How an overdose-targeting nasal spray is part of ‘true Salvation vision’
- kirranicolle
- Aug 31
- 4 min read
BY KIRRALEE NICOLLE
Today is International Overdose Awareness Day, and a reminder that overdose can, and must, be prevented. It is only through community-wide effort that the issue of overdose can be addressed, and The Salvation Army’s Alcohol and Other Drugs (AOD) Service is working to implement frameworks for preventing and treating the issue of overdose in the Australian community. One of those involves the distribution of a medication called Naloxone.
It’s a Wednesday at The Salvation Army’s Towards Independence Sobering-Up Unit near Adelaide’s Whitmore Square, and tonight, rooms will be full, and the line outside long.
Team Leader Kirsten Pennington, who comes from a background of restaurant management, loves her job and is especially proud of her team of 26 staff, who she says are highly skilled and capable. Kirsten job-shares with her colleague, Jodie Hobbs.
“They’re just amazing,” she says. “They get a lot of abuse, and they never take their eye off the ball. They are constantly helping people with complex lives and, as a result, sometimes challenging and complex behaviours. It’s very special and it’s a really good atmosphere. There’s a lot of camaraderie and humour, which is what you need in a place like this.”
Some examples of staff camaraderie at the Unit - a map depicting the origins of each member of the multicultural staff team, and a board celebrating beloved pets. Images: Kirralee Nicolle
The demands on the team are immense due to a recent and sudden increase in the need for the service.
“I’ve been here three years,” she says. “The first two years, we probably only hit capacity about four nights a year. And then we hit capacity one night, and then we just kept hitting capacity every night, for [what] I think now [is] probably close to a year.”
As most of the clients at the unit are homeless, Kirsten attributes the increased need to the housing crisis, as well as migration of First Nations Australians from northern areas around Darwin and Alice Springs.
The Sobering-Up Unit’s Needle and Syringe Program is an authorised Naloxone provider. Naloxone, formerly only available as an intramuscular injection, is now available as a nasal spray. It temporarily reverses the effects of opioid overdose, enabling oxygen flow to the brain of an affected person while waiting for paramedics to arrive. It has the added benefit of being a low-risk medication, which means peer-to-peer administration is possible. Naloxone is also stocked in many other Salvation Army AOD centres.
Kirsten says that in South Australia, the authorisation process to become an alternative supplier of Naloxone is quite involved, with extensive training and paperwork for all authorised staff. Each time staff offer the medication to a client for peer-to-peer administration, there is a conversation about the process and knowing when to administer. She says despite the fact that methamphetamine use is far more prevalent than opioids such as heroin, morphine or fentanyl, she had been surprised at how high the take-up has been.
“The aim is to make sure that if you’re giving someone this product, they know how to use it. So that’s the point of the conversation – do you know the signs of overdose, do you know what to do if someone’s overdosing, [and] do you know how to use this product?” Kirsten says.
According to Kirsten, having an option like Naloxone on hand represents what she calls “the next step in harm minimisation”. Although she says she understands why for some people, that phrase is a controversial one.
“A lot of people simply don’t believe in it, to be honest,” she says. “They think it’s encouraging people to take drugs. The reality is that people will always drink [or] take drugs. So, we need to make it as safe as possible for them and for the rest of the community.
“It’s [about] making the people that access that service feel supported, feel seen, and feel that we’re working to help them keep safe.”
Additional to the Syringe and Needle Program, the Sobering-Up Unit also provides for other aspects of client wellbeing, such as warm clothing, shoes and blankets. The Unit has a strong relationship with surrounding TSA stores and corps, who partner with them in ensuring clients’ basic needs are met.
The Salvation Army’s AOD General Manager Kathryn Wright says The Salvation Army was the first organisation in Australia to develop a policy around allowing staff to use Naloxone on site, which was first rolled out in Melbourne. She says The Salvation Army is also one of the largest not-for-profit distributors of the medication. She says after they rolled out their policy, she had representatives from other not-for-profit organisations asking to borrow TSA’s policy.
“Everyone was a little bit nervous about it at the at the start,” she says. “Like, what if we do the wrong thing? [But] you can’t actually do the wrong thing with Naloxone because if you give it to someone who hasn’t overdosed on an opioid, it doesn’t do anything.”
Kathryn says the impression that having a medication like Naloxone on site gives to clients is one of hope.
“The message that it conveys is your life is important, it’s worth saving,” she says.
“Even though it’s short-acting, it gives time for the heavier intervention if it’s a serious overdose. It helps people feel valued. It certainly minimises the harm that they’re going to experience as a consequence of overdose, and it often saves lives.”
The Sobering-Up Unit operates 24 hours a day, seven days a week, and has a 30-bed capacity. Though The Salvation Army opened the building in 1987 for a variety of AOD services, the Sobering-Up Unit has been operational since 2005. It is the largest of its kind in Australia.
Staff at the centre rarely turn anyone away for behavioural reasons.
“The Sobering-Up Unit is a real embodiment of the true Salvation vision,” Kirsten says. “Unless you use the service and need the service or family or friends need it, people don’t want to know about it. It’s ugly, it’s not popular, it’s not feel-good. Without it, the people that we help would have nothing. They are the most vulnerable, the most complex. A lot of other services [are] not going to deal with them while they’re presenting with challenging behaviours. They have poor mental health and addiction issues and they’re homeless, so they’re frustrated.
“It’s one of the services that really shows the truth of what helping people that no one else wants to help [looks like].”
To find out more about The Salvation Army's Sobering-Up Unit, see here.
