–Written by Hannah Robertson-Newman
I am an outreach worker for the street team for Streetwork in Edinburgh, it’s part of Simon Community Scotland and my job is to try to guide rough sleepers to access support and try to find a safe place to live.
We decide to go down towards Leith, it’s a Saturday night and it’s busy with a lot of people in bars plus the Lion King is being shown at the playhouse, the crowds will probably attract more people begging. Freddy and I both stop to fix our matching waterproof jackets in a hopeful attempt to stay dry and note that we have already walked 16,000 steps today. The crowd swarming into their various destinations carries us as we begin walking towards Leith, both of us looking down to make sure we spot anyone begging.
We turn a corner and I notice that a few bodies in the crowd have stopped and that the steady stream of people was moving out the way of something, the way water flows around a boulder. Freddy and I both go over to investigate. This is when I first start to worry, it is a body laying on the ground, the spectators look panicked, someone is on the phone but nobody is touching him, nobody seems to want to get too close. It’s a young man, wearing loose clothing that is ripped and stained in places he is laying out on the dirty floor with a blanket over his legs that is soaked through, he is painfully thin and his pale face has an expression of lost oblivion. He could easily be mistaken for a pile of rubbish tossed to the side waiting for someone else to come along and clean up, there is a cup in front of him with a few coppers in. I get closer and look at his face, my stomach sinks, I know him.
Tony, he is young, no older than 22. I had sat with him only a few days before talking about his life. He is charismatic and cheeky. Tony only knows the streets, he was raised in the protective community bubble of shared trauma. His brother begs near here and I know both of them are currently sleeping in a bin shed. We have tried to get both brothers into accommodation and into safety but they are hesitant, they do not trust the system that has let them down so much. The pull of addiction has been a constant in Tony’s life for as long as he can remember, his parents were addicts and when he was in care he began to use to escape the pain. Tony is a deep soul, he is creative and witty, he likes art and talks about the cars he would like. Tony is fearful, he does not fully believe life could get better, it has been on a downward trajectory since he can remember and though the offer for accommodation is there how does he know that it would be better? And what happens if he puts his hopes on it and trusts again then it is taken away from him? No better to stay safe in what he knows he can survive on the street, he has his brother, and he has the comforting oblivion that comes with his gear to take away the pain.
I push past the onlookers trying to pretend that I am the confident professional I am meant to be and say I know him when people look. I get close to his face and call his name, no response. His eyes are open and glazed. I have never noticed before they are a sharp blue, I look closer, my heart beating and see the unmistakable tiny pupils of pinprick eyes that go hand in hand with opiate use. I shake his shoulder and call his name. I am praying to anyone that will listen that he will sit up, tell me to go away, tell me I’m overreacting and he is fine, anything… but nothing. My heart sinks and I look at Freddy who shares my concern, this is an overdose I am sure of it but we have both only just received our training a few weeks ago and have not yet put it into action.
Opiate overdoses can be reversed with a drug called Naloxone, it is a clever invention that has saved so many lives of those most in pain. I got my training a few weeks ago, it was fun and relaxed and the trainer explained how it affects the opiate in the brain and can buy time for an ambulance to arrive. We enjoyed chatting about risk factors while injecting the naloxone into oranges and practising CPR. It felt very controlled and calm and a mile away from the reality I was in now sitting, with the rain pouring down while a crowd watch me.
I look up and the police have arrived, four of them drawn over by the crowd probably. I am hopeful for a second, the police are here! They are who you expect to save the day in an emergency! But then realisation dawns on me, Police aren’t trained on Naloxone, I am, Police don’t carry Naloxone, but I do, it’s going to be up to me. I have a brief conversation with a police officer and as soon as I mention I work for Streetwork and I am Naloxone trained he seems relieved himself. Police seem to act without the need for much discussion, apparently, through years of experience, they automatically begin controlling the crowd of onlookers and clearing space for me to work. One officer informs me that the ambulance is on the way but it’s a Saturday night, it’s busy, I nod my head with realisation overdoses aren’t the biggest priority.
My attention goes back to Tony, he looks younger than 22 he could easily pass for a high school kid, I guess in some ways with his limited experiences in life this is true. I put my hand under his head. I want to protect him from the cold concrete. Freddy and I work to lay him flat, he is soaked through and boney. I am also soggy now that I am on the ground with him, I am shaking with a mixture of cold and adrenaline. I listen to his breathing, it is shallow but it is there, relief for the first time, this means I don’t need to do CPR at this moment. I go to my bag and pull out the yellow box of the Naloxone kit and peel off the plastic wrapper. I crack the casing open in the way I was taught only a few weeks ago and it springs open, so seamless. Inside there are two blue needles, a syringe with a stopper on the top and an instruction leaflet, everything you need to save a life. I pick up one needle encased in a plastic wrapper and the barrel. I have trained in this action, attaching the needle to the barrel but my hands are shaking and I keep fumbling with the stopper, Freddy takes it off me and doses it. I go to Tony and I call his name again. I start telling him it’s going to be okay. I am here, I don’t know if he can hear me. I roll him into the recovery position on his side one hand to protect his head from the cold concrete and with one leg bent up… it looks just like how I sleep.
Freddy hands me the needle, he has a pleading look on his face. It’s his first time seeing this as well and I can tell he wants me to take the lead. I take the needle in my hand and look at Tony, he is drooling slightly, his breath slow and raspy, I inject him in the leg with the Naloxone, one dose, just like I am trained to do. It’s a weird sensation injecting another human and I thank the designer of the Naloxone kit silently in my head for having the forethought of measuring out the different doses on the side of the syringe. I sit back. I know I need to wait for 2 to 3 minutes is all it takes for this wonder drug to do magic, I keep calling Tony’s name hoping to bring him back to me.
There is a long heavy pause while the rain keeps coming down, a puddle has started to form right where I am sitting. Tony stirs, he lets out a long moan and I hear his breathing start to return to normal. His eyes become more focused and he looks at me, he is angry “what are you doing?” he demands. It’s not unnormal for someone to come back to reality and not be happy about it, I have just taken his high away from him and he may have been begging all day for that chance of relief. Tony doesn’t know how terrified I was seeing his lifeless pale body crumpled on the ground and just how close it seemed that his breathing would stop forever. Tony only knows he was at peace in quiet oblivion away from pain then I came along stabbed him in the leg with a sharp needle and dragged him back to the cold and rainy reality.
That was my first time intervening with someone who overdosed, I have had a lot more experience and I may be well practised now but it still scares me, each time I came close to watching a life slip away but managed to help guide it back. I saw Tony not long after he was taken away by the ambulance crew that night. We were talking and he suddenly looked at me with a clear realisation “you Naloxoned me didn’t you? “, “Yes” I replied, waiting for him to be angry at me for taking his high away from him. “Thank you,” He said looking away “I didn’t want to die”.
Tony is doing well now he is in a flat with his brother, the first time they have trusted that four walls won’t be taken away from them in a long time. They are building an existence for themselves that isn’t purely encapsulating their desire to escape reality, now their reality isn’t so bad they don’t want to flee from it. To save someone from an overdose means that they have time to save themselves, and I thank everything that I was there that soggy night with my Naloxone kit when Tony needed me.
– All Simon Community Scotland on site staff, including our Street teams, are trained in the use of Naloxone.