Background:

The UK government stated that at least 321 deaths involved nitazenes to September 2024. These synthetic opioids have contaminated heroin and other drugs. In July 2023 a National Patient Safety Alert was issued after a spike in fatal overdoses occurred in Birmingham, involving nitazenes.

Objectives:

A group of individuals was established from 5 organisations. We wanted to ensure that safety messaging on nitazenes, given by all organisations, was consistent. We aimed to reduce the risk of mixed-messaging.

Methods:

‘Stayin’ Alive’ Plans were developed and disseminated across the services. These focused on the person at risk having more relevant insight into the likely scenario of an overdose than any drugs worker. Therefore, only they could devise a plan which would mitigate their risk. This changed the conversation from ‘Don’t do this, do that’ to ‘What’s your plan to manage the risk?’ Cards were provided, plans recorded and held by the owner of that plan.

Results:

Keyworkers in the member organisations then engaged PWUD to make Stayin’ Alive Plans. This raised the awareness of overdose among all those who were engaged. Around 25,000 individuals across all providers completed plans. It is however more difficult to demonstrate conclusively that these plans have reduced overdoses involving nitazenes.

Implications:

The task of responding to nitazenes provided an impetus to collaborate. When collective wisdom and ideas are shared, this may lead to novel approaches to mitigate risk. Collaboration is likely to remain important in the coming years as the drugs market becomes ever more risky.