On the frontline of tackling the drugs crisis with Glasgow City Mission

“It’s the best, best thing that’s ever been invented in this country is Naloxone, it really is,” says Charlene, team leader at Glasgow City Mission’s winter night shelter, as she briefs the staff and volunteers on the night’s activities.

The night shelter hit the headlines last year after figures emerged that 17 lives had been saved the previous winter – almost one a week in the 18 weeks the shelter was open – by administering Naloxone, an emergency antidote to an opiates overdose.

Naloxone reverses the effects of the drug for around half an hour, enough time for an ambulance to arrive.

And because it is harmless, it doesn’t matter if the person turns out not to have taken an overdose after all. If in doubt, just do it, Charlene advises.

“Yeah, not everybody’s happy because we’re going to be taking their drugs out their system when that injection gets put into them,” she says.

“We’ve had a couple of times where folk are like, soon as you mention Naloxone, it’s like they start to come alive and they’re like, ‘Don’t Naloxone me! You’re gonna take it away from me.’

“But at the end of the day, we’re here to save lives and if that is by Naloxoning them, then that’s what we do, because it is a lifesaver.”

Charlene herself has experience of addiction and homelessness and has in fact stayed in the night shelter as a guest in the past, which gives her a particular compassion for the guests, who she says are “like family” when they are in their care.

She’s as passionate about the job as she is about the benefits of Naloxone. “I love it, I love it, I love it. I love my job,” she says.

Security at the night shelter is high, for everyone’s safety.

Clients have to hand over their belongings to be locked up overnight and everyone is scanned with a handheld metal detector to prevent knives, sharps or drugs being brought in.

All staff wear body-worn cameras, in case anything kicks off, although it only does “once in a blue moon”, Charlene says.

This might sound threatening, but in fact, the effect is the opposite. It feels very calm and very safe inside the shelter.

The night Holyrood visits, staff are pleased because they haven’t had to use Naloxone for two weeks, but drugs are an ever-present concern.

Asked what percentage of their guests have a drugs issue, night shelter manager Elyse MacKinnon says most do.

“We treat every guest the same when they come in, but the majority would have some sort of addiction, whether that is in their past or currently. What they’re taking, we can’t always guarantee.

“What’s surprising, though, is our guests are really open about it, so if we are concerned about a guest, we will just ask them, ‘Listen, what have you taken today just so we know how to best look after you’, and nine times out of ten, they’re actually willing to tell you because it’s a safe place.

“We want this to be a safe place where they feel comfortable to actually tell the staff and they know that we are looking out for them.

“We don’t sleep during the night. We’re constantly monitoring our guests to make sure that they are doing OK because we’re very much aware that a lot of the drugs on the street just now are horrific.”

Staff are alert to the signs that someone may have taken an overdose. One particular one is anyone ‘gouching’, slumped, looking as if they have fallen asleep, at the tables.

They keep an area of easily accessible beds for anyone they think might be vulnerable in case of emergencies and may wake them during the night to check they’re OK.

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Mornings are also a risky time, when the guests get their bags back, says Elyse. 

Naloxone is administered through a ready-filled syringe, although it is also available as a nasal spray, which is about to be trialled by Police Scotland.

Naloxone training is part of the night shelter training, so staff and most regular volunteers know how to do it.

And they are always on the phone to the ambulance service while they are administering the drug. But even so, the first time of using Naloxone can be quite intimidating.

“I remember the first time that we had to administer Naloxone in the night shelter,” says Elyse.

“So, my very first year, we had a man who had overdosed in the toilets in the morning and that initial moment of being like, ‘Oh my gosh, this is when our training kicks in’.

“It was a bit daunting and I remember the three of us being there but in the moment, it’s almost a split second because you realise that actually, that’s not important just now, your fear is not important, but this life is important.

“So you set up the needle and you put in the first one and just hope for the best. That’s all you can do.”

Another staff member, Ross, says the first time he was “really nervous” and “a bit fumbly with the box”.

“We get little syringes and there’s five doses in each syringe and I remember the first time I was like, ‘Is somebody counting two minutes, who’s got two minutes?”, but it’s very easy and quick to use, so the second time he was much calmer and it has now just become a regular, familiar thing to do.

He says: “I remember like the first time we used it this year, it was actually myself and Charlene were on, and Charlene was saying, ‘Ross, can you Naloxone this guy?’

“It’s just like, ‘yeah, sure’, and that’s what this is like, it just becomes such a comfortable part of what you have to do sometimes, but I don’t think having that attitude towards it is making light of what it actually does.

“We’re very aware of how important it is, and how important it is in this kind of setting.

“But I think once you’ve worked here for a while, and you see a lot in here, you tend to take things in your stride.”

Glasgow City Mission teams also administer Naloxone on the streets where necessary and Holyrood also joins Alfie, a member of Glasgow City Mission’s street team, on a circuit of the city centre, where he chats to people who are out begging and encourages them to take up the services that are on offer.

