, naloxone.

This may include -

  • The police
  • Local ambulance service clinical lead
  • Needle exchanges
  • The local coroner (they may be interested in new efforts to prevent future deaths)
  • Local hostel managers
  • Other services in your organisation
  • Friends, family, carers of residents (with the permission of the resident)

You may also want to see about participating in local strategic groups looking at harm reduction, recovery practice and drug related deaths.

Recording and reporting

Speak to your local drug service for guidance on local recording and reporting arrangements.

Overdose prevention, management and use of naloxone should be a standard part of each resident’s service introduction, initial assessment, support plan and review.

Keep up-to-date records of staff and residents who have completed naloxone training, are prescribed naloxone (with batch number and expiry date) and willing to be called in case of another resident’s overdose. This could be kept on a central database and feature as part of individual resident’s risk assessment and risk management strategies. You should record information on where individuals keep their naloxone, if not in a standardised place for each resident.

Where an incident involving an overdose has occurred, an incident form should be completed with a summary of the situation and outcome. The supplying drug service may also want to keep a record of this and review upon re-supply or other regular points. Incidents should be reviewed soon after by the manager and staff team to see what worked well and any learning to inform future practice.