⫸STICKY⫷ BuddyUp app (UK and Ireland) - New digital service for people who use drugs

[PaigeSmithCranstoun]

Hello,

My name's Paige Smith and I am the Innovation Programme Lead with Cranstoun. Cranstoun is a UK based forward-thinking and ambitious social justice charity and we mean business when we talk about harm reduction. We are committed to reducing the harms linked to substance use in every way we can imagine. From our naloxone supply to our BuddyUp app, Diamorphine Assisted Treatment, DIVERT and injecting equipment provision, we are in the business of improving lives.

I am looking to reach people that might be interested in trying a new digital service we are offering for people who use drugs in the UK and Republic of Ireland. The service is free to use, and the app can be downloaded from your usual app store, titled “BuddyUp with Cranstoun”. The service is available to anyone in the UK or Republic of Ireland over the age of 18. You need not contact us before you use the service, unless you have any questions.

In addition to our current services, Cranstoun are committed to delivering world class innovations to reverse the drug death crisis. BuddyUp is a new, app-based service available on Google Play and the App Store and the concept is that people who are using drugs alone can download the app and be connected to a Cranstoun team member (called a supporter), with whom they can build a rescue plan, detailing where emergency services help can be sent to them in the event they become unresponsive after using a drug and while calling the service. The plan is only activated if our BuddyUp supporters suspect that the app user has overdosed.

BuddyUp is a low threshold, harm reduction service, aiming to ensure that an episode of drug use does not result in fatal overdose. During the pilot it is running with selective hours with the ambition of having an expanded service in the near future. It will help us to reach all parts of the UK, allowing people who are in rural locations to access the same support as someone living in a city. A similar app is already operational in North America, through the Brave Co-operative.

How this works in practice is that BuddyUp ensures that if someone uses a drug alone, a trained Cranstoun team member can remain in contact with them during and after they use drug(s) and enact their overdose rescue plan if the caller becomes unresponsive. If a caller becomes unresponsive, their rescue plan, (location (address), rescue instructions such as where to find the key, security codes, which door to use, and any additional information the caller would like to include) is revealed to the supporter. The supporter would then call the emergency services and provide the details of the rescue plan so that help can be sent to the address provided.

Should you have any questions on how the service works or want to talk through anything in more detail please do get in contact with us on [email protected] or via the Bluelight private messaging system.

If you do use the app and wish to provide us with any feedback, please also use the contact details above to do so.

You can also find further information on the service at: https://cranstoun.org/help-and-advice/harm-reduction/buddyup/

Admin note: Cranstoun are also supporting Bluelight by purchasing site-wide advertisement of BuddyUp.

Hope to speak to you soon,

Paige Smith

Innovation Programme Lead
Cranstoun

Admin note: Cranstoun have been in communications with admin. We will be providing site-wide support for the project. We are aware it isn't the standard research project that we typically promote at Drug Studies; nevertheless, we think the project is strongly aligned with our mission at Bluelight, and ideally hope that people in all jurisdictions will one day have access to this level of support.

 

[Tronica]

Thanks a lot @PaigeSmithCranstoun

Would you please be able to add some more details about the project's funding? Where does the funding come from? Do people have to pay for the service at any stage?

Also I'd be keen to know - how many people have used the app? How many drug use events does the app get used for per annum? How many 'supporters' do you have? What's the pathway to become a supporter? (I know a lot of Bluelighters informally support people who use drugs in their networks and may be well placed to contribute in this way, too)

 

[PaigeSmithCranstoun]

Thanks a lot @PaigeSmithCranstoun

Would you please be able to add some more details about the project's funding? Where does the funding come from? Do people have to pay for the service at any stage?

Also I'd be keen to know - how many people have used the app? How many drug use events does the app get used for per annum? How many 'supporters' do you have? What's the pathway to become a supporter? (I know a lot of Bluelighters informally support people who use drugs in their networks and may be well placed to contribute in this way, too)

Hi @Tronica

Thanks for your message - of course, I'd be happy to provide some further detail.

BuddyUp is currently funded internally through Cranstoun. We had a small amount of funds provided to us at the beginning of the project by local authorities to support with pilot implementation costs, but since then we have been funding ourselves. We are looking at external funding opportunities at present to allow us to continue and expand the service. At no point does the person using the app have to pay for the BuddyUp service.

