Virtual Overdose Monitoring Could Help in Reducing Drug Overdose

Virtual monitoring services gives hope for those suffering from substance abuse which is a serious medical issue. Opioids have analgesic and sedative effects, and are commonly used for the management of pain. After intake, opioids can cause euphoria, which is one of the main reasons why they are taken for non-medical reasons. Opioids include heroin, morphine, codeine, fentanyl, methadone, tramadol, and other similar substances. Due to their pharmacological effects, they can cause difficulties in breathing, and an opioid overdose can sometimes lead to death (1^✔ ✔Trusted Source
Opioid overdose

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Their regular non-medical use, prolonged use, misuse, and usage without medical supervision can lead to opioid dependence. The characteristic feature of dependence is a strong internal drive to use opioids, which manifests itself as an impaired ability to control its use, increased tendency to use over other activities, and persistence of use despite its harmful or negative consequences. Physiological features of dependence may also be present, including increased tolerance to the effects of opioids, withdrawal symptoms following cessation, or reduction in use, and repeated use of opioids or pharmacologically similar substances, to prevent or alleviate withdrawal symptoms (2^✔ ✔Trusted Source
International Statistical Classification of Diseases and Related Health Problems (ICD)

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There were 107,622 overdose deaths in 2021, the highest annual death toll on record from drug overdose fatalities, and a 15% increase from the previous year (3^✔ ✔Trusted Source
Provisional Drug Overdose Death Counts

Go to source). Isolation and solitary use of drugs are the main cause of death in people suffering from substance abuse.

Virtual Overdose Monitoring to Prevent Overdose Deaths

Virtual overdose monitoring services are those that use digital technologies, such as smartphone applications or phone lines, to provide a variety of support that is focused on harm reduction, such as overdose monitoring, harm reduction education, and referrals to health and social services (4^✔ ✔Trusted Source
Table of Contents

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Initially, callers connect anonymously with a peer operator to develop a personally tailored emergency response plan that can be activated during a suspected adverse event (e.g., overdose or drug poisoning, mental health crisis). Safer methods of use, such as the use of smaller doses, are typically encouraged, along with referrals to health and social services.

On subsequent calls, an overdose prevention operator monitors the caller throughout the duration of their episode of substance use. If any adverse event is suspected (e.g., lack of response, sounds indicating respiratory compromise), the operator activates the predetermined emergency response plan. Plans may include emergency medical services (EMS) via 911 dispatch or a prearranged individual contact capable of providing timely emergency care (e.g., cardiopulmonary resuscitation, naloxone administration).

Virtual overdose monitoring services operate 24 hours a day using a variety of telecommunication platforms and are available to a diverse population of people who use substances. Services have no restrictions on substance type or route of administration.

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Systematic reviews have shown that in-person and supervized consumption services prevent opioid-related deaths during acute substance abuse and mitigate the risk of secondary substance-related harms such as HIV transmission, particularly among people who inject substances (5^✔ ✔Trusted Source
Supervised consumption services for acute care hospital patients

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However, much less evidence is available for virtual overdose monitoring services. There are studies that show that virtual help can cause harm reduction. One primary study, found that 68% of individuals who used substances and had a cellphone stated that they were willing to use technology-based solutions to mitigate the risks of overdose (6^✔ ✔Trusted Source
Acceptability of technological solutions for overdose monitoring: Perspectives of people who use drugs

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A prospective study involving both people who used opioids and community members showed that laypeople were able to respond to 71 (95.9%) of 74 overdoses using technology, suggesting that equipping laypeople with naloxone and an emergency response application may successfully reverse overdoses in the community (7^✔ ✔Trusted Source
Layperson reversal of opioid overdose supported by smartphone alert: A prospective observational cohort study

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A qualitative study found potential benefits of “drug spotting,” which is a longstanding, informal community practice whereby a person who intends to use drugs asks a friend, family member, or person with lived experience to monitor their drug use via text, phone, or video call (8^✔ ✔Trusted Source
Opioid overdose detection using smartphones

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Virtual overdose monitoring services are novel public health interventions capable of providing timely and accessible harm reduction and overdose prevention services for people who use substances. Evidence and data suggest that virtual overdose monitoring services have promise as an adjunct to supervised consumption services in the continuum of care for people who use substances.

References:

1. Opioid overdose - (https://www.who.int/news-room/fact-sheets/detail/opioid-overdose)
2. International Statistical Classification of Diseases and Related Health Problems (ICD) - (https://www.who.int/standards/classifications/classification-of-diseases)
3. Provisional Drug Overdose Death Counts - (https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm)
4. Table of Contents - (https://www.cmaj.ca/content/194/46)
5. Supervised consumption services for acute care hospital patients - (https://www.cmaj.ca/content/192/18/E476)
6. Acceptability of technological solutions for overdose monitoring: Perspectives of people who use drugs - (https://pubmed.ncbi.nlm.nih.gov/31657675/)
7. Layperson reversal of opioid overdose supported by smartphone alert: A prospective observational cohort study - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7486335/)
8. Opioid overdose detection using smartphones - (https://pubmed.ncbi.nlm.nih.gov/30626717/)

Source-Medindia