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

• Published in: Harm reduction journal Vol. 21; no. 1; pp. 31 - 11
• Main Authors: Rioux, William, Teare, Adrian, Rider, Nathan, Jones, Stephanie, Ghosh, S Monty
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 05.02.2024; BioMed Central; BMC
• Subjects: Analysis; Applications programs; COVID-19; Drug overdose; Drug Overdose - epidemiology; Drug poisoning; Drug use; Drug utilization; Drugs; Epidemics; Harm Reduction; Health aspects; Hotlines; Humans; Interest groups; Internet; Interviews; Medical care, Cost of; Medical personnel; Methodology; Methods; Mobile Applications; Mobile computing; Morbidity; Mortality; Overdose; Peers; Perceptions; Public health; Qualitative Research; Substance use; Supervised consumption; Telephone hotlines; Virtual overdose monitoring services; Canada; Harm reduction; Supervised consumption; Drug poisoning; Overdose; Public health; Virtual overdose monitoring services
• ISSN: 1477-7517; 1477-7517
• DOI: 10.1186/s12954-024-00944-9

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. 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. 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. 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.