4. How to run an unsanctioned overdose prevention van; experiences from Glasgow 2020-2021

Scottish drug-related deaths are the highest on record, and the largest outbreak of HIV among people who inject drugs (PWID) in the UK has been ongoing in Glasgow since 2015. There remains a lack of government support for an official site to address these challenges. Aims: To describe the service model of an unsanctioned site in Glasgow.

Description of challenges faced including a) vehicle and physical supplies, b) services provided, c) staffing and financial model, and d) need for and lack of wider support as service demand grew.

The first vehicle, a minibus purchased with personal savings, was converted by modifying the interior, obtaining sterile injecting equipment, overcoming insurance challenges, and COVID precautions including PPE and creating a space where PWID feel comfortable. Mechanical problems in January 2021 forced change, and a former ambulance was converted to provide the new service. Rules included using your own drugs, and agreeing to an overdose intervention if needed. In total 894 injections were recorded, however, over 1000 were supervised. There were nine overdoses reversed. Staffing was voluntary, with two main volunteers. Other potential volunteers from the local University were stopped from doing so. Funding was by donation.

An overdose prevention service can successfully operate alongside local police, businesses, and residents in the UK. It was an important focal point and supportive space for local PWID. However, the lack of formal support ultimately led to increased pressure, and the closure of the service.