JMIR Publications

ABSTRACT

Background:

Globally, drug-related deaths (DRDs) are increasing, posing a significant challenge. Scotland has the highest DRD rate in Europe and one of the highest globally. The Scottish Government launched the Digital Lifelines Scotland (DLS) program to increase the provision of digital technology in harm reduction services and other support services. Digital technology responses to DRDs can include education through digital platforms, improved access to treatment and support via telehealth and mobile apps, analysis of data to identify risk factors, and the use of digital tools for naloxone distribution. However, digital technology should be integrated into a comprehensive approach that increases access to services and addresses underlying causes. Digital transformation could enhance harm reduction service and support, but challenges must be addressed for successful implementation. The DLS program aims to enhance digital inclusion and improve health outcomes for people who use or are affected by drug use, to reduce the risk of DRDs.

Objective:

This study aims to explore the role of digital technology as an enabler and supporter in enhancing existing services and innovating new solutions, rather than being a standalone solution. Specifically focusing on individuals who use drugs, the research investigates the potential of digital inclusion and technology provision for preventing DRDs within the context of the DLS program.

Methods:

Semi-structured interviews were conducted with 47 people: 21 service users, 14 service providers and 12 program staff who were all involved in DLS. Interviews were audio recorded, transcribed and then coded. Analysis was done in three phases; I) thematic analysis of interview data to identify the benefits of digital technologies in this sector; II) identification of the challenges and enablers of utilizing digital technologies using the Technology, People, Organizations and Macroenvironment (TPOM) conceptual framework; and III) mapping digital technology provision to services offered in order to understand the extent of digital transformation of the field.

Results:

Participants identified increased connectivity, enhanced access to services, and improved wellbeing as key benefits. Digital devices facilitated social connections, alleviated loneliness, and fostered a sense of community. Devices enabled engagement with services and support workers, providing better access to resources. Additionally, digital technology was perceived as a preventive measure to reduce harmful drug use. Lack of technical knowledge, organizational constraints, usability challenges, including device preferences and security issues, were identified.

Conclusions:

The study found digital inclusion through provision of devices and connection has potential to enhance support in the harm reduction sector. However, it highlighted the limitations of existing digital inclusion programs in achieving comprehensive digital transformation. To progress there is a need for sustained engagement, cultural change, and economic considerations to overcome barriers.