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1:10

People fixing, people

1:12

fixing the world.

1:19

Welcome to People Fixing the World from

1:21

the BBC World Service. I'm Myra

1:23

Anubi and on this programme, I find

1:26

interesting solutions to some of the world's problems.

1:29

This week, it's about one simple idea

1:31

that's trying to reduce the number of people

1:34

dying from drug overdoses.

1:41

In the world, according to the World Health

1:43

Organization, more than half a million

1:45

people die from misusing drugs

1:48

every year. And most of those deaths

1:50

are because of a group of drugs called opioids.

1:53

Now two opioids that you might have heard

1:55

of are fentanyl and heroin. And

1:58

today, we'll mainly be focusing on fentanyl.

1:59

Now

2:02

heroin is a highly addictive painkiller

2:04

which uses smoke or snot

2:06

or inject in order to get high. It

2:09

makes people feel drowsy and calm but

2:12

it also slows down the whole nervous

2:14

system and if you take too much

2:17

you can overdose. Your

2:21

breathing gets slower to the point where

2:23

your body starts to shut down. Your

2:26

skin then turns grey as your oxygen supply fails. You

2:29

become unresponsive and if

2:32

something isn't done you could die. Hayden,

2:38

who's 31, overdosed a few

2:40

years ago.

2:41

And the first thing I can remember

2:43

is waking up with

2:46

my trousers and my ankles. Hayden

2:48

recently came out of prison after being convicted

2:50

of selling drugs by oath while

2:52

he was in prison that he overdosed on

2:55

a cocktail of

2:55

drugs, including the prescription

2:57

opioid codeine. And when I turned

3:00

round because I was on the floor I couldn't see

3:02

anything. I couldn't see walls. All I've

3:05

seen was officers and nurses

3:07

and I'm talking and I've six

3:09

by nine

3:12

foot seven, fifteen

3:16

twenty staff. And

3:19

they were on me really well and I knew them really

3:21

well. That

3:24

massively impacted me on

3:26

a day to day basis looking

3:28

them in the eye. After that

3:30

the guilt, the shame I felt

3:33

was unbelievable.

3:36

He was treated by a medical officer

3:38

who gave him a special medicine called

3:40

naloxone which can temporarily

3:43

reverse the effects of an opioid overdose. And

3:46

Hayden says it was a naloxone

3:49

which saved his life.

3:50

And the naloxone just

3:52

brought me back to then I was able

3:54

to go to hospital and get sorted

3:57

and naturally came up from high school and I can make a difference.

4:00

about it, but

4:01

you could have died there.

4:03

In some parts of the world, Naloxone

4:05

has been used in hospitals and by paramedics

4:07

for years, but the problem here is

4:09

that by the time an ambulance arrives

4:12

at the scene of an overdose, it's

4:14

often too late to do anything. However,

4:17

this is where our solution today

4:19

comes in. It's a project that's working

4:21

to put this life-saving antidote into

4:24

the hands of people who are most likely

4:26

to be there when someone overdoses.

4:29

This will buy them more time to call an ambulance

4:31

and get the person to hospital.

4:36

I'm joined now in studio by our reporter,

4:38

Craig Langran, who's been to Scotland

4:40

to see how this is working

4:42

there. And as always, it's great to see

4:44

you, Craig. Good to see you, Myra.

4:45

I suppose the first thing we need to understand

4:48

here is how bad is the drug

4:49

problem in Scotland? Yeah, it's pretty bad.

4:52

So for many years, it's had one of the

4:54

worst rates of drug deaths anywhere

4:56

in Europe. Until recently, that

4:59

figure had been rising steadily for over 20

5:01

years. And then it peaked

5:03

in 2021 when over 1,300 people died. But

5:07

the Scottish government has been trying to do everything

5:09

they can to solve this problem. And part

5:11

of that has been to get a lot of naloxone

5:14

into the places where it might be able to

5:16

save people's lives.

5:17

Right, so the thing with naloxone is it can

5:19

buy you around 20 to 30 minutes

5:22

to save the life of someone who's overdosing,

5:25

only if you get it to them in time. And

5:28

since 2011, they've been using

5:30

naloxone to save drug users' lives in Scotland.

5:33

But two years ago, they started training up the

5:35

people most likely to be there right

5:37

when an overdose is happening. I

5:39

went to see the training for myself. Will

5:42

we do introductions then, quick mate? Yes, yeah, let's

5:44

do that. Is that useful? That's useful, yeah, yeah.

