COVID-19 and the opportunity for gender-responsive virtual and remote substance use treatment and harm reduction services

Perri, Melissa; Schmidt, Rose A.; Guţă, Adrian; Kaminski, Natalie; Rudzinski, Katherine; Strike, Carol

doi:10.1016/j.drugpo.2022.103815

Cited by 12 publications

(12 citation statements)

References 48 publications

(87 reference statements)

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“…It was further hypothesized that there may be gender-specific use preferences in regard to these services. Indeed virtual spotting (such as that provided by hotline-based services) has been previously speculated to create a safer space for women and gender minorities who face increased rates of domestic violence and stalking behaviors when accessing SCS [ 24 ]. Previous studies of one MORS service (the National Overdose Response Service ) have found similar results in that the majority of the individuals using the services identified as women and gender minorities made up a significant proportion (81.9%) of service users who reported their gender [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…While hotline-based services such as the National Overdose Response Service and Never Use Alone do not store identifiable health information, other apps like Lifeguard, Brave and the Digital Overdose Response Service may store sensitive information such as names, dates of birth and addresses which could theoretically be compromised in the event of a cyberattack [ 8 – 12 ]. Indeed, the criminalization of substances is a continued theme that is seen across the literature, with many individuals expressing concerns regarding the loss of child custody, employment and the limitations of the Good Samaritan Act (as it relates to the execution of a warrant) with police attended overdoses [ 24 , 28 , 29 ]. Similarly, data collection and surveillance practices which are employed within harm reduction programs have been argued to potentially result in decreased service uptake and widening of health inequalities in PWUS [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…Smartphone ownership and literacy, however, have also been demonstrated to be lower among low-income, racial and ethnic minorities, and basic text messaging or talk (as seen in hotlines) was recommended to reach populations in “urban safety-net outpatient settings” [ 34 ]. The same study states that applications would be applicable to “younger and relatively wealthier” individuals [ 34 ], and as a result may appeal to those who may be dissuaded from accessing in-person services for fear of stigma, loss of employment or child custody [ 24 , 32 ]. While this is a broader system-based issue, a focus on improving access to these technologies and improving literacy around technology use would be key to ensuring improved uptake of these services and improving overall access and utilization equity.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Preference for hotline versus mobile application/countdown-based mobile overdose response services: a qualitative study

Rioux,

Teare,

Rider

et al. 2024

Harm Reduct J

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Background In response to the exacerbated rates of morbidity and mortality associated with the overlapping overdose and COVID-19 epidemics, novel strategies have been developed, implemented, operationalized and scaled to reduce the harms resulting from this crisis. Since the emergence of mobile overdose response services (MORS), two strategies have aimed to help reduce the mortality associated with acute overdose including staffed hotline-based services and unstaffed timer-based services. In this article, we aim to gather the perspectives of various key interest groups on these technologies to determine which might best support service users. Methods Forty-seven participants from various interested groups including people who use substances who have and have not used MORS, healthcare workers, family members, harm reduction employees and MORS operators participated in semi-structured interviews. Transcripts were coded and analyzed using a thematic analysis approach. Results Four major themes emerged regarding participant perspectives on the differences between services, namely differences in connection, perceived safety, privacy and accessibility, alongside features that are recommended for MORS in the future. Conclusions Overall, participants noted that individuals who use substances vary in their desire for connection during a substance use session offered by hotline and timer-based service modalities. Participants perceived hotline-based approaches to be more reliable and thus potentially safer than their timer-based counterparts but noted that access to technology is a limitation of both approaches.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Preference for hotline versus mobile application/countdown-based mobile overdose response services: a qualitative study

