National hotline provides effective virtual supervision for substance users

Emergency medical services are dispatched immediately if the user becomes unresponsive.

EDMONTON — Drug overdoses can be prevented and lives saved by providing telephone supervision for people who are using substances alone, according to new research published in the Canadian Medical Association Journal.

Researchers reported no deaths during a pilot of the National Overdose Response Service (NORS) telephone hotline from December 2020 to February 2022. Staff took 2,171 calls from 222 unique callers and monitored them over the phone while they used substances including opioids, cocaine, methamphetamine or other drugs, either intravenously or by inhalation. During 53 of the calls, the clients became unresponsive and staff were concerned they might be in trouble, so emergency services were alerted. After following up, it was confirmed that all survived.

“Anywhere from 50 to 70 per cent of overdoses and drug poisonings nationally occur in people's own homes while they're using alone,” says principal investigator Monty Ghosh, assistant professor of medicine at the University of Alberta, as well as at the University of Calgary. “If you don't have supervised consumption or a friend who can monitor you, then we're here to support you so that you stay safe.”

People take the risk of using substances alone because they are afraid of stigma, explains Ghosh, who works as an internist at the University of Alberta Hospital in Edmonton and as an addiction specialist at the Foothills Medical Centre and the AHS Rapid Access Addiction Medicine program in Calgary. 

“They're afraid of being seen. They're afraid of being identified. They're afraid of being arrested and incarcerated and criminalized,” he says.

The researchers reported that 62 per cent of callers were women and 94 per cent were from urban areas in Ontario, Quebec and Alberta. Evenings are the peak time for calls. 

Callers are asked to provide only minimal personal information — their location, what drugs they are using — data that are either destroyed or anonymized after the call. Staff and the caller agree on a check-in schedule, then keep the line open until they’re confident the caller is safe. Staff will connect callers with addiction counselling or mental health services if requested. 

The National Overdose Response Service was founded in December 2020 by Ghosh and others in partnership with Grenfell Ministries and Brave Technology Co-op.

Ghosh hopes to continue offering the service while studying its impact and is currently conducting a national survey of substance users. He’d like to understand why women use the service more than men or gender-diverse individuals, and he’d like to shed light on how well mobile apps — which allow users to set a timer that will automatically dispatch EMS if not refreshed in a timely manner — can support harm reduction. 

The study can be seen here. The full story can be seen here. To arrange interviews with Monty Ghosh or Lisa Morris-Miller, director of NORS, please contact:
Ross Neitz | U of A media strategist | ross.neitz@ualberta.ca | 780-297-8354