5:47

So my name is... We're in a small room upstairs

5:49

in an office in central Glasgow. Two

5:51

men in their 30s are sitting at one end of

5:53

a long table, getting a lesson on preventing

5:55

drug overdoses from two instructors

5:58

wearing matching sweaters.

5:59

touching on the high risk factors for overdose.

6:02

Can anybody tell me some of the high risk factors for

6:04

overdose? Also family

6:06

members, they sign a bit of series, Christmas,

6:09

teams, stuff like that.

6:11

Folks don't go that well, are they? Yeah definitely,

6:14

definitely high risk times for people using

6:17

alone definitely. The people

6:20

learning know these risks all

6:22

too well. Both of them are former

6:24

drug users including Hayden who

6:26

we heard from earlier who joined this project

6:29

after he was released from prison. And

6:31

I thought well

6:34

nothing good is coming out of this me,

6:37

Hayden and not using

6:39

it and being ashamed of it and using more drugs. So

6:41

I was like why don't I try and see if I can help

6:43

people using my own experiences.

6:47

Wes who's leading the session also

6:49

has this first-hand experience. I've

6:52

had a few near fatal

6:54

overdoses, I've had one scenario

6:57

where I woke up probably about three

6:59

and a half miles away from where I'd used.

7:01

I had very

7:03

sore chest, I had the sensors attached

7:06

to my chest, my chest has actually been shaved,

7:08

I had no recollection of being attended

7:11

by paramedics or being in hospital. I presume

7:13

I was in hospital because I had

7:15

like I say the ECG monitors kind

7:17

of on my chest, just very disorientating.

7:21

But these people aren't the target of this project.

7:24

The charity running the training, the Scottish

7:26

Drugs Forum employs these former

7:28

users as outreach workers who then go

7:31

out onto the streets to teach current

7:33

drug users how to administer naloxone

7:35

and save each other's lives if they overdose. They

7:38

have to go to the current drug users because

7:40

they probably won't come to a training session

7:42

like this at the right time. So

7:45

utilizing local networks is really

7:47

essential to do it, you know word of mouth

7:49

is really important but

7:51

we use all the avenues that we kind

7:53

of can really. And that's where the outreach

7:56

workers come in because they know where to

7:58

find people in the community. and they

8:00

can more easily build trust than someone who

8:03

didn't have that lived experience.

8:05

Here's Haydn again. Wes

8:30

and his co-trainer Amir

8:33

are teaching the basic first aid the outreach

8:35

workers need before they can hit the

8:37

streets.

8:38

We

8:45

start with identifying an overdose. If

9:00

they aren't breathing then it's straight into CPR to chest compressions

9:03

and breaths. You

9:26

call for an ambulance and you've

9:28

got to inject them with the anti overdose drug

9:30

naloxone. Wes handed me the kit

9:33

they used to take a closer look. We've

9:35

got a yellow box and then just opened

9:37

up the

9:41

yellow box here. And inside

9:45

we've got a 2ml syringe

9:49

and then two needles. Everything

9:51

inside has got this kind of cellophane

9:54

wrapper. Thousands and thousands

9:56

of these boxes have been distributed in Scotland.

9:59

turns injected into a muscle, not

10:02

into a vein. And on the table

10:04

in front of me was a soft, squishy yellow

10:06

ball, about the size of a tennis ball, which

10:08

we're using today to practise injecting

10:11

into a leg muscle. You want the

10:13

outer thigh ideally, I'm going

10:15

to hold the syringe

10:17

like a dart and I'm going to be really quite

10:19

assertive with that. I'm going to be quite firm with it because

10:21

I want it to go all the way into the person's leg,

10:24

right up into the bit of plastic. I see.

10:26

That's off and then we're going

10:28

to pretend we've got a dose loaded in there. I

10:31

can see you towering back in the stairway. Nope,

10:34

so you want to inset that sick. And

10:39

then you push it, I see. And

10:41

then you would come all the way out. So all

10:43

of the needles disappeared into the ball.

