Understanding Naloxone Uptake from an Emergency Department Distribution Program Using a Low-Energy Bluetooth Real-time Location System

UMMS Affiliation

Department of Emergency Medicine, Division of Medical Toxicology

Publication Date


Document Type



Emergency Medicine | Medical Toxicology | Substance Abuse and Addiction | Telemedicine | Translational Medical Research


INTRODUCTION: Emergency department (ED)-based naloxone distribution programs are a widespread harm reduction strategy. However, data describing the community penetrance of naloxone distributed from these programs are lacking. This study gauges acceptance of naloxone use and monitoring technology among people who use drugs (PWUD), and explores the use of real-time location systems (RTLS) in monitoring naloxone movements.

METHODS: A prospective observational study was conducted on a convenience sample of individuals (N = 30) presenting to a tertiary-care academic medical center ED for an opioid-related complaint. A naloxone kit equipped with a low-energy Bluetooth (BLE) tracking system was employed to detect movement of naloxone off the hospital campus as a proxy for community penetrance, followed by a qualitative interview to gauge participant acceptance of naloxone use and monitoring technology.

RESULTS: Detection of BLE signals verified transit of 24 distributed naloxone kits off our hospital campus. Three participants whose BLE signals were not captured reported taking their kits with them following discharge, suggesting technological errors occurred; another three participants were lost to follow-up. Qualitative interviews demonstrated that participants accepted ED-based naloxone distribution programs and passive tracking technologies, but revealed concerns regarding hypothetical continuous monitoring systems and problematic interactions with first responders and law enforcement personnel.

CONCLUSIONS: Based on acquired BLE signals, 80% of dispensed naloxone kits left the hospital campus. Use of RTLS to passively geolocate naloxone rescue kits is feasible, but detection can be adversely affected by technological errors. PWUD are amenable to transient monitoring technologies but identified barriers to implementation.


UMCCTS funding, Digital health, Harm reduction, Naloxone, Opioids, Technology

DOI of Published Version



Lai JT, Chapman BP, Carreiro SP, Babu KM, Boyer EW, Chai PR. Understanding Naloxone Uptake from an Emergency Department Distribution Program Using a Low-Energy Bluetooth Real-time Location System. J Med Toxicol. 2020 Apr 6. doi: 10.1007/s13181-020-00774-8. Epub ahead of print. PMID: 32253630. Link to article on publisher's site

Journal/Book/Conference Title

Journal of medical toxicology : official journal of the American College of Medical Toxicology

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Link to Article in PubMed

PubMed ID