We have seen limited usage in our pilot so far (the service became available nationally in July 2023), and put that down to a few primary reasons based on feedback we have received.*

To date we have had 520+ downloads of the app, with 6 calls reaching supporters. The calls reaching supporters so far have been one of a few scenarios;

1. A call from someone who used drugs just before calling through to BuddyUp. The person had just used crack cocaine and was calling should they need help, as they were using alone. The person did not requirement emergency support, and the call was ended when both they and the supporter felt comfortable to do so.

2. We’ve had a call from a person asking for harm reduction advice, but not intending to use the drug there and then so didn’t wish to stay on the line should an emergency response be needed. This is a really positive example of how beyond it's primary aim, BuddyUp is also able to provide harm reduction advice that is often otherwise difficult to obtain, particularly for people not engaged with services.

3. We’ve also had calls from people who use drugs who would like to understand more about how BuddyUp works, or from professionals who would like to share this with the people who use their services.


We currently have 10 trained supporters.

To become a supporter, people can apply using the form contained within this link - https://cranstoun.org/volunteer-roles/buddyup-volunteer-supporter-2/

Alternatively, people can get in touch with me by email at [email protected] and I can support this process.


*We know that the main physical barrier to using BuddyUp as it is at the moment is the requirement of a smartphone, with it being an app-based service. We would appreciate feedback as to whether a phoneline version of the app may be of interest to people?

We also know that particularly in a UK setting where we don't currently have Overdose Prevention Centres/Drug Consumption Rooms that the notion of using drugs 'with' someone (in the virtual sense in the case of BuddyUp) is quite a new thing for people, so we did expect it might take some time for a service concept such as this to be trusted and used on a wider scale.

Additionally, some of the questions we've received also indicate a nervousness around what data we collect, and what we do with that data. Therefore, it's really important to us that we are clear in our messaging that people can anonymously and privately connect to a BuddyUp supporter through the app. We do not require full names (supporters will ask for something they can refer to callers as during the call, but this can be just a first name or a nickname etc), nor do we collect phone numbers. As the call is made through the app, all calls come through as anonymous. We receive location and rescue information (the information contained within the rescue plan) to support an emergency rescue only in the event the person requires it, so if the person doesn’t become unresponsive or require emergency support during the period of the call. The way this works is that the rescue plan is created by the caller, and is kept in a secure packet of information on the callers device. This works by the BuddyUp supporter pressing a button their end to say they think the caller needs help and would like the rescue plan to be released to them so they can contact emergency services, which in turn starts a countdown timer on the callers phone. The caller has the ability to stop the information being shared by clicking a button to say that they are okay, or by verbally responding to their supporter before the timer cancels out. The timer cancelling out is what triggers the rescue plan (and therefore location information) to be released to the supporter. When the rescue plan is released, the information is stored for a limited time (24 hours), as an emergency fail-safe measure only. The information is then wiped from the server to maintain the callers anonymity.

We believe it is a combination of the above, alongside the importance of making sure word gets out there about this service, that has resulted in limited usage to date. Therefore, our focus is on finding solutions to address these barriers, and to use various different networks (such as yourselves) to spread the word that this service is available to people. Particularly given the numbers of drug related deaths in the UK, and the number of those that we know are dying along and behind closed doors, we believe BuddyUp is an important puzzle piece in what needs to be a much wider offering for people who use drugs in the UK.


We are always looking for feedback on the service itself if you use it, but also information as to why you would or wouldn't use a service like this is also hugely beneficial to us to understand how we might address that.

I hope that is useful, and I'd be happy to answer any further questions if you, or anyone else, has any.


Best wishes

Paige

 

[neversickanymore]

DS>EADD

 

[Tronica]

@PaigeSmithCranstoun Thanks for the detail here. It's really helpful.

Hopefully some of the EADD community can comment directly on the issues you have described

 

[neversickanymore]

I have to say after looking at the published goals they look really promising to me. After living through and also looking at and studying substance use/abuse/addiction, there is no simple or a one tiered solution.. it just doesn't exist. It's complex and I really think Paige is right on here with the approach that looks to address it on all its levels.

