Harm reduction is the goal of this drug use hotline. Experts say it works
Kyle Smith spends a lot of his free time on the phone. But he's not chatting with his friends about sports or life.
He’s talking to people who are using drugs.
Smith is a volunteer with the Never Use Alone national hotline, a harm reduction service established about four years ago that provides substance users with a phone companion who monitors them while they’re using.
“I find it more fulfilling than I guess anything I've ever put a lot of time into,” Smith said.
According to the Centers for Disease Control and Prevention, there were nearly 108,000 drug overdose deaths in the United State in 2021, an increase of about 15% from 2020. Nearly two-thirds of fatal overdoses occur when the user is alone, the CDC said.
As someone who has struggled with drug use himself, Smith said his real-life experience comes in handy when he’s talking to a caller.
“I've seen overdoses happen in real life. So, even over the phone, I can tell,” he said.
If a hotline volunteer suspects an overdose is happening, they call emergency medical services to respond.
Since he started in February, Smith has taken at least 200 calls, some short and some as long as two hours.
Twice, he’s been on the line when the caller overdosed. He said in one case, a family member later reached out and thanked him for saving her sister's life.
“That really touched me,” he said.
Jessica Blanchard, the hotline’s educational director, is a longtime registered nurse who works in an emergency room in Georgia. She hires and trains the volunteers.
She said the phone calls are quite routine. Callers follow the prompts and then a volunteer answers.
Sometimes, it’s her taking the call.
“I answer the phone: ‘Never Use Alone,’ it's Jessie,” she said.
Then there’s a checklist she runs down with the caller, which includes making sure their doors are unlocked. She also ensures that Narcan, an opioid overdose reversal drug, is available and that she’s on speakerphone.
“I would already know he's snorting fentanyl because he's already told me,” Blanchard said, “and I'll say, ‘All right, let me know when you take your first hit.’”
Blanchard said the hotline can get up to 50 calls a day. She said sometimes volunteers will video chat with a caller to get visual cues, but detecting an overdose over the phone is not a perfect science.
“I bring out my ‘mama hillbilly in the yard yelling at the dog’ voice. I say, ‘All right, now you got about one more time of me calling your name, and if you don't answer I am going to call emergency services,’” Blanchard said.
If the caller doesn’t respond at that moment, EMS gets called.
Blanchard said Never Use Alone doesn’t push people toward rehabilitation or have any other recovery agenda other than to save lives. These factors make the hotline a good tool, according to local recovery advocate Amy D’Amico.
“They're just taking the world as it is, and taking people as they are and providing something for them that might keep them alive,” said D’Amico, who once struggled with substance abuse herself.
D’Amico, who is now a lawyer, said she knows a few people who have used the hotline. She said one thing that concerns them is the possibility of police responding to calls instead of emergency medical professionals.
“It can be scary if you're squatting in an abandoned building, because you're already doing criminal trespass,” she said. “You don't want people to know where you're staying.”
She said if Never Use Alone can guarantee that EMS workers respond, the hotline is a promising tool.
“Anything that can help along the way, and remind them of community and compassion, and their own humanity, is going to help,” D’Amico said.
The national Never Use Alone hotline number is (800) 484-3731.