Since launching in April 2021, the Digital Overdose Response Service (DORS) has been used dozens of times to prevent drug-poisoning deaths in Alberta.
The app allows people who are using drugs alone to be monitored and have EMS respond to their location if they become unconscious and need medical help.
“It’s very important to have something like this,” said Monty Ghosh, the addictions physician who helped create the app.
“We know that over 70 per cent of the population who is dying from drug-poisoning events are dying using alone by themselves.
“There needs to be a way to circumvent this.
“We know not everyone is accessing a supervised consumption site, which is a gold standard for dealing with overdose situations, drug-poisoning situations, and so having alternatives available to people is key.”
The idea for the app came from one of Ghosh’s patients. He lived in Grande Prairie and would often use alone, but when he did, he Facetimed with a friend in Edmonton who had his address and would call EMS if he needed help.
“They’d formulated a strategy to prevent themselves from having a bad outcome from a drug-poisoning event,” he said.
“Utilizing that idea, we tried to scale that provincially through a grant through Alberta Innovates and eventually through Health Canada and the Government of Alberta.”
When someone uses the app, they input their address and an emergency contact. When they activate the app, a countdown starts.
“You can refresh the countdown, and if you’re not refreshing when you’re using the countdown, an alarm sounds. First, the alarm gets louder and louder, trying to wake you up and rouse you so that you’re able to respond to it. But if you’re still not responsive, (it) patches through an operator with STARS and they’ll check in on you, and they’ll say: ‘Hey, are you OK? Are there any issues or concerns?’ And if you’re still not responsive, they’ll dispatch EMS services to your location.”
So far, DORS has seen more than 1,400 registered users and 200 people have initiated one session of the app. There have been 86 situations that escalated to STARS and 18 situations that resulted in EMS dispatch for resuscitation services.
“That’s pretty amazing,” Ghosh said.
“That’s great news that people are using the app and it’s great that it’s reaching a population that’s often difficult to reach.”
“The vast majority of individuals using the service are individuals who are gender minorities, such as females and gender-diverse individuals, which is very different than people who use physical supervised consumption sites.
“We also noted that about 46 per cent of the individuals using the service don’t necessarily have access to physical supervised consumption sites,” Ghosh said.
The DORS app cannot guarantee that an overdose will not occur, but it does provide ongoing monitoring to ensure medical response reaches an individual as quickly as possible if they become unresponsive.
Supervised consumption sites are still the best way to prevent overdose deaths, Ghosh said.
“People should not be using alone … Anything is better than nothing. Ideally, again, a physical SCS is the gold standard because you can get resuscitated right away from there in these facilities.”
Ghosh credits the Alberta government for all its work in turning this idea into a reality. He also benefited from the leg work of other groups working on similar projects: Grenfell Ministries in Ontario and the BRAVE app in Vancouver. He also credits his late friend Rebecca Morris Miller, who died from an overdose.
“Having as many different services available to this population is key and very supportive and helpful,” he said.
The DORS app also provides information on national and provincial addiction recovery supports and services.
Ghosh is now working on a national hotline — the National Overdose Response Service (NORS) — with Health Canada.
People using alone can call 1-888-688-6677 and be connected with a person with lived experience.
If the caller needs medical help, a response is activated.
“That can be either a community response, where they’ll contact someone nearby, a loved one, to come by to resuscitate them, or they’ll contact EMS services.
“The (NORS) project has been very successful so far. It’s very much direct person-to-person interaction, which is a bit different than DORS, which involves a bit more anonymity,” Ghosh said.
“With the national overdose response service, we’ve had 77 emergency callouts throughout the country — not a single death so far. So the signs are definitely positive. This is working.”
The DORS app is available through Apple Store and Google Play.
Digital Overdose Response Service, Alberta app.
DORS
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