Like Charlene, Alfie too has experience of addiction, with a dramatic personal story. A previous life as a DJ led to him taking prescription drugs and then heroin.

On reaching rock bottom, he decided to kill himself, but he couldn’t go through with it sober, so went out to buy a bottle of vodka, but on the way got talking to an old lady and ended up in a church.

From there he went into rehab, became clean, became a Christian and now helps others.

Alfie is totally straightforward with regards to drug use. “What are you on?” he asks everyone we talk to, and they tell him, apart from one man, who is adamant he is only begging for money for a haircut – although he refuses the offer of a free one at the mission.

“We get a good response because we’ve got no agenda,” Alfie explains.

Around 95 per cent of beggars on the streets of Glasgow are drug addicts, Alfie says.

They may or may not also be homeless – many are in hostels – but they aren’t begging for food and accommodation.

On Buchanan Street, Alfie points out a man begging across the road who, he says, is “addicted” to being on the streets.

He has been offered help and accommodation a number of times by different agencies, but he chooses not to take it.

Alfie suggests that he probably had a life without a great deal of love. On the streets, he gets a lot of attention, people who talk to him and ask after him all day and give him money regularly.

He isn’t keen to talk, but we stop and chat to him.

He tells us he made £280 in one day before Christmas. He spent it all on drugs.

Alfie describes his frustration at watching people give him money, a wee old lady will say, ‘There you go, son’, and drop a tenner in his hat and the man will say, ‘Cover for me’ as he goes off to shoot up.

It’s him that will have to deal with the overdose, he notes.

Alfie is emphatic that the one thing he wants to get across is that the public should not give money to people begging on the streets of Glasgow.

He tells Holyrood: “It breaks my heart. Honestly, it breaks my heart and I feel like running after the public when they give them money.

“I feel like going after them and saying, ‘Can I tell youse what’s happening here?’

“I really, really want to, but I can’t, because… how can you campaign against people that are being so nice, to go up to somebody and say, ‘Why are you giving them money?’

“It’s a horrible thing, because they think they’re doing a really, really nice thing and it makes them feel good, and it is a nice thing, but just to make them understand, actually the percentage of that money, how much of that is going into heroin and other addictive drugs is horrible.

“It breaks my heart. It really, really hurts. It’s probably my worst frustration in this job.”

And administering Naloxone on the streets is much more challenging than at the night shelter.

Alfie describes one time he came out of the station and saw a man who had clearly overdosed.

He wasn’t working at the time but happened to have Naloxone in his bag. While he was trying to administer it, one of the man’s friends started attacking him and trying to grab his arms.

Two girls also took advantage of the situation and began going through the guy’s pockets and stealing money. It later turned out to be Alfie’s money the girls had stolen – he had pulled it out his pocket in his rush to get his phone to call an ambulance.

By the time the ambulance came, the addict had recovered enough to start lashing out, kicking the paramedic’s box across the road and trying to push him against the wall.

Another time, Alfie and Charlene were out together as a team and came across a woman who they realised had had an overdose and they administered Naloxone, but when she came round, she also tried to attack them.

Alfie says: “She was trying to kick us and grab us, it was really quite violent… every time she got up, she was swinging punches and she was swinging feet and she was trying to swing at anybody – so the public as well.

“And then she would run, but she was that full of the Valium, which the Naloxone doesn’t affect, so she was still staggering all over the place and she kept falling and every time she fell, we ran up and we’re trying to comfort her, you know, just reassuring her that the ambulance was coming, then she would just get up again and go crazy with us.

“That lasted half an hour, but eventually the drugs had kicked in completely again and she couldn’t move and she was starting to fall asleep again.

“That’s when I lay down next to her and just kept talking to her at this point, you know, just saying, ‘Aye, it’s OK, we’re just going to get you a taxi up the road,’ and she started to calm down and then the paramedics pulled up.”

But Charlene is clear that the results are worth it, noting that if they hadn’t been able to carry Naloxone in their bags that lady would probably have died.

Saving 17 lives in 18 weeks is “incredible”, she says, and notes the drugs death figures would be much higher were it not for that.

“We don’t know what our guests are taking, so we don’t know if it’s OK.

“We don’t know if the Valium that are going around the now has opiates in it, because there’s that much stuff in the drugs just now.

“But I’m just like, if we think there’s somebody’s in an overdose and we can’t get them awake, we will Naloxone them, because it saves their life. It is such a precious thing.

“And yeah, once our guests come around, they’re like, [puts on angry voice] ‘You’ve just took my hit out of me’, but at the time, they just don’t realise.

“But then they’ll come back to us the following day or, you know, a week’s time and they’ll say, ‘Thank you so much for doing that because you actually saved my life’.

“So it’s good having it on site. It’s well needed because there’s just too many drug-related deaths. It’s worthwhile. It’s worthwhile having it.

“And I believe it should be everywhere.

“It should be in train stations, it should be everywhere that has public access, even shops should have it because what if somebody is in a shop and they’ve had an overdose?

“Why can it not be in places like that?”