Smartphone-Based Ecological Momentary Assessment to Monitor Opioid Use and Overdose Among People Who Use Opioids:
Kamal Gautam1, Kiran Paudel1, Jeffrey A Wickersham2
1Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT, 06269-1101, United States, 1 860-486-2834.
JMIR Human Factors
|June 29, 2026
Summary
Smartphone-based Ecological Momentary Assessment (EMA) is feasible and acceptable for monitoring opioid use and overdose risk in people who use opioids. This digital health tool can improve harm reduction strategies and inform interventions.
Area of Science:
- Digital Health
- Public Health
- Substance Use Research
Background:
- Opioids cause significant annual overdose deaths in the US, highlighting the need for dynamic risk assessment.
- Current assessment methods are often retrospective and fail to capture real-time behavioral changes influencing overdose risk.
- Ecological Momentary Assessment (EMA) offers a solution for repeated, near real-time reporting of behaviors and experiences in natural settings.
Purpose of the Study:
- To evaluate the feasibility and acceptability of smartphone-based EMA for monitoring opioid use, overdose events, and naloxone access.
- To assess the potential of EMA in understanding dynamic risk factors among individuals using opioids.
Main Methods:
- Recruited participants from a syringe services program for a 30-day smartphone-based EMA study.
- Administered twice-daily EMA prompts assessing opioid craving, drug use intentions, opioid use, overdose experiences, and naloxone access.
- Assessed feasibility via recruitment, retention, and completion rates; evaluated acceptability through surveys and qualitative interviews.
Main Results:
- High feasibility demonstrated by 90% participant completion and 85% average compliance with EMA prompts.
- Participants reported significant instances of opioid craving, intent to use illicit drugs, and opioid use.
- Two overdose events were reported, with participants carrying naloxone during both incidents.
- High acceptability reported, with participants finding EMA easy to use, private, and minimally burdensome, though some noted emotional discomfort.
Conclusions:
- Smartphone-based EMA is a feasible and acceptable method for monitoring opioid use, overdose experiences, and naloxone access in people who use opioids.
- EMA can enhance the monitoring of high-risk behaviors and inform the development of digital health interventions for harm reduction.
- This approach holds promise for reducing overdose risk and improving outcomes for individuals with opioid use disorder.
Related Concept Videos
01:20Opioid Analgesics: Morphine and Other Natural Cogeners
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
01:23Holter Monitor: 24-Hour Monitoring
Holter monitoring is a continuous electrocardiography (ECG) recording that tracks the heart's electrical activity over an extended period, generally 24 to 48 hours. This noninvasive diagnostic tool detects irregular heart rhythms that may not be captured during a standard ECG performed in a clinical setting.DeviceThe Holter monitor is a portable, small device connected to several electrodes on the patient's chest. These electrodes detect the heart's electrical signals and transmit them to the...