Chris Rintoul worked as a Social Worker in both the pre- and post-ceasefire eras in Belfast, N. Ireland. He developed accommodation services for PWID and training to support the development of THN. In 2021 he joined Cranstoun, leading on the development of harm reduction responses across the organisation.

Nitazenes were first detected in the UK in 2021, with the National Crime Agency reporting in May 2024 there had been 176 deaths involving them. These strong synthetic opioids have contaminated heroin, novel benzodiazepines, illicit oxycodone and other drugs.

In July 2023 a National Patient Safety Alert was issued. A spike of fatal overdoses was detected in Birmingham, England. They were later determined to have involved nitazenes in heroin. Concurrently a group was established of concerned people working in a range of organisations. This group collaborated, providing advice for services working with people at risk of overdose. However, as numbers grew, the pace at which it responded slowed.

The group size reduced to members from 5 organisations, those with a national harm reduction role within them. Actions were agreed more quickly to respond to nitazenes. ‘Stayin’ Alive’ Plans were developed and disseminated to relevant services. These focused on the bearer having more relevant insight into the likely scenario of a future overdose than any drugs worker. Therefore, only they could devise a plan which would mitigate their risk of overdose. This changed the conversation from ‘Don’t do this, do that’ to ‘What’s your plan to manage the risk?’ Cards were provided, plans recorded and held by the owner of that plan.

Members of the group work for organisations in competition with each other. Despite this, no competition existed between members. The task of responding to nitazenes required experts to collaborate. In 2024 the group provided ‘Opioid OD - DO something’ posters for IOAD. Several unanticipated benefits also occurred. Decisions made by the group did not require sign off by the broader organisations; if the group agreed, that sufficed. One organisation disseminated 20,000 testing strips, in part, as a result of the strength of support for testing strips within the group.