Investigating uses of peer-operated Virtual Overdose Monitoring Services (VOMS) beyond overdose response: a qualitative study

ABSTRACT

Background: Virtual overdose monitoring services (VOMS) are novel technologies that allow remote monitoring of individuals while they use substances (especially those who use alone) electronically.

Objectives: The authors explored key partner perspectives regarding services offered by VOMS beyond overdose response with the aim of understanding the breadth and perception of the services amongst those that use these services and are impacted by them.

Methods: Forty-seven participants from six key partner groups [peers who had used VOMS (25%), peers who had not used VOMS (17%), family members of peers (11%), health professionals (21%), harm reduction sector employees (15%), and VOMS operators (15%)] underwent 20-to-60-minute semi-structured telephone interviews. Of peer and family groups, thirteen participants identified as female, eleven as male and one as non-binary, gender data was not recorded for other key partner groups. Interview guides were developed and interviews were conducted until saturation was reached across all participants. Themes and subthemes were identified and member checked with partner groups.

Results: Participants indicated that uses of VOMS beyond overdose monitoring included: (1) providing mental health support and community referral; (2) methamphetamine agitation de-escalation; (3) advice on self-care and harm reduction; and (4) a sense of community and peer support. Respondents were divided on how VOMS might affect emergency services (5).

Conclusions: VOMS are currently being used for purposes beyond drug poisoning prevention, including community methamphetamine psychosis de-escalation, mental health support, and community peer support. VOMS are capable of delivering a broad suite of harm reduction services and referring clients to recovery-oriented services.

KEYWORDS:

• Overdose
• drug poisoning
• virtual overdose monitoring services
• harm reduction
• supervised consumption
• safe consumption

Acknowledgments

The authors would like to acknowledge the contributions of Health Canada’s Substance Use and Addictions Program (SUAP) and the Canadian Institutes of Health Research (CIHR) for helping fund this project. The study design, data collection and analysis, interpretation of results, or the decision to submit for publication was done independently of SUAP and CIHR. Health Canada’s views are not necessarily represented by the views expressed in this article. We would also like to thank the National Overdose Response Service (NORS), Grenfell Ministries, and the Substance User Network of the Atlantic Region (SUNAR) for helping recruit participants. We also appreciate the work of Three Hive Consulting in conducting interviews and aiding with analysis.

Disclosure statement

MG is a co-founder of the National Overdose Response Service (NORS) and a board member of the Canadian Society of Addiction Medicine; he has no personal financial conflicts of interest to disclose. The results of this work may be used to make operational changes at NORS or to apply for additional funding for NORS. PT is a phone line supervisor with NORS and has no personal financial interest in this work. The remaining authors are not affiliated with NORS or any other VOMS and certify they have no competing interests.

Additional information

Funding

This work was supported by Health Canada’s Substance Use and Addictions Program (SUAP) Grant [Agreement Number 2122-HQ-000021] and the Canadian Institutes of Health Research (CIHR) Grant [Funding Reference Number (FRN) 181006]. SUAP and CIHR did not play any role in study design, data collection and analysis, interpretation of results, or the decision to submit for publication. The views expressed herein do not necessarily represent the views of Health Canada or the CIHR.