 

[Zopiclone bandit]

In addition to our current services, Cranstoun are committed to delivering world class innovations to reverse the drug death crisis. BuddyUp is a new, app-based service available on Google Play and the App Store and the concept is that people who are using drugs alone can download the app and be connected to a Cranstoun team member (called a supporter), with whom they can build a rescue plan

And it was Cranstoun who kicked my best mate off his Meth script, he had been on the afghan #3 for 12 years & went over to Legal meth to try & get clean, the moment he missed a single doctors slot you lot removed his meth script & let him go sick.

Now his bang at it again with a bigger gear habit than before & is smoking 5-7 bags per day just to stop being sick, Id suggest BEFORE you go making apps you get your house in order in regard to making people go back to heroin!!!!!!!

 

[Tronica]

And it was Cranstoun who kicked my best mate off his Meth script, he had been on the afghan #3 for 12 years & went over to Legal meth to try & get clean, the moment he missed a single doctors slot you lot removed his meth script & let him go sick.

Now his bang at it again with a bigger gear habit than before & is smoking 5-7 bags per day just to stop being sick, Id suggest BEFORE you go making apps you get your house in order in regard to making people go back to heroin!!!!!!!

That's a really awful situation for your friend. I'm sorry to hear it. It's really important for people who want it to have access to opioid substitution therapy, but yet I'm aware it's not universally available around the world.

 

[mauve]

@PaigeSmithCranstoun thank you for the detailed information about the app. Is the digital aspect similar to the helpline Scotland trialed a couple years ago called never use alone...

Thanks

 

[PaigeSmithCranstoun]

@PaigeSmithCranstoun thank you for the detailed information about the app. Is the digital aspect similar to the helpline Scotland trialed a couple years ago called never use alone...

Thanks

@mauve thank you for getting in touch. Yes - the concept is similar however the key difference is that with BuddyUp all of the information is contained within the app itself. So in practice what that means is instead of the caller having to verbally provide their location information (address, access instructions etc) to the supporter at the start of the call, as is the case with a phone line, with BuddyUp the caller can enter this information into the app in advance of calling. This information is then kept securely on the callers device and is only released to the BuddyUp supporter if they become unresponsive and the supporter determines they require emergency help. This means that we only receive that information if it is truly necessary. So, should the caller and supporter be happy to end the call with no emergency response required, BuddyUp would not receive information in regards to the callers location/address.

I hope that's helpful.

 

[F.U.B.A.R.]

And it was Cranstoun who kicked my best mate off his Meth script, he had been on the afghan #3 for 12 years & went over to Legal meth to try & get clean, the moment he missed a single doctors slot you lot removed his meth script & let him go sick.

Now his bang at it again with a bigger gear habit than before & is smoking 5-7 bags per day just to stop being sick, Id suggest BEFORE you go making apps you get your house in order in regard to making people go back to heroin!!!!!!!

I'm with you on this one mate.

Apps ain't gonna solve the world's problems.


Plus, why do you have to be over 18 to use this 'service'?

Most problematic drug use occurs way before this age...

 

[Tronica]

I'm with you on this one mate.

Apps ain't gonna solve the world's problems.


Plus, why do you have to be over 18 to use this 'service'?

Most problematic drug use occurs way before this age...

No-one would suggest apps would solve the world's problems.

Why not have both? I mean, many people absolutely need in-person treatment services and harm reduction services etc. And many people also benefit from digitally delivered help, support and community. It's possible in the drug space to meet the multiple needs of multiple different types of people who have different needs and issues... I would argue, anyway.

Same with youth versus adults. Drug support services are needed for all ages.
Unfortunately, there are specific difficulties with catering for people under 18 in many countries - legal ones around insurance, consent, etc.
Often research studies have to push very hard or are denied opportunity to meet needs of people under 18.
I've been involved in pushing for inclusion of 16 & 17 year olds in studies, arguing people that age can consent without 'parental consent', but once you are required to get parental consent (e.g. <16), and it's about their drug use, it's hardly likely any kids are going to be keen to use the service...

The drug checking service I've been working with in Australia did manage to get no age limits, arguing that it was especially critical for <18s to be able to access this service. Which was excellent, but isn't always possible for all services to do.

 

[Tronica]

More generally, if there is someone using drugs alone and they use this service and it means someone has an ambulance called and gets naloxone and doesn't die... why wouldn't we support that as a great example of harm reduction?

 

[F.U.B.A.R.]

