The NaloxBox+ project addresses a need for enhanced situational awareness and readiness of organizations committed to providing public access tools to support community opioid overdose rescue. Community access NaloxBox containers house naloxone, a rescue mask, and rescue infographics but lack the capability to automatically notify owners of container access events and impending naloxone expiration dates. The project team will therefore design, test, and deploy a novel configuration of a commercial Internet-of-Things (IoT) cellular communications system to experimentally augment installed NaloxBoxes for automated alerts and notifications.

Currently, facility managers responsible for NaloxBoxes need to manually confirm whether the naloxone medications have expired or are missing, or whether there has been an overdose situation requiring naloxone in their facility. If this information is not readily available, the resources necessary to initiate critical rescue actions may not be available to individuals on the premises during a suspected overdose event while awaiting emergency medical services. Furthermore, any delays in delivery of evidence-supported interventions matter given the prevalence and potency of fentanyl and its derivatives in the circulating drug supply.

In response, the NaloxBox+ project will experimentally modify select, deployed NaloxBoxes with a technology upgrade that adds IoT-based capabilities along with access to a Web application designed to support NaloxBox owners. Additionally, this Web portal will enable NaloxBox owners to electronically enter information about why the NaloxBox was accessed and, if contents were used for an overdose situation, details of rescue interventions and outcomes in a de-identified manner for quality assurance and research purposes.

By creating, deploying, and testing a pilot NaloxBox+ system with 25 prototype devices in Rhode Island facilities serving clients with a high risk of opioid overdose over a 12-month period, the project team proposes to collect data on NaloxBox access events and utilization. These data should help establish evidence as to whether community access opioid rescue containers and their contents successfully support timely overdose rescue, and these data should also lay the foundation for a larger trial of technology-enhanced NaloxBoxes. Additionally, successful completion of the NaloxBox+ project will provide the non-profit organization responsible for NaloxBox manufacturing and distribution with the information necessary to drive commercialization and dissemination.