10:46

The middle of the muscle is where you want the medication,

10:48

that's why it's intramuscular. You don't want it just under

10:50

the surface of the skin, you don't want it just in the muscle

10:53

a wee bit, you want it right in the middle of the muscle. That

10:55

helps it dissipate and get into the bloodstream

10:57

more quickly. Do you think this kit is easy

10:59

enough to use for somebody who's also

11:02

taking drugs themselves? Yeah,

11:04

definitely. I

11:07

think it's very straightforward to

11:09

use. I think if anything, especially

11:11

if it's a person who might be injecting, they'll be more

11:13

familiar with needles and syringes and probably

11:15

have more confidence in assembling a

11:17

kit than a general member of the public.

11:20

So just the main points to recap, which

11:22

you'll

11:23

already be familiar with, this is all the stuff that's

11:25

on the one-to-one checklist when you're training people.

11:31

After about an hour or so of training, the outreach

11:34

workers are ready to go out and pass on their knowledge

11:36

to the current drug users.

11:41

So it's two weeks after that training session

11:43

and I'm on the streets of Dumfries with Haven

11:46

and West. Dumfries is a small

11:48

town south of Glasgow and it's one

11:50

of the many places in Scotland where this sort

11:52

of peer support happens. So,

11:55

Haven, what are we doing today? Right

11:57

now we're just going to walk up in Fleish High

11:59

Street in my house.

11:59

just going to go about have a look and see

12:02

if we can see anybody that's looking to get trained

12:05

train them there and then give them a kit and hopefully

12:08

prevent some people from dying

12:12

and then if we cut down one

12:15

of these side alleys and

12:17

then we'll maybe circle back

12:20

how many people do you usually tend to try not?

12:23

Well it all varies because

12:25

I mean it depends on who you're catching,

12:28

when you're catching, the location

12:30

as well, the weather I suppose, it's rainy today.

12:32

Yeah so it's a really not

12:35

nice day today so we might

12:37

not see a lot of folk out but we're

12:40

always out it doesn't matter if we hit one

12:42

person or a hundred people somebody's

12:45

train that's a kit is used that's

12:47

somebody's life saved but if not

12:50

at least everybody has a bit of knowledge that

12:52

they've taken away and hopefully they

12:55

can break that stigma. With no

12:57

one out on the streets Hayden changes

12:59

tactics and heads into a nearby chemist.

13:01

So we're just going to go in here have a

13:04

wee chat with anyone there see if there's anybody

13:06

in there that's looking to be safe. Heroin

13:09

users go to chemists to exchange their needles

13:12

or to pick up a prescription for opiate substitute

13:14

treatments or OSTs like

13:16

methadone which they're often prescribed

13:19

in countries like Scotland to help wean

13:21

them off the drug. So I basically

13:23

just went and and they round the back

13:26

there's a back door where where a bibbity can

13:28

go and pick up the OSTs from so what we're going to

13:33

do is we're going to go round the back and see if anybody's

13:35

there that's needing trains or anybody that comes

13:37

that's looking at the train. You might be

13:39

wise if that's right to hang back a wee bit

13:41

and maybe we'll go and see if there is anybody that's

13:44

coming in or out of the clinic okay

13:46

put some off yeah

13:47

seeing the mic and stuff yeah yeah it

13:57

looks like Hayden and Wes are just coming back now

14:00

How did you

14:03

get on? It

14:05

was good we saw a tap who was open

14:07

to getting trained and that the stuff we wanted

14:10

just kept getting pretty wet. Yeah definitely.

14:13

More than happy which is good so obviously

14:15

that's potentially a high

14:17

chance that tap could be used

14:20

in obviously

14:22

sitting with friends and stuff like that that

14:25

are obviously used or so. It's

14:28

good that we managed to get him and it's good that he's actually

14:30

stopped and got trained as well. What

14:33

was he like? Just a guy,

14:35

just a guy, that guy on a bike going

14:37

about his daily routine was

14:40

open to potentially helping reduce

14:42

drug deaths and done free. Had

14:44

that bagel jacket then I did. The

14:47

training the man in the big jacket received took

14:49

about five minutes or so and it was exactly

14:52

the same as the training I'd received in Glasgow

14:54

a couple of weeks earlier. At the end

14:56

of the training he was given a naloxone kit

14:58

to take away. I'm finding people

15:01

that have had drug

15:04

issues in the past or currently active

15:06

in drug issues are more accepting

15:09

and willing and quick off the

15:12

back to do a yell-kick-a-kick.

