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. 2024 Jan 12;19(1):4.
doi: 10.1186/s13722-023-00433-7.

Perspectives of healthcare workers on the integration of overdose detection technologies in acute care settings

William Rioux  1 , Kyle Kilby  2 , Stephanie Jones  3 , Pamela Joshi  4 , Stephanie Vandenberg  5 , S Monty Ghosh  6   7
Affiliations

Perspectives of healthcare workers on the integration of overdose detection technologies in acute care settings

William Rioux et al. Addict Sci Clin Pract. .

Abstract

Background: People who use drugs (PWUD) face disproportionately high rates of hospitalizations and patient-initiated discharge (leaving against medical advice), explained by a combination of stigma, withdrawal, judgment, blame, and improper pain management. In addition, evidence has shown that despite abstinence-based policies within healthcare settings, PWUD continue to use their substances in healthcare environments often hidden away from hospital staff, resulting in fatalities. Various novel overdose detection technologies (ODTs) have been developed with early adoption in a few settings to reduce the morbidity and mortality from risky substance use patterns within healthcare environments. Our study aimed to gain the perspectives of healthcare workers across Canada on implementing ODTs within these settings.

Method: We used purposive and snowball sampling to recruit 16 healthcare professionals to participate in semi-structured interviews completed by two evaluators. Interview transcripts were analyzed using thematic analysis to identify key themes and subthemes.

Results: Participants recognized ODTs as a potentially feasible solution for increasing the safety of PWUD in healthcare settings. Our results suggest the mixed ability of these services to decrease stigma and build rapport with PWUD. Participants further highlighted barriers to implementing these services, including pre-established policies, legal recourse, and coordination of emergency responses to suspected overdoses. Lastly, participants highlight that ODTs should only be one part of a multifaceted approach to reducing harm in healthcare settings and could currently be integrated into discharge planning.

Conclusion: Healthcare professionals from across Canada found ODTs to be an acceptable intervention, but only as part of a larger suite of harm reduction interventions to reduce the harms associated with illicit drug use in healthcare settings. In contrast, participants noted institutional policies, stigma on behalf of healthcare workers and leadership would present significant challenges to their uptake and dissemination.

Keywords: Acute care; Harm reduction; Opioid; Overdose; Overdose detection technologies.

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Conflict of interest statement

M.G. co-founded NORS and belongs to the Canadian Society of Addiction Medicine and has no personal financial conflicts of interest to disclose. The results of this work may be used to apply for funding for NORS or to make operational changes to NORS. The rest of the authors are unaffiliated with any other ODTs or NORS in particular and have no competing interests to declare.

Figures

Fig. 1
Fig. 1
The Model for ODTs in acute care settings
See this image and copyright information in PMC

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