Overdose Detection Technologies—A New Frontier in Preventing Solitary Drug Overdose Deaths

Abstract

This Viewpoint examines current opioid overdose detection technologies and their utility in detecting potential drug overdose episodes and preventing solitary overdose deaths in the US.

Evaluation of Strategies to Enhance Community-Based Naloxone Distribution Supported by an Opioid Settlement

“…31 Global innovations in overdose detection technologies could also increase overdose detection and response to reduce OODs. 15 Brave (an app that anonymously connects people who use drugs alone to help in the event that they overdose), Never Use Alone (a US hotline to support, virtually supervise, and dispatch responders), and the National Overdose Response Service (a similar Canadian hotline) are currently available. Although these emerging overdose detection technologies present unique strengths, such as low cost and improved scalability and reach (particularly in rural areas), 32 there are some challenges in adopting these technologies, such as low awareness, lack of funding for implementation and evaluation, high costs, and privacy concerns.…”

“…The first publicly recognized OPCs in the US are being piloted in Providence, Rhode Island, and New York City; 603 overdose reversals and 0 deaths have been recorded in the first year of operation of OPCs in New York City . Global innovations in overdose detection technologies could also increase overdose detection and response to reduce OODs . Brave (an app that anonymously connects people who use drugs alone to help in the event that they overdose), Never Use Alone (a US hotline to support, virtually supervise, and dispatch responders), and the National Overdose Response Service (a similar Canadian hotline) are currently available.…”

“…Next, we modeled hypothetical interventions that aim to reduce solitary drug use and thus increase the likelihood of witnessed overdoses (and therefore the opportunity for naloxone to be administered) in private or semiprivate settings. Given the scarcity of evidence on the effectiveness of these relatively new or pilot interventions, 15 we assessed discrete levels of incremental increases in the probability of an overdose being witnessed in these settings, from 0% (baseline) to 20%, 40%, and 60% (approximately equivalent to the probability of overdoses being witnessed in public settings). We did not model interventions that aim to increase the likelihood of naloxone administration during overdose events occurring in public settings because these settings account for only a few opioid overdoses, 21 interventions to address public overdoses are distinct from those intended in private or semiprivate settings, and the probability of witnessed overdoses in public settings was already more than 80% in the model.…”

“…Unfortunately, only one-third of fatal overdoses in the US occurred with a bystander present, defined as someone being physically present during or shortly preceding a drug overdose who potentially had the opportunity to intervene and respond . Some recent interventions to address solitary drug use—and thus increase the likelihood that naloxone is administered in the event of an overdose—include peer support programs, overdose prevention centers (OPCs, sometimes referred to as supervised consumption sites, which are places where people can consume preobtained drugs in a monitored setting where staff can immediately intervene in the event of an overdose), telephone hotlines, mobile apps, stationary wired or wireless devices (such as passive motion detection system and button alert system), and wearable biosensors . In addition to expanding naloxone distribution, statewide efforts are under way in Rhode Island to promote and fund some of these initiatives using the state’s opioid settlement funds…”