More generally, if there is someone using drugs alone and they use this service and it means someone has an ambulance called and gets naloxone and doesn't die... why wouldn't we support that as a great example of harm reduction?

Fair point Tronica.

I'm just a miserable old cunt that is fuckin sick of the whole 'there's an app for that' culture.

A few lives potentially saved is far better than none.


But I still think that drug services should be more interested in the clients on a personal level than creating apps.


I have a very dim view of the so called 'drug services' as in my experience, they did fuck all except prescribe methadone - for which I'm grateful as it worked - eventually.


But any doctor should be able to do that...

 

[Tronica]

Fair point Tronica.

I'm just a miserable old cunt that is fuckin sick of the whole 'there's an app for that' culture.

A few lives potentially saved is far better than none.


But I still think that drug services should be more interested in the clients on a personal level than creating apps.


I have a very dim view of the so called 'drug services' as in my experience, they did fuck all except prescribe methadone - for which I'm grateful as it worked - eventually.


But any doctor should be able to do that...

Thanks. I agree that we can’t replace drug services with tech, and more generally, folks can get wooed by tech as a solution to all our problems, erroneously. And I don’t think there’s any country in the world that has funded drug treatment fully. I know that here in Australia researchers have estimated that we need at least double the number of services to meet demand (ie double the funding).

What would make a massive difference in Australia is full decriminalisation for all drugs. That is, use and possess offences attracting no penalty. We have drug diversion for these offences which involves compulsory session with drug counsellor. I’ve got drug counsellor colleagues who spend most of their funded time on these sessions for which only one on ten actually have a drug problem that needs treatment. Yet there are long wait lists for all kinds of treatment including drug counselling

And yup opioid replacement therapy needs to be easier to access. Here very few pharmacies will dispense making it harder to get. Only some doctors are registered to prescribe which is another barrier. Drug stigma is a massive cause with many clinics just not keen to serve this population. They wouldn’t do that about cancer or diabetes would they?

Another thing to promote more of is “safer consumption sites” - called various names globally. In Australia these are “medically supervised injecting centres”, in the US, more euphemistically “overdose prevention sites”. I understand these don’t exist in the UK and part of the idea of BuddyUp is to fill some of that gap. Australia has made it about medical supervision of injecting but that’s a really expensive model, and there are only 2 sites in Australia so it serves a very select group who live close to those sites. The app version uses trained health staff and or volunteers who are drug users themselves or have experience with drugs, and all remotely located. So it’s a lot cheaper. But still helps that someone is monitoring the person especially if they are taking opioids. We know that using alone is a top reason for fatal OD. Having said that just getting naloxone out to people and their friends and family makes a difference too.

I heard from a UK colleague recently that in the last year there were 2 deaths per week there where nitazenes were detected, likely ppl using heroin substituted or adulterated with nitazenes. My hope is that this doesn’t turn into a US style fentanyl analogue overdose crisis. But also maybe such a public health disaster might shock people into funding more innovative things and fully funding what we have - we can see in Canada that their tragic number of opioid deaths has led to much greater government funding of services, and willingly to fund drug checking services too.

 

[skunkworks]

I think the problem FUBAR alludes too is that of 'technology creep' - so for instance, remember during the Sars Covid19 pandemic how GPs locked down their surgeries and almost all interaction had to be by telephone. I wasn't the only one who thought 'I bet this carries on after the pandemic' and sure enough that is what happened.
My surgery now defaults to telephone consultations for all non emergencies with the usual merry-go-round of phoning the switchboard at exactly 8:15am if you want an appointment. Someone thought that a fancy new telephone switchboard directing calls automatically by voice recognition would streamline inquiries by phone and that very technology morphed into the clusterfuck monster we have in the UK now.
All anyone suffering illness wants is to speak to a sympathetic receptionist and get an appointment within a day or so (preferably the same GP they usually see) ...
Covid bought about having to phone repeat prescriptions in, now they badger us to do it all via the NHS GP surgery app. Well I cannot. I have no drivers licence or passport and am not on the electoral roll so the NHS app rejects my application and they won't take repeat RX requests over the phone.
I'm an IT person and I know it can make lives so much easier and better. It can also cost taxpayers the £35,000,000,000 for Dido Harding's Track and Trace fiasco or the £500,000,000 it cost to open, not use, then mothball the Nightingale Hospitals. Then there is the Post Office scandal with Fujitsu's software falsely flagging up hundreds of sub-post masters as thieves who ended up wrongly convicted & jailed.
Both 'Futurama' and 'Rick and Morty' ruthlessly satirized the whole 'there's and app for that' culture brilliantly.
I'm with FUBAR - it's mostly a load of ill conceived, badly implemented and monumentally expensive bollocks.

