The National Overdose Response System is a free virtual overdose monitoring service phone line connecting people anonymously to personalized emergency response plans or supervised substance use.
Virtual overdose monitoring services may help reduce deaths from opioids and other substances by providing timely, anonymous access to emergency care, according to a new review published in the Canadian Medical Association Journal.
Using phones and smartphone apps and operating 24 hours a day, virtual overdose monitoring services connect people anonymously with those who can develop personalized emergency response plans or supervise substance use.
One such service is the National Overdose Response System (NORS). According to the review, between Dec. 15, 2020, and Feb. 28, 2022, NORS monitored 2,172 substance use events and 53 adverse events required emergency response while no fatalities were reported.
Staff contacted all clients who required emergency response after their events to verify outcomes.
The majority of calls, 60 per cent, originated in Ontario, while 6.6 per cent of calls came from Alberta and just over 94 per cent of calls were from urban areas.
Of the 2,273 types of drugs reported used, 75.7 per cent were opioids, followed by cocaine at 8.9 per cent, methamphetamine at 7.4 per cent and unknown or unreported at 7.2 per cent.
In an interview, NORS operations director Lisa Morris-Miller said calls typically last 15-20 minutes and mental health support is provided to callers.
“Our human family is struggling and it’s not up to us to judge someone’s relationship with their substances,” she said.
“We take every call with compassion and curiosity and there’s no judgment. We just want to keep people safe while they’re using. And there’s a lot that needs to change and a lot that should change to keep people safe. But this is a small step.”
Morris-Miller said there are key barriers for people accessing the service, like stigma around substance use.
“One of the beautiful things to watch happen at NORS is that once there’s a space that’s created for people where that shame is alleviated, they do better,” she said.
“We’ve had callers that were calling in using four or five, six times a day hard, hard substances like fentanyl, and just creating that peer relationship because the line is run by peers, they’ve started their own recovery journeys.”
She said it’s not just people who may be living on the street who access the service, but construction workers, bankers and even pro athletes.
The review was done in part by Dr. Monty Ghosh, a co-founder and adviser for NORS and an internist and addiction specialist at the University of Alberta, and Tyler Marshall, a post-doctoral associate at the University of Calgary.
In a news release about the review, Ghosh said virtual overdose monitoring services are capable of providing timely and accessible reduction and overdose prevention services.
“Evidence, including pilot data from the National Overdose Response Service, suggests that virtual overdose monitoring services have promise as an adjunct to supervised consumption services in the continuum of care for people who use substances,” he said.
The authors of the review are calling for more high-quality research to better understand the potential benefits and risks of virtual overdose monitoring services.
NORS has been funded by Health Canada’s Substance Use and Addiction Program, but Morris-Miller would also like to see more permanent funding.
“In order to get that there needs to be a very blatant study done on the necessity of the service,” she said.
If you or someone you know is using substances, do not use alone. If you are using alone, you can contact the National Overdose Response Service at 1-888-688-NORS for support, or download the BRAVE or DORS app.