Overdose safety helpline during the COVID-19 pandemic – A promising new service & lessons learned.

Author: Stephen Murray

Theme: Models of Care Year: 2023

In 2021, the United States recently surpassed more than 100,000 deaths from overdose largely due to fentanyl in the drug supply. Using fentanyl without anyone ready to administer naloxone or rescue breathing is a primary risk factor for fatal overdose. Overdose safety helplines monitor people using alone and trigger a rescue response when needed. Here we describe the implementation of one overdose safety helpline in Massachusetts. 

Description of model of care/intervention:
The Massachusetts Overdose Prevention Helpline started April 2020, and provided free 24/7 service, originally under the name Never Use Alone Massachusetts. The service is staffed by volunteer operators with lived or living drug use experience. Operators are trained to get caller location, discuss overdose safety plan, confirm phone is charged, ensure they’re accessible to first responders, and provide company to the caller while they use.  When callers are looking for services such as harm reduction or treatment, the operator assists them in locating resources. Operators on duty are connected via phone tree software, and utilize a service that ensures immediate connection with local emergency responders.

From 12/2019-12/2022, 534 calls were received from Massachusetts residents. Three overdoses were detected with a 100% save rate. Lessons learned include 1) technology can provide effective virtual spotting 2) volunteer operators with living experience are willing to participate 3) The majority of calls do not result in an overdose, but provide opportunities for connection to a PWUD who is isolated 4) the system needs to be scaled to provide more comprehensive service

Conclusion and next steps:
Institutional support, funding and broader adoption of this program has the potential to improve its reach and to help save lives. Better training and operator support would help to reduce operator turnover and improve long-term retention. More work is needed to understand barriers to calling and how to engage more PWUD.

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