Edit to say - This is no way intended to denigrate the original poster from Cranstoun and I genuinely wish them all the best with this novel idea

 

[Tronica]

I think the problem FUBAR alludes too is that of 'technology creep' - so for instance, remember during the Sars Covid19 pandemic how GPs locked down their surgeries and almost all interaction had to be by telephone. I wasn't the only one who thought 'I bet this carries on after the pandemic' and sure enough that is what happened.
My surgery now defaults to telephone consultations for all non emergencies with the usual merry-go-round of phoning the switchboard at exactly 8:15am if you want an appointment. Someone thought that a fancy new telephone switchboard directing calls automatically by voice recognition would streamline inquiries by phone and that very technology morphed into the clusterfuck monster we have in the UK now.
All anyone suffering illness wants is to speak to a sympathetic receptionist and get an appointment within a day or so (preferably the same GP they usually see) ...
Covid bought about having to phone repeat prescriptions in, now they badger us to do it all via the NHS GP surgery app. Well I cannot. I have no drivers licence or passport and am not on the electoral roll so the NHS app rejects my application and they won't take repeat RX requests over the phone.
I'm an IT person and I know it can make lives so much easier and better. It can also cost taxpayers the £35,000,000,000 for Dido Harding's Track and Trace fiasco or the £500,000,000 it cost to open, not use, then mothball the Nightingale Hospitals. Then there is the Post Office scandal with Fujitsu's software falsely flagging up hundreds of sub-post masters as thieves who ended up wrongly convicted & jailed.
Both 'Futurama' and 'Rick and Morty' ruthlessly satirized the whole 'there's and app for that' culture brilliantly.
I'm with FUBAR - it's mostly a load of ill conceived, badly implemented and monumentally expensive bollocks.

Edit to say - This is no way intended to denigrate the original poster from Cranstoun and I genuinely wish them all the best with this novel idea

It is super annoying when things get so automated that you can't get genuine service.
In Australia, the prime example of that is Centrelink or Services Australia (welfare provider). If you want to talk to someone live, it is so damn hard to do - I think they do it on purpose so they hope half the people will give up on getting payments...

I think this initiative is more aimed at a situation where someone would otherwise be using drugs alone.
As in, they'd normally be alone and there's no-one else around in-person, so they use the app and connect with a volunteer or trained worker who is able to stay with them (online) until it's determined that they are alright - given the issues with drugs at the moment possibly containing other things like nitazenes that could require they need urgent medical help or naloxone.

 

[PaigeSmithCranstoun]

Hi all, so sorry - I seemed to stop getting notifications on this thread so hadn’t seen your messages. Really appreciate your thoughts and comments, and I’ve just been digesting them this morning.

Completely appreciate the ‘there’s an app for that’ issue, and I’d like to emphasise that this service is not at all intended to replace any existing face to face appointments or services that exist. Tronica has put it well – whilst we always advise never to use alone, we know in reality it does happen, and that many people who die of overdose do so alone. This is where BuddyUp can come in. Absolutely, apps alone aren’t going to solve the worlds problems, but think of it as an additional option for people, another tool offered to people with an aim of reducing unnecessary drug related deaths, particularly given the significant threats of further contaminations of synthetic drugs – namely nitazenes and xylazine – into the drug supply.

We aim to offer a suite of services which provide options for both those who wish to halt their use entirely, and those who do not wish to do so, but would benefit from support to reduce harm, be healthier and stay alive. BuddyUp is just one part of that, and if someone does ask for help to access drug treatment services in their area during a call, we can provide this information.

Re the over 18 part, I do agree – but as Tronica has mentioned it is due to restrictions with insurance etc. This is something we continue to explore.

Since my last comment on this thread, we have now used BuddyUp to get emergency services support to someone who became unresponsive on the line with us when using drugs alone. This is a situation that could have been fatal as no one apart from the BuddyUp supporter knew this person was using