Perspectives of people who use drugs on implementing overdose response technologies in acute care settings: a qualitative study

People who use drugs (PWUD) face many barriers in healthcare settings. Illicit substance use during hospital stays, including solitary use in bathrooms, is prevalent, leading to a higher risk of overdoses. In this study, we examine the views of PWUD on implementing novel strategies such as overdose response technologies (ORTs) into acute care and explore the perceived acceptability, impacts, and barriers of these interventions. We used convenience sampling to recruit 10 participants from hospitals and addiction medicine clinics, and semi-structured interviews were conducted. The interviews included an explanation of the five main types of ORTs relevant to acute care settings (hotlines, applications, overdose buttons, reverse motion detectors, and wearables), followed by questions where the participant had to critically evaluate whether each ORTs would be effective for each scenario. Open-ended coding and thematic analysis were used, and themes were derived from the data as it was reviewed. Participants acknowledged the advantages and potential risks of integrating ORTs into acute care. It was recognized that ORTs could help improve the relationships between PWUD and healthcare providers, reduce mortality rates in hospital bathrooms, and provide peer support during hospital stays. PWUD highlighted privacy concerns, logistical barriers, and stated that ORTs can also negatively impact their relationships with healthcare providers due to stigma. Although many participants felt that incorporating ORTs would be an advantage to their care within hospitals, our study also highlighted implementation barriers and broader policy changes that need to be addressed. Working towards addressing such barriers and changes can allow ORTs to be the next tool to help mitigate barriers faced by PWUD.