ArticleJournal of substance use and addiction treatment2025
"It's something we're connected to": Acceptability and adoption of overdose detection technologies implemented in San Francisco permanent supportive housing.
Article in Journal of substance use and addiction treatment, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
4 citing papers in PubMed.
- The permanent supportive housing overdose prevention project.Drug and alcohol dependence · 2026Article
- Mechanisms of overdose from unintentional fentanyl use when intending to use stimulants: a qualitative study of people who use stimulants and avoid opioids.Research square · 2026Article
- Assessing attitudes towards elements of the overdose response hotlines/applications (ORHAs).Harm reduction journal · 2026Article
- Understanding overdose risk and response in permanent supportive housing: results of focus groups with tenants, staff, and leaders.Addiction science & clinical practice · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
introductionThe transition from homelessness to permanent supportive housing (PSH) is associated with solitary drug use, which heightens the risk for fatal overdose. Overdose detection technologies show promise in reducing fatal overdose in supportive housing environments. We conducted a longitudinal, mixed-methods study in a 50-unit single-room occupancy PSH building in San Francisco, California-tracing the implementation of wall-mounted, push-activated technologies (Brave Buttons) that alert designated responders to potential onsite emergencies, including overdose.
methodsBetween May 2021 and February 2022, we conducted 35 days of naturalistic observation as well as serial, semi-structured interviews with 8 building staff (e.g., housing services coordinators, front desk clerks, custodians) and 5 tenant specialists, who promoted and sensitized residents to Brave Buttons prior to their installation. We administered surveys to all residents, assessing acceptability and uses of Brave Buttons. We calculated descriptive statistics regarding Brave Button installations and activations using administrative device data. Through inductive, iterative thematic analysis, we synthesized participant narratives to identify early expectations, implementation determinants, and adaptive strategies to bolster acceptability and adoption of Brave Buttons.
resultsDespite high demand for overdose prevention solutions, staff and tenant specialists initially expressed doubts towards the adoption potential of Brave Buttons in the PSH building, citing resident mistrust of novel technologies with surveillance properties, liability related to (failed) overdose responses, and building staff capacity and willingness to respond to Button activations. Responding to these anticipated implementation constraints, a group of staff and tenant specialists hosted "engagement sessions" to build resident affinity/trust with Brave Buttons and leveraged tenant specialists' rapport with residents for technology sensitization. By December 2021, Buttons were voluntarily installed in 72 % of resident rooms and were used for multiple purposes, including overdoses and safety/wellness checks. The Buttons also helped formalize informal systems of care among residents and strengthened connections between residents and building staff.
conclusionAdaptive strategic planning, responsive to emerging sources of implementation opposition, was critical to addressing perceived barriers to Brave Button acceptability and adoption in the PSH building.
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