VR is just as effective for naloxone training as in-person instruction, study says

The results of this study offer public health workers a scalable, low-cost and effective way to educate the community on how to treat someone experiencing an opioid overdose.
By Mallory Hackett
01:09 pm

Photo credit: Penn Nursing

Virtual reality opioid overdose prevention programs can be just as effective as in-person training to give people the knowledge and confidence to administer naloxone, according to a study conducted by the University of Pennsylvania and the Philadelphia Department of Public Health.

Naloxone, also called Narcan or Evzio, is a prescription medication created to rapidly reverse opioid overdoses. All 50 states have passed a naloxone access law and 46 states allow prescriptions to be given out to third parties, according to the Prescription Drug Abuse Policy System.

Since members of the community can carry and administer naloxone to a person experiencing an opioid overdose, public health organizations have been conducting training programs, but researchers wanted a way to reach even more people.

"Overdoses aren't happening in hospitals and doctor's offices," said Nicholas Giordano, former Lecturer at Penn's School of Nursing and a researcher for 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."


Participants of the intervention were given either a nine-minute immersive video developed by the researchers or an in-person one-on-one training that ranged in length from five to 20 minutes.

Across both groups, knowledge and attitude scores increased following the intervention, which researchers discovered using pre- and post-tests.

“Although the immersive video [opioid overdose prevention program] does not provide the opportunity for trainees to ask questions of their trainers, or for trainers to tailor the OOPP to the trainee, participants still gained similar levels of knowledge as their peers in the standard OOPP while feeling equally capable of applying knowledge gained,” the authors wrote in the study.

The results of this study offer public health workers a scalable, low-cost and effective way to educate the community on how to treat someone experiencing an opioid overdose, according to the authors.


To develop their VR opioid overdose prevention program, the researchers adapted a 60-minute in-person training into a nine-minute immersive video.

The team tested the video at free naloxone giveaways and training sessions hosted by the Philadelphia Department of Public Health at nine local libraries. About a third of the 94 participants received the in-person instruction, while the others watched the VR training video.

After the initial training, participants answered questions about their experience to determine if they learned enough to safely administer naloxone. Before the intervention was over, participants were given the option to receive the other training to ensure everyone had access to all of the information.


Opioid overdoses have become an epidemic in the U.S., according to the Centers for Disease Control and Prevention. Between 1999 and 2018, almost 450,000 people died from overdoses involving opioids.

Increasing access to and understanding of how to administer naloxone is just one way to address increasing overdose rates.

The CDC is also working on improving the way opioids are prescribed to ensure patients have access to safe pain treatments while reducing the number of people who misuse them. The agency is also working to treat opioid use disorder by expanding access to medication-assisted therapy.

Outside of regulatory agencies, many digital health companies are creating tools to help prevent opioid overdoses.

Masimo released its Bridge device which is a wearable, single-patient-use, percutaneous neurostimulator that is placed behind the ear. It applies electrical impulses to the cranial nerves around the ear, which can reduce neuron activity and reduce opioid withdrawal symptoms.

The new digital substance-abuse-recovery platform called Ophelia launched earlier this year with a seed funding round of $2.7 million. The subscription-based platform gives people a way to fill their withdrawal prescriptions as well as giving them online support from caregivers.

Quit Genius, a digital addiction-recovery program, extended its platform to support alcohol and opioid addictions this year as well. The program includes one-on-one counseling with a board-certified counselor, physician-led pharmaceutical therapy and drug testing.


"We were really pleased to discover that our VR training works just as well as an in-person training," said Natalie Herbert, one of the authors 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."



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