Electronic harm reduction interventions for drug overdose monitoring and prevention: A scoping review

Loverock, Alexandra; Marshall, Tyler; Viste, Dylan; Safi, Fahad; Rioux, Will; Sedaghat, Navid; Kennedy, Megan; Ghosh, S. Monty

doi:10.1016/j.drugalcdep.2023.110878

Cited by 15 publications

(5 citation statements)

References 58 publications

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“…Due to surging numbers of overdoses resulting from an increasingly toxic drug supply compounded by public health messaging promoting isolation, which ran directly counter to previous messaging to “never use alone”, novel strategies were explored including the use of overdose response technologies [ 12 – 17 ]. One innovative strategy, “spotting” is a method in which individuals are able to supervise clients while using substances virtually through the use of telecommunications and enact a response (which includes notifying a trusted community member or emergency medical services to intervene and provide naloxone) in the event of an overdose [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Implementing Canada’s first national virtual phone based overdose prevention service: lessons learned from creating the National Overdose Response Service (NORS)

Rioux,

Taplay,

Morris-Miller

et al. 2024

Harm Reduct J

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The opioid epidemic remains one of the largest public health crises in North America to date. While there have been many diverse strategies developed to reduce the harms associated with substance use, these are primarily concentrated within a few large urban centers. As a result, there have been increased calls for equitable access to harm reduction services for those who cannot or choose not to access in-person harm reduction services. In December 2020, Canada’s National Overdose Response Service (NORS) a telephone based overdose response hotline and virtual supervised consumption service, was established in collaboration with various agencies and people with lived and living experience of substance use (PWLLE) across Canada to expand access to harm reduction services using novel Opioid Response Technology. In this manuscript we explore the lessons learned from the establishment and continued operation of the service exploring topics related to the initial establishment of the service, securing a phone line, routing technology, EMS dispatch solutions, peer and volunteer recruitment, legal and ethical support, policy and procedure development, securing funding, and marketing. Furthermore, we detail how this service has grown and changed in response to the various needs of service users.

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Section: Introductionmentioning

confidence: 99%

Implementing Canada’s first national virtual phone based overdose prevention service: lessons learned from creating the National Overdose Response Service (NORS)

Rioux,

Taplay,

Morris-Miller

et al. 2024

Harm Reduct J

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“…British Columbia and Alberta have both implemented automatic countdown-based mobile applications such as Connect by LifeGuard and the Digital Overdose Response Service (DORS), respectively, which initiate an emergency response if the individual is unable to shut off or renew the application timer. The e cacy of these interventions is yet to be determined, but a summary of other services has been recently highlighted in a systematic review 10 .…”

Section: Introductionmentioning

confidence: 99%

Bridging the Gap in Harm Reduction Using Mobile Overdose Response Services (MORS) in the Context of the COVID-19 Pandemic: A Qualitative Study

Seo,

Rioux,

Rider

et al. 2024

J Urban Health

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The COVID-19 pandemic introduced a myriad of challenges for accessing healthcare services, especially for people who use substances (PWUS). Numerous supervised consumption sites (SCS) across Canada faced shutdowns and reduced operating capacity in order to comply with public health measures, which has exacerbated the mortality rates associated with opioid toxicity. In an effort to reduce the harms associated with these dual public health crises, Mobile Overdose Response Services (MORS) were introduced to allow PWUS to consume substances under virtual supervision. Here, we examine the role of MORS in the context of the pandemic. A total of 59 semi-structured interviews were conducted with relevant interest groups, including PWUS, health care providers, harm reduction workers, and operational experts. Major themes and subthemes were identi ed using inductive thematic analysis informed by grounded theory. Overall, participants felt that the COVID-19 pandemic shifted the public focus away from harm reduction and neglected the needs of PWUS. MORS were regarded as a useful tool to mitigate the closure/reduced capacity of physical SCS, prevent the transmission of COVID-19, and help alleviate the prevailing sense of isolation during public health crises. MORS were seen as a useful and muchnecessary adjunct service to address the unmet needs of physical SCS during the pandemic and beyond.

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“…Fortunately, novel virtual overdose monitoring services (VOMS), or mobile overdose response services (MORS), have been developed as an adjunct solution to SCS, aiming to address the current gaps in harm reduction care for these individuals. These technology-based overdose prevention services include a variety of hotline, mobile phone applications, and automated services which can virtually provide harm reduction support for individuals using alone [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Association of drug overdoses and user characteristics of Canada’s national mobile/virtual overdose response hotline: the National Overdose Response Service (NORS)

Viste,

Rioux,

Cristall

et al. 2023

BMC Public Health

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Background Several novel overdose response technology interventions, also known as mobile overdose response services (MORS), have emerged as adjunct measures to reduce the harms associated with the drug poisoning epidemic. This retrospective observational study aims to identify the characteristics and outcomes of individuals utilizing one such service, the National Overdose Response Service (NORS). Methods A retrospective analysis was conducted using NORS call logs from December 2020 to April 2023 imputed by operators. A variety of variables were examined including demographics, substance use and route, location, and call outcomes. Odds ratios and 95% confidence intervals were calculated around variables of interest to test the association between key indicators and drug poisonings. Results Of the 6528 completed calls on the line, 3994 (61.2%) were for supervised drug consumption, 1703 (26.1%) were for mental health support, 354 (5.42%) were for harm reduction education or resources, and 477 (7.31%) were for other purposes. Overall, there were 77 (1.18%) overdose events requiring a physical/ in-person intervention. Of the total calls, 3235 (49.5%) were from women, and 1070 (16.3%) were from people who identified as gender diverse. Calls mostly originated from urban locations (n = 5796, 88.7%) and the province of Ontario (n = 4137, 63.3%). Odds ratios indicate that using opioids (OR 6.72, CI 95% 3.69–13.52), opioids in combination with methamphetamine (OR 9.70, CI 95% 3.24–23.06), multiple consumption routes (OR 6.54, CI 95% 2.46–14.37), and calls occurring in British Columbia (B.C) (OR 3.55, CI 95% 1.46–7.33) had a significantly higher likelihood of a drug poisoning. No deaths were recorded and only 3 false callouts had occurred. The overall drug poisoning event incidence to phone calls was 1.2%. Conclusion NORS presents a complimentary opportunity to access harm reduction services for individuals that prefer to use alone or face barriers to accessing in-person supervised consumption services especially gender minorities with high-risk use patterns.

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Electronic harm reduction interventions for drug overdose monitoring and prevention: A scoping review

Cited by 15 publications

References 58 publications

Implementing Canada’s first national virtual phone based overdose prevention service: lessons learned from creating the National Overdose Response Service (NORS)

Implementing Canada’s first national virtual phone based overdose prevention service: lessons learned from creating the National Overdose Response Service (NORS)

Bridging the Gap in Harm Reduction Using Mobile Overdose Response Services (MORS) in the Context of the COVID-19 Pandemic: A Qualitative Study

Association of drug overdoses and user characteristics of Canada’s national mobile/virtual overdose response hotline: the National Overdose Response Service (NORS)

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