A scoping review of <scp>mHealth</scp> technologies for opioid overdose prevention, detection and response

Tas, Basak; Lawn, Will; Traykova, Elena V.; Evans, Rebecca A. S.; Murvai, Barbara; Walker, Hollie; Strang, John

doi:10.1111/dar.13645

Cited by 8 publications

(6 citation statements)

References 56 publications

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“…Using heroin alone, or sequestered from others, renders assistance difficult, if not impossible. The use of wearable technology ('mHealth') to detect and initiate responses to overdose represents a potential new form of intervention that does not rely on others being present [50]. To date, however, such an intervention for people who use heroin has not occurred in Australia.…”

Section: Discussionmentioning

confidence: 99%

A descriptive coronial study of heroin toxicity deaths in Australia, 2020–2022: Characteristics, toxicology and survival times

Darke,

Duflou,

Peacock

et al. 2023

Addiction

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Background and aimsMortality rates among people who use heroin are estimated to be 15 times that of the general population. The study aimed to determine (1) the case characteristics and circumstances of death of heroin‐related toxicity deaths in Australia, 2020–2022; (2) their toxicological profile and major autopsy findings; (3) the proportion of cases in which blood 6‐acetyl morphine (6AM) was detected, as a proxy measure of survival times; and (4) compare 6AM positive and negative cases on toxicology, circumstances of death and acute clinical presentation.DesignRetrospective study of heroin toxicity deaths in Australia, 2020–2022, retrieved from the National Coronial Information System.SettingThis study was conducted Australia‐wide.CasesThere were 610 cases of fatal heroin‐related drug toxicity.MeasurementsInformation was collected on characteristics, manner of death, toxicology and autopsy results.FindingsThe mean age was 42.6 years (range 18–73 years), 80.5% were male and 7.5% were enrolled in a drug treatment programme. The circumstances of death were as follows: unintentional drug toxicity (86.2%), combined unintentional drug toxicity/disease (11.3%) and intentional drug toxicity (2.5%). The median free morphine concentration was 0.17 mg/L (range 0.00–4.20 mg/L). Psychoactive drugs other than heroin were present in 95.2% (Confidence Interval 93.1%–96.8%), most commonly hypnosedatives (62.3%, 58.2%–66.4%) and psychostimulants (44.8%, 40.7%–49.1%). Major autopsy findings of clinical significance included acute bronchopneumonia (14.8%, 11.3%–18.8%), emphysema (16.9%, 13.2%–21.1%), cardiomegaly (30.1%, 12.7%–28.2%), coronary artery disease (27.4%, 23.0%–32.3%), coronary replacement fibrosis (13.4%, 10.1%–17.3%), hepatic cirrhosis (8.8%, 6.6%–12.2%) and renal fibrosis (10.3%, 7.3%–14.0%). In 47.0% (42.3%–51.2%), 6AM was present in blood.ConclusionsThe ‘typical’ heroin overdose case in Australia from 2020 to 2022 was a male who injected heroin, aged in the 40s, not enrolled in a treatment programme and had used multiple drugs. In over half of cases, there had been a sufficient survival time for 6‐acetyl morphine to have been metabolised, which may indicate times in excess of 20–30 min.

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Section: Discussionmentioning

confidence: 99%

A descriptive coronial study of heroin toxicity deaths in Australia, 2020–2022: Characteristics, toxicology and survival times

Darke,

Duflou,

Peacock

et al. 2023

Addiction

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“…People who are older who use heroin should be advised of their risk for shorter survival times. The use of wearable technology (‘mHealth’) to detect, and initiate responses to overdose represents a potential new form of intervention that does not rely upon others being present ( Tas et al, 2023 ). The provision of take-home naloxone is warranted for all people who use heroin, but is particularly salient those who are older, as take-home naloxone has been demonstrated to be an effective intervention ( McDonald et al, 2017 ; Moustaqim-Barrette et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Differences in heroin overdose deaths in Australia by age, 2020-2022: Disease and estimated survival times

Darke,

Duflou,

Peacock

et al. 2024

Drug and Alcohol Dependence Reports

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“…Users suggested the device could be readily available within a city center facility such as SISS and that they could receive a device when collecting needle packs and Naloxone. In light of this, this article adds to a growing body of literature that shows how the potential for digital interventions, such as wearable technologies, can help avoid opiate overdose (2,(16)(17)(18)(19). Overall, SISS workers agreed that the device would be of great benefit in principle to users, particularly in terms of harm reduction.…”

Section: Focus Group Findingsmentioning

confidence: 97%

“…Wearable technology has great potential in the Harm Reduction space to detect overdose, particularly when people use alone, but has been underutilized (15). A growing body of literature demonstrates the potential of digital interventions, including wearable devices, for preventing opiate overdose (2,(16)(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Reducing opioid related deaths for individuals who are at high risk of death from overdose: a co-production study with people housed within prison and hostel accommodation during Covid-19

Campbell

Millen

Guo

et al. 2023

Front. Public Health

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BackgroundA record number of Opioid-related deaths occurred in Northern Ireland in 2021 and it is acknowledged that the Covid-19 pandemic compounded drugs related deaths crisis. This co-production study set out to refine the design of a wearable device for Opioid users to detect and subsequently prevent a potential overdose situation.MethodPurposive sampling was used to recruit people who had substance use disorders and were living in a hostel and prison during the Covid-19 pandemic. Principles of co-production influenced the study, which encompassed a focus group phase and a wearable phase. The initial phase included three focus groups with participants who inject Opioids and one focus group with workers from a street injector support service. During the wearable phase, the participant group tested the feasibility of the wearable technology in a controlled environment. This included testing the transferability of data from the device to a backend server on the cloud.ResultsAll focus group participants expressed an interest in the wearable technology when it was presented to them and agreed, that in principle, such a device would be extremely beneficial to help reduce the risk of overdose within the active drug using community. Participants outlined factors which would help or hinder the design of this proposed device and their decision to wear it, if it were readily available to them. Findings from wearable phase indicated that it was feasible to use a wearable device for monitoring Opioid users’ biomarkers remotely. The provision of information regarding the specific functionality of the device was considered key and could be disseminated via front line services. The data acquisition and transfer process would not be a barrier for future research.ConclusionUnderstanding the benefit and disadvantages of technologies such as a wearable device to prevent Opioid-related deaths will be critical for mitigating the risk of overdose for people who use Heroin. It was also clear that this would be particularly relevant during Covid-19 lock-down periods, when the effects of the pandemic further exacerbated the isolation and solitude experienced by people who use Heroin.

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A scoping review of mHealth technologies for opioid overdose prevention, detection and response

Cited by 8 publications

References 56 publications

A descriptive coronial study of heroin toxicity deaths in Australia, 2020–2022: Characteristics, toxicology and survival times

A descriptive coronial study of heroin toxicity deaths in Australia, 2020–2022: Characteristics, toxicology and survival times

Differences in heroin overdose deaths in Australia by age, 2020-2022: Disease and estimated survival times

Reducing opioid related deaths for individuals who are at high risk of death from overdose: a co-production study with people housed within prison and hostel accommodation during Covid-19

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