Naloxone distribution in the community began in Vietnam in 2010, after the leader of one drug user support group learned about it at an international harm reduction conference. Before that, naloxone wasn’t even commonly available in emergency rooms in Vietnam. Today, drug user support groups in various parts of the country are equipped with naloxone and are on call for overdose cases. Under Vietnamese law, administration of medications by injection is limited to certain categories of medical professionals, yet members of the drug user groups feel an imperative to save the lives of their peers. They are working to demonstrate the effectiveness of peer naloxone response, and to eventually be able to distribute naloxone directly to drug users.
Why partner with police?
Because the drug user groups are working with a population stigmatized by society – and they themselves often experience that stigma – they feel it’s vital that they get the support of local authorities, including police. They do this by having occasional meetings with police, to introduce them to their activities and the rationale behind them.
You, Me and Us
In Ho Chi Minh City, the drug user support group You, Me, and Us distributes a card with overdose information and their phone numbers to people in the community who use drugs. Group leaders are available 24 hours a day to respond to overdose cases. They provide instructions by phone on rescue breathing, and take a motorbike to the scene to administer naloxone.
During one overdose case, a policeman was present when the outreach worker, Tuan, arrived. The victim was still alive, though barely breathing. The policeman told Tuan that if the person died, he would hold Tuan responsible. Having used naloxone before, Tuan felt confident that it would not make the situation worse, and he felt obligated to try to help. He administered naloxone and the victim was revived.
A growing partnership
The policeman was impressed, and the group invited him to participate – in plain clothes – in a subsequent group meeting where overdose prevention and response were discussed. Since then, the police have called on You, Me, and Us for assistance not only in overdose cases, but when they come across drug users who need services, or when there are dirty needles to be cleaned up in an area. “The residents where we work have seen us in a very different light, knowing the good things we are doing,” Tuan reports. “Especially when those of us who are saving the lives of others used to be considered negative people in the community.”
Today, You, Me, and Us carry out their overdose response activities with the knowledge and acceptance of local police. Though the police haven’t yet made a public statement in support of the group, “the fact that they ask for our help shows that the authorities’ attitudes about drug user groups will be less harsh if we show them the positive impacts of our work,” Tuan explains. As You, Me, and Us plans to demonstrate the effectiveness of peer overdose response in order to advocate for even wider naloxone distribution, this police support will remain important.