Rioux,

Teare,

Rider

et al. 2024

Harm Reduct J

View full text Add to dashboard Cite

show abstract

“…Previous commentaries suggest that public health agencies and community stakeholders should tailor messaging to those most impacted by the drug overdose crisis, namely men who use drugs alone [ 27 ]. Furthermore, preliminary data around VOMS use including qualitative interviews and early statistics indicate that these interventions can potentially address the lack of access or comfort in using in-person harm reduction services [ 28 , 29 ]. Participants highlighted the importance of advertising this service as an adjunct to supervised consumption services rather than a replacement.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and acceptability of inserts promoting virtual overdose monitoring services (VOMS) in naloxone kits: a qualitative study

et al. 2023

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Background In response to the ongoing opioid epidemic, there have been efforts to develop novel harm reduction strategies alongside scaling of currently implemented programs. Virtual overdose monitoring services (VOMS) are a novel intervention which aims to reduce substance-related mortality through technology for those who are out of reach of current supervised consumption sites. Scaling of naloxone programs presents a unique opportunity to promote VOMS to people at risk of substance-related mortality. This study aims to explore the feasibility and acceptability of naloxone kit inserts in promoting awareness of VOMS. Method We used purposive and snowball sampling to recruit 52 key informants, including people who use drugs (PWUD) with experience using VOMS (n = 16), PWUD with no prior experience using VOMS (n = 9), family members of PWUD (n = 5), healthcare and emergency services professionals (n = 10), community-based harm reduction organizations (n = 6), and VOMS administrators/peer support workers (n = 6). Two evaluators completed semi-structured interviews. Interview transcripts were analyzed using thematic analysis informed to identify key themes. Results Four key interrelated themes emerged, including the acceptability of naloxone kit inserts to promote VOMS, best practices for implementation, key messaging to include within promotional materials and facilitators to dissemination of harm reduction material. Participants highlighted that messaging should be promoted both inside and outside the kits, should be concise, provide basic information about VOMS and can be facilitated through current distribution streams. Messaging could further be used to draw attention to local harm reduction services and could be promoted on other supplies, including lighters and safer consumption supplies. Conclusion Findings demonstrate that it is acceptable to promote VOMS within naloxone kits and highlight interviewees preferred ways to do so. Key themes that emerged from interviewees can be used to inform the dissemination of harm reduction information, including VOMS and bolster current strategies for reducing illicit drug overdose.

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“…Perhaps the online treatment delivery method was effective for women as it gave them the opportunity to seek treatment while simultaneously fulfilling other duties (e.g., familial responsibilities, attending to their WHEN A PANDEMIC MEETS AN EPIDEMIC 50 children). In fact, researchers have asserted that virtual services are gender-responsive and reflect the unique needs of women (Perri et al, 2022). Furthermore, as hypothesized, results indicated that there was a significant decrease in RAAM presentation for individuals who were experiencing precarious housing since the onset of the pandemic.…”

Section: Demographic Differences and Treatment Accessmentioning

confidence: 88%

When a Pandemic Meets an Epidemic: How COVID-19 has Affected Treatment Access Among Individuals with Problematic Opioid Use

Polakova¹

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The study examined the impact of the COVID-19 pandemic on treatment access among individuals (n=225) presenting with problematic opioid use to the Rapid Access Addiction Medicine (RAAM) clinic at The Royal in Ottawa, Ontario. The COVID-19 pandemic led to government-imposed restrictions and service limitations. The RAAM clinic underwent two primary changes: (1) delivering services virtually rather than in-person appointments and ( 2) shifting from walk-in services to appointment-based services. The study was a retrospective chart review and data were extracted from an electronic health record, Meditech. Participants were patients who had an initial presentation to the RAAM clinic between March 16 th , 2019, and March 15 th , 2021, and had used opioids within the 30 days prior to their visit. Results indicated that RAAM changes decreased some groups' access to care such that fewer patients experiencing precarious housing and mental health comorbidities presented to the RAAM clinic after the onset of the pandemic.

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COVID-19 and the opportunity for gender-responsive virtual and remote substance use treatment and harm reduction services

Cited by 12 publications

References 48 publications

Preference for hotline versus mobile application/countdown-based mobile overdose response services: a qualitative study

Preference for hotline versus mobile application/countdown-based mobile overdose response services: a qualitative study

Feasibility and acceptability of inserts promoting virtual overdose monitoring services (VOMS) in naloxone kits: a qualitative study

When a Pandemic Meets an Epidemic: How COVID-19 has Affected Treatment Access Among Individuals with Problematic Opioid Use

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