“I think that that really could benefit a lonely user:” perceptions of overdose response hotlines among people who use opioids

Abstract Background Overdose response hotlines, such as the SafeSpot and Never Use Alone phone hotlines and Brave smartphone application, are promising tools to reduce fatal overdose risk among people who use drugs (PWUD). These free and confidential services connect callers to a trained operator wh...

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Main Authors: Rachel E. Gicquelais, Rachel P. Chenoweth, Nora Jacobson, Caitlin Conway, Gina M. Bryan
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Harm Reduction Journal
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Online Access:https://doi.org/10.1186/s12954-025-01283-z
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author Rachel E. Gicquelais
Rachel P. Chenoweth
Nora Jacobson
Caitlin Conway
Gina M. Bryan
author_facet Rachel E. Gicquelais
Rachel P. Chenoweth
Nora Jacobson
Caitlin Conway
Gina M. Bryan
author_sort Rachel E. Gicquelais
collection DOAJ
description Abstract Background Overdose response hotlines, such as the SafeSpot and Never Use Alone phone hotlines and Brave smartphone application, are promising tools to reduce fatal overdose risk among people who use drugs (PWUD). These free and confidential services connect callers to a trained operator who monitors them for adverse reactions during and after drug use. We explored PWUD’s perceptions of overdose response hotlines. Methods PWUD receiving substance use treatment in a facility in a Midwestern US city were screened for eligibility using the NIDA-Modified ASSIST questionnaire and invited to enroll if they had a moderate or severe substance involvement score for use of street or prescription opioids. Ten participants completed a 30–45-minute in-depth interview focused on overdose prevention, including perceptions and use of overdose response hotlines, in February 2022. Inductive content analysis was used to describe perspectives on overdose response hotlines. Results Only 1 of the 10 participants had heard of overdose response hotlines, but most were optimistic about their potential benefits for PWUD. One participant said, “I believe that if word was out there, people would use it.” Another stated, “I would trust it today. I know that there is [sic] people trying to change what’s going on in our culture with opiates.” Participants described several potential barriers to utilization, including distrust, especially in the context of drug-induced paranoia and concerns about being arrested, and the cost of an emergency medical response if an overdose occurred. One participant stated, “people get paranoid when they’re using drugs. And to be like, ‘I’m using!’ over the phone, that’s not too easy.” Another said, “If you call 911, the police are coming and if you’re using, you’re going to jail.” Conclusions Overdose response hotlines are acceptable and trustworthy fatal overdose prevention tools. However, several barriers may limit their utilization, including distrust, drug-induced paranoia, and the cost and potential consequences should an overdose occur, including arrest or cost of emergency response. Further study of utilization, acceptability, and policy and practical solutions addressing perceived barriers to utilizing these services are needed.
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spelling doaj-art-2911548c85714d55acb391bec303cdc82025-08-20T04:01:56ZengBMCHarm Reduction Journal1477-75172025-07-012211910.1186/s12954-025-01283-z“I think that that really could benefit a lonely user:” perceptions of overdose response hotlines among people who use opioidsRachel E. Gicquelais0Rachel P. Chenoweth1Nora Jacobson2Caitlin Conway3Gina M. Bryan4Departments of Population Health Sciences & Medicine, University of Wisconsin-Madison School of Medicine and Public HealthUniversity of Wisconsin-Madison School of NursingUniversity of Wisconsin-Madison School of NursingUniversity of Wisconsin-Madison School of NursingUniversity of Wisconsin-Madison School of NursingAbstract Background Overdose response hotlines, such as the SafeSpot and Never Use Alone phone hotlines and Brave smartphone application, are promising tools to reduce fatal overdose risk among people who use drugs (PWUD). These free and confidential services connect callers to a trained operator who monitors them for adverse reactions during and after drug use. We explored PWUD’s perceptions of overdose response hotlines. Methods PWUD receiving substance use treatment in a facility in a Midwestern US city were screened for eligibility using the NIDA-Modified ASSIST questionnaire and invited to enroll if they had a moderate or severe substance involvement score for use of street or prescription opioids. Ten participants completed a 30–45-minute in-depth interview focused on overdose prevention, including perceptions and use of overdose response hotlines, in February 2022. Inductive content analysis was used to describe perspectives on overdose response hotlines. Results Only 1 of the 10 participants had heard of overdose response hotlines, but most were optimistic about their potential benefits for PWUD. One participant said, “I believe that if word was out there, people would use it.” Another stated, “I would trust it today. I know that there is [sic] people trying to change what’s going on in our culture with opiates.” Participants described several potential barriers to utilization, including distrust, especially in the context of drug-induced paranoia and concerns about being arrested, and the cost of an emergency medical response if an overdose occurred. One participant stated, “people get paranoid when they’re using drugs. And to be like, ‘I’m using!’ over the phone, that’s not too easy.” Another said, “If you call 911, the police are coming and if you’re using, you’re going to jail.” Conclusions Overdose response hotlines are acceptable and trustworthy fatal overdose prevention tools. However, several barriers may limit their utilization, including distrust, drug-induced paranoia, and the cost and potential consequences should an overdose occur, including arrest or cost of emergency response. Further study of utilization, acceptability, and policy and practical solutions addressing perceived barriers to utilizing these services are needed.https://doi.org/10.1186/s12954-025-01283-zOverdosePeople who use drugsOverdose response hotlinesE-harm reduction
spellingShingle Rachel E. Gicquelais
Rachel P. Chenoweth
Nora Jacobson
Caitlin Conway
Gina M. Bryan
“I think that that really could benefit a lonely user:” perceptions of overdose response hotlines among people who use opioids
Harm Reduction Journal
Overdose
People who use drugs
Overdose response hotlines
E-harm reduction
title “I think that that really could benefit a lonely user:” perceptions of overdose response hotlines among people who use opioids
title_full “I think that that really could benefit a lonely user:” perceptions of overdose response hotlines among people who use opioids
title_fullStr “I think that that really could benefit a lonely user:” perceptions of overdose response hotlines among people who use opioids
title_full_unstemmed “I think that that really could benefit a lonely user:” perceptions of overdose response hotlines among people who use opioids
title_short “I think that that really could benefit a lonely user:” perceptions of overdose response hotlines among people who use opioids
title_sort i think that that really could benefit a lonely user perceptions of overdose response hotlines among people who use opioids
topic Overdose
People who use drugs
Overdose response hotlines
E-harm reduction
url https://doi.org/10.1186/s12954-025-01283-z
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