Recent data shows that opioid overdose deaths have dropped nationwide, and researchers said the spread of opioid overdose reversal medications may be contributing to the decline.
But studies suggest some communities still struggle with access and distribution of naloxone — also known by its brand name nasal spray Narcan.
“Rural communities are very challenged,” said Scott Barrows, who directs the OSF HealthCare Innovation Design Lab student in Peoria, Ill.
Barrows said it takes significantly longer for an ambulance to respond in rural areas and there may not be Narcan dispensers. “If someone overdoses, it might take 40 minutes for an ambulance to get there.
“So, it’s really critical to educate,” he said.
Both virtual and in-person training modules have been in use to raise awareness and teach people how to administer Narcan. A recent study showed that between 2020 and 2022, the number of overdosing people who got Narcan from a layperson before Emergency Medical Services arrived increased by more than 40%.
Now, a team of Illinois researchers are testing whether a virtual reality app that trains people on how to use Narcan may further spread awareness and get people more comfortable and confident to act in a crisis.
Wasantha Jayawardene, an assistant professor of public health in the School of Human Sciences at Southern Illinois University Carbondale, conceived the idea for a Narcan training VR tool. When he worked at Indiana University, Jayawardene and his team conducted clinical trials from 2020 to 2021 on a web-based application that uses a self-paced demonstration to train people on how to use Narcan. He said the study showed the tool could improve training access, but his team struggled to learn whether participants applied the training in real life.
Other research also shows people are not always confident or willing to respond to an overdose.
“People gain knowledge and skills, but still, they are reluctant to go and intervene when they see someone who needs help,” he said.
With the immersive nature of virtual reality, Jayawardene said he hopes there could be a higher chance of bystander intervention.
Jaywardene has been working with a team of researchers at Illinois State University — funded through an Illinois Innovation Network grant — to develop an app that would provide Narcan training on an Apple Vision Pro headset. OSF HealthCare has also been lending support through funding from the Connected Communities Initiative with ISU. The training app is still in development and is not yet publicly available.
The VR training starts with the person strapping on a VR headset. Then, the game sets the scene: A trainer walks the person through the fact that, on the floor in front of them, a person is having an opioid overdose. From there, the trainer will command and educate about how to recognize signs of an overdose, how to correctly administer Narcan and how to make sure the person is safe after that.
“You're looking at their fingernails and discoloring and their eyes,” said Roy Magnuson, the director of emerging technologies for instruction and research at ISU’s Office of Technology Solutions. “You're having to do mouth-to-mouth. So you literally have to, like, lean over and you're performing these things.”
Magnuson said he has taken the training on several occasions since it became usable.
“You see all these things that give you this, like, real sense of embodiment and being in that experience: the audio kind of kicking in and hearing these things behind you, and you get the sense that there's actually, you know, police outside the room,” he said.
When he completed the 10-minute training the first time, Magnuson said he felt emotional.
“You've gone through this whole arc,” he said. “You're like, ‘Man, thank god this person's stable.’”
Matt Kase, the lead developer on the app, said his goal wasn’t to make the training “tear-jerking,” though that's not bad. He says the training is rooted in best practices and proven methods from organizations such as the Substance Abuse and Mental Health Services Administration.
“There's a whole field of games that aren't Mario and collecting coins. They're serious games, which are used for educational purposes,” he said.
Magnuson said this project is also about more than just adding to the arsenal of already available tools for opioid overdose education. It’s about making a product that can last, and potentially cater to unseen markets.
“Because we're throwing a dart at, you know, two, three, four, five years down the line, do these things work? Does eye tracking work? Does all this fidelity work?” he said.
With a $3,500 price tag per VR headset, though, Barrows with OSF said he can foresee some challenges hitting the rural market that the group intends to reach. But figuring out if the hypothesis about mixed reality’s effectiveness in promoting bystander intervention is the first hurdle to tackle.
“It's not an answer for everything, but I think it's a valuable piece of how we're going to take on this crisis,” Barrows said.
Melissa Ellin is a reporter at WGLT and a Report for America corps member, focused on mental health coverage. You can reach her at maelli5@ilstu.edu.
Side Effects Public Media is a health reporting collaboration based at WFYI in Indianapolis. We partner with NPR stations across the Midwest and surrounding areas — including KBIA and KCUR in Missouri, Iowa Public Radio, Ideastream in Ohio and WFPL in Kentucky.
