ORION Identifies Opioid Abusers But Fails to Improve Their Outlook

Still, the European e-health tool shows clinical promise, researchers say.

Image has been edited. Courtesy of Sam Metsfan, Wikimedia Commons.

A European digital health tool helped people who are caught in the opioid crisis by identifying those most at risk for an overdose, but the technology did little to make them believe they could overcome opioid addiction, according to a new study.

The investigation focused on ORION, which is short for Overdose Risk Information, an e-health program designed to help healthcare providers pinpoint people at risk of a drug overdose. The software also strives to teach patients about their risk factors and how lifestyle changes can cut them down.

Here, researchers from various European universities examined ORION’s effects in more than 170 opioid-dependent people who were receiving inpatient or outpatient treatment in 4 countries: the United Kingdom, Germany, Italy, and Denmark. Participants answered questions about their drug use and other personal information and then received information on overdose risk.

“Despite the lack of improvement in overall self-efficacy, the e-health tool, available for free download, did show a positive impact in a clinical setting in 4 different cultures,” said Brenda K. Wiederhold, PhD, MBA, editor in chief of Cyberpscyhology, Behavior and Social networking, the journal that published the study.

The good news, researchers noted, was that ORION identified the people who needed to change their ways the most if they were to dodge an opioid overdose. An individual’s number of risk factors proved to be an “important predictor of poor self-efficacy both before and after ORION administration,” they wrote. So, by gauging what an addict is doing, the tool showed promise in understanding that person’s own perceived power to get clean or practice harm reduction, thus measuring just how susceptible that user was to an overdose.

The application also provided useful information, taught people about drug overdoses, and instilled some sense to change their alcohol and drug intake behavior, as reported by patients who participated in the trial, according to the study.

But that did not translate to a sense of control or behaviors and thoughts that typically regulate whether people change their health regimens, the researchers wrote.

“A one-shot e-health tool cannot influence complex domains such as self-efficacy, involving a broad and stable sense of personal competence to deal effectively with a variety of stressful situations,” the team, led by Giuseppe Carrà, MD, PhD, a psychiatry professor at the University College of London, wrote.

From here, researchers hope to see the continuous monitoring of lifestyle risk factors as means to initiate behavior change through ORION, an effort that would require training for professionals using the digital health tool. The opportunity for greater success is there because people who are addicted to opioids often “bargain with themselves” to decide upon an appropriate level of risk.

“The advantage of the ORION tool may be, with repeated use with a patient, that this balance is recalibrated to achieve an acceptable risk level, focusing feasible treatment programs toward modifiable characteristics,” Carrà and her colleagues wrote.

ORION is just 1 example of how researchers, healthcare professionals, and hopeful entrepreneurs are trying to use technology to chip away at a scourge of opioid dependency that has hammered the United States and beyond. Yesterday, for instance, Healthcare Analytics News™ covered a private telehealth effort marketed to rehabilitation clinics looking to continue care after patients leave treatment, when the risk of relapse is high.

ORION, in particular, has been the subject of a good deal of research. A study published last fall suggested that the technology can prod drug users to “engage in exploring changes to their overdose risk when presented on a computer screen appears to increase willingness to change risky behavior.”

European leaders funded the program with the hope of curbing climbing overdose rates on that continent and elsewhere. The US has labeled the opioid epidemic a public health crisis and is seeing tens and thousands of overdose deaths each year.

The latest study, “Engagement in the Overdose RIsk InfOrmatioN (ORION) e-Health Tool for Opioid Overdose Prevention and Self-Efficacy: A Preliminary Study,” is available for free until mid-February.