15:19

Now Craig is in studio with a blue

15:21

pouch that I know has the

15:23

naloxone kit. So it's

15:25

about the size of a pencil case. As

15:28

you can see if I open it up here, take

15:30

this yellow box out. Let's open it

15:33

up. Have a look.

15:35

So inside these are syringe

15:38

and two needles.

15:39

No naloxone

15:41

though.

15:41

No naloxone. Now how much are these

15:43

kits and where are they getting the money

15:45

to distribute them?

15:46

So a kit like this costs roughly £20.

15:50

Nearly 25 US dollars and

15:52

most of that money comes from funding from

15:54

the Scottish Government. By the way

15:56

Myra there's also another way to deliver

15:58

naloxone. is a nasal

16:00

spray which is being used quite a bit in the US

16:03

and they're also being used in some parts of Scotland

16:05

too.

16:06

And they're giving away loads of these kits

16:09

to current drug users after

16:11

what about 10 minutes of training. So

16:13

I have to ask, are there any side

16:16

effects if naloxone isn't administered

16:18

in the right way? No, no, so there aren't any side

16:20

effects and even if someone accidentally

16:23

took a bit too much it would still be completely

16:25

safe. Also, if it was given to

16:27

someone by mistake who hadn't even taken any

16:29

opioids, the naloxone just

16:32

wouldn't have any effect at all in that instance.

16:35

Craig,

16:35

another big thing here is, isn't

16:37

this just encouraging heroin users

16:40

to keep using the drug because they

16:42

know that they have naloxone on

16:44

their side?

16:45

Yeah, so that's a good question Myra. I

16:47

think the argument is that heroin really

16:50

doesn't tend to be a recreational drug and

16:53

users often have a myriad of

16:55

complex underlying issues such as trauma,

16:58

mental health concerns and at the

17:00

end of the day if someone wants to take heroin they're

17:02

probably going to do it anyway without

17:05

much concern for their personal safety.

17:11

You're listening to People Fixing the World

17:13

from the BBC World Service and we've

17:16

just been hearing about a team of former

17:18

drug users who are going out to the streets

17:20

to train current drug users on

17:22

how to use a medicine called naloxone

17:25

that can save their friends in case of an

17:28

overdose. But Craig, this is just one

17:30

part of the strategy being used in Scotland

17:32

because they're trying to get this medicine

17:34

everywhere. Yeah, so the Scottish government

17:36

are now treating drug deaths as a public health

17:38

issue as opposed to a criminal justice one

17:41

and the idea is that by reducing stigma

17:44

and the fear of arrest I suppose

17:46

that might encourage more people to get the support

17:48

they need. They put £20

17:51

million, so that's almost

17:53

US$25 million into reducing

17:55

drug related deaths in 2020

17:58

and one part of that is just distributing. contributing naloxone

18:01

to anyone who might have contact with people

18:03

who could overdose.

18:04

Mmm, so people like police officers or prison

18:06

officers? Yeah, even

18:07

taxi drivers. So I met someone

18:09

called Dougie. He's a former policeman

18:12

who now drives a black taxi in Glasgow.

18:19

Taxis will operate in every area

18:21

of the city. We will see people at

18:24

their best and at their worst. With

18:26

a fleet of 700, there is every likelihood

18:29

that there will be a taxi in close proximity

18:32

to someone who requires

18:34

an intervention with naloxone.

18:37

Dougie took me for tour of the city in his taxi.

18:41

So coming up in the right here, you see

18:43

an area which has

18:45

now been closed for some time since

18:48

the line's vacant. But this is an area

18:50

where homeless people

18:52

would gather at night and

18:54

they will be predominantly

18:57

drunk users. Do you have the kit

18:59

here with you? Yes I do. But it would be possible

19:01

to take it. Of course.

19:04

Dougie keeps a little blue pouch containing

19:06

his naloxone kit in the glove box. He

19:09

hasn't had to use it yet, but it's there

19:11

if he needs it.

19:12

And I'm pleased

19:14

that I'm able to contribute something positive

19:17

towards the problem that Glasgow has.

19:20

And Craig, they didn't just stop there because they're

19:22

trying to get this medicine into the hands

19:24

of other people. So people like friends

19:27

and family as well.

19:27

Yeah, and anyone can now do a short online

19:30

course and then get a naloxone kit in the post. And

19:32

the key thing about this is they don't even need a prescription.

19:35

Sue's Gallagher used to run this part of the

19:37

service. The

19:38

first service in the whole of UK that

19:40

provided a postal service out to anybody

19:43

that wanted a kit. So not just looking at people who

19:45

use drugs, not just looking at family members, anybody

19:47

at all.

19:48

This click and deliver service was launched

19:50

by Scottish families affected by alcohol

19:53

and drugs. The charity Sue's used

19:55

to work for, so that people could access

19:57

naloxone during the long Covid-19 lockdown.

19:59

downs but then two weeks we were up

20:02

operational of and was hosted on

20:04

my web say week for a cat sense dot

20:06

com era him to go to

20:07

the pandemic meant to sues had to run

20:09

the operation from a slightly unusual

20:11

location

20:12

anyone time i had three thousand the locks on cats

20:15

up my last on the associate poke

20:17

cheese and all the envelopes and everything that went

20:19

along say that so you know we were tonight

20:21

on to two hundred and twenty said the you

20:23

know at this late be the lips of production

20:25

lane and mothers and of it's him

20:27

mother asked him and his dislike there's boxes

20:30

everywhere everywhere you go those books is so when

20:32

it with the left at the beach should ask what ultimate the

20:34

loaf before he can for work so he could nicholls

20:36

is up more to poke season i'm like see them lace

20:39

meet save him lace

20:40

the online course you need to take to get it posted

20:42

out takes about twenty minutes or so to complete

20:45

and once that's done someone can just put that he tells

20:47

in on line and a ticket package stop

20:49

discreetly and posted directly to them fat

20:52

people could order the kids from the privacy of their own

20:54

homes made the service very popular

20:57

indeed and intermediate

20:58

the can go to community pharmacy it's

21:00

to be able access to look so and and the stack muscle

21:02

see to that can be quite overwhelming

21:04

although the click and deliver services still going

21:07

strong seizes recently started a new

21:09

row of the scottish ambulance service training

21:11

paramedics to have a on the spot in the locks

21:13

and training when they called out when overdose

21:16

lists axes is still trying to do as

21:18

much as he can opt to craig

21:20

give me an idea how many of these kids

21:23

have they given away

21:24

yes they've given away over a hundred thousand

21:26

cuts in total interestingly a quarter

21:29

of those kits have been handed out within the last year

21:31

and this he was the first time the number of drug

21:34

related deaths in scotland's actually went down

21:36

being overly kind

21:37

and cessna a attribute that to the work

21:39

that was and his team i doing

21:41

know none of us ready for some because

21:43

i'm and this is something i put suez to

21:45

and he said is hard to definitively say it's

21:47

how many lives of being saved as

21:49

we don't know how many of the kids handed out at

21:51

the end up being used right right and

21:54

another thing this worth mentioning is that they've only

21:56

been training current drug users and

21:58

how to use the not saying for the last

23:56

trying

24:00

to change our world. Until

24:02

then, thanks for listening.

24:09

There are plenty of podcasts about

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the latest match results, analyzing

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the game and discussing millionaire

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sports

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stars.

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Amazing Sports Stories is different. It's

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about the underdogs. Now some of the tryouts

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you would get there and they'd say, no girls on our ice

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and they wouldn't even let me try out. Those

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challenging authorities. The

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Black Student Alliance approached

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us with the idea of participating

24:35

in the protest against the Mormon Church.

24:38

And exploring the myths and

24:40

legends. Are

24:41

County Mayo a great team, delighted

24:43

by mystical forces we can't quite comprehend?

24:46

Yeah, you almost get suspicious that there may

24:48

be some credence behind me, because...

24:49

Expect the unexpected. We

24:52

end up doing something really extraordinary. Amazing

24:54

Sports Stories from the BBC World

24:56

Service. Find it wherever you get

24:59

your BBC podcast.

25:11

The Colorado River provides drinking

25:13

water for nearly 40 million people

25:16

across the world. But with the

25:18

ongoing mega drought, we're using

25:20

more water than the river has to

25:22

give. And private investors

25:24

have discovered a financial windfall

25:27

in buying

25:27

water rights.

25:29

This season, How We Survive

25:31

investigates who is cashing in

25:33

on the climate crisis and what it means

25:35

for the rest of us. Listen to How

25:38

We Survive wherever you get

25:39

your podcasts.