Pennsylvania researchers seek overdose response training for civilians through virtual reality


When it comes to drug overdoses, quick action could be the difference between life and death, and now, researchers from the University of Pennsylvania School of Nursing have created a means to train everyone to be prepared to dispense lifesaving naloxone: a virtual reality video.

In many parts of the United States, people can already acquire naloxone, an opioid overdose reversal medication, without a prescription. But there is a difference between having the tool and knowing how to use it. Prior to the outbreak of COVID-19, many public health organizations offered in-person training sessions to teach the public how to determine if a person might be experiencing an overdose and how to administer naloxone. Naloxone is available through Narcan nasal spray, which is approved by the U.S. Food and Drug Administration.

Health officials have tried to find means of addressing the fact that over the last 20 years, the United States has experienced a 200 percent increase in its opioid overdose death rate.

“Overdoses aren’t happening in hospitals and doctor’s offices,” said Nicholas Giordano, a former lecturer at Penn’s School of Nursing during the study. “They’re happening in our communities: in parks, libraries, and even in our own homes. It’s crucial that we get the ability to save lives into the hands of the people on the front lines in close proximity to individuals at risk of overdose.”

Researchers from the University of Pennsylvania and the Philadelphia Department of Public Health worked together to adapt a 60-minute, in-person training course into a nine-minute virtual reality video. Describing the training as stepwise and systematic, Giordano noted that both the initial training and the video were developed in partnership with nurse educators, clinical experts, harm reduction activists, and people previously revived by naloxone.

“Several libraries in Philadelphia have VR headsets available on-site and were loaning the equipment out prior to the pandemic,” Giordano told Health Crisis Alert. “This includes many of the libraries we partnered with to disseminate and test the training as mentioned in the study. Our team is exploring hygienic options for disseminating VR headsets to individuals interested in participating in the training.”

However, the video requires no high-end technology to run, just a smartphone and headset with special lenses to watch in its proper form, or through YouTube for the basic experience, meaning it is freely available online.

It was tested at nine libraries in Philadelphia during naloxone giveaway days in 2019 and early 2020, before the pandemic. Of 94 people who received instruction at these events – about two-thirds received the virtual reality training, versus the traditional instruction – those who participated in the virtual version improved their knowledge compared to those who took the in-person training.

“We were really pleased to discover that our VR training works just as well as an in-person training,” said Natalie Herbert, a 2020 graduate of Penn’s Annenberg School for Communication and lead author of the study. “We weren’t looking to replace the trainings public health organizations are already offering; rather, we were hoping to offer an alternative for folks who can’t get to an in-person training, but still want the knowledge. And we’re excited to be able to do that.”

A grant from Independence Blue Cross enabled the researchers to provide the training for free. Still, they hope to partner with libraries, public health organizations, and others in the future to see more people trained.