This is the tale of how U-Turn developed our Opiate Overdose Response app for smartphones.

It is also the story of 2 ordinary working people from Belfast who have followed a dream to do something that had not been done before to prevent fatal overdoses.

We started thinking about providing a free app in April 2011 after noticing that there were very few apps available to respond to opiate overdose emergencies in non-clinical settings. Those that did exist were fairly basic and not interactive, that is, they were unable to give specific advice to the user depending on the situation they came across. We knew that a growing number of people who use opiates had Android smartphones, as well as those around them who may have been concerned with their welfare.

First we sketched a complex algorithm of opiate overdose, taking account of the numerous variables the app user might encounter. For algorithm think of a flow chart with feedback loops, just more complex as many circumstances are variable in overdoses! Within it there had to be separate pathways depending on whether the casualty is breathing normally or not, whether the user is able to call an ambulance or not, or whether naloxone is available or not. We combined our knowledge of overdoses and were helped by Adam Hanna, a specialist in resuscitation, to ensure it was technically sound i.e. followed resuscitation guidelines where necessary. This became the framework from which the ‘It’s an Emergency’ section sprang from.

At the same time we started talking to Tim Wilson who took on the role of managing the build of the app with a team of developers he put together. Initially we had wanted to use voice recognition technology within the Emergency section of the app; through Tim it became clear that this would be unwise since it is still prone to glitches and failure despite recent technology advances. It was not therefore appropriate to go with voice recognition. We settled for this section of the app becoming an audio guide complemented by clear, succinct text and ‘aircraft card’ style drawings with large press button options to navigate through the appropriate pathway. Tim’s knowledge of the technological possibilities and ours of overdose became synergistic and we learned quite a bit about each other’s ‘field’.

We also consulted Rory Campbell, a specialist solicitor in the field of new technology innovations. Because we were intending to provide advice in life-threatening situations we ourselves needed advice on how to limit our legal liability should something ‘go wrong’. As part of this we redoubled our efforts to ensure the advice we were giving was supported by the best-available evidence base and that the component parts of the app were reliable. Rory provided us with somewhat lengthy (but probably necessary) Terms & Conditions including a disclaimer. This was especially important for us as several insurance companies we talked to, ran a mile from us when we asked about product liability insurance!

For us the insurance aspect was a turning point in some ways; we had to decide then whether to take a risk without insurance. Pat O’Hare proved to be extremely helpful at this point, and not for the last time either. He helped us focus on our dream of providing a high quality app and we again remembered what advances in harm reduction have always been about; taking risks to reduce risks.

In the early autumn the build of the app commenced and we busied ourselves reviewing the ‘aircraft card’ draft drawings and various voiceover takes until we were satisfied with them. The audible voice is that of an American female with experience in radio. Her voice fitted perfectly; clear but soft and caring but also directive. We needed several takes of the voiceover as in the first one the rate of speech was too slow and could have meant that the user of the guide would not respond to the overdose casualty quickly enough. Then in the second take it was too quick and we were concerned that users might miss crucial parts of the advice given.

Thought went into other sections of the app also. We both felt that a training section called ‘Your Guide’ would be essential preparation for anyone who might subsequently come across someone in an overdosed state. Perhaps it is our experience as trainers which made this so plain to us. Other sections to be included were ‘Contact Us’ and ‘Useful Information’ containing website addresses we respect as well as our own.

We also began the interesting journey into an unfamiliar world for us of marketing and seeking sponsorship. We had by then spent a fair sum, most of which was borrowed from family and friends, and needed to ensure that we could continue to operate as a business by attracting sponsors. From day one we had decided that we would give the app away for free as soon as we possibly can, once we have recouped our costs and made a small amount on top to pay for future updates and a little recompense for the time we have put in. We recognise that people who use drugs may not be able to afford the £1.99 initial market entry price. At the time of writing we are still seeking sponsorship as we still have only 1 sponsor; Martindale Pharma gave us a modest educational grant to help us keep things moving for which we are very grateful.

We have had many delightful and encouraging conversations with our friends in the harm reduction community along the way; too many to list here, you know who you are already. Without such a supportive community around us we doubt we would have got this far.

Today we have the final version after a series of early ones that needed tweaks and bugs fixed.

We are very pleased. We are very proud. We will be even happier and more proud if it helps anyone to save someone’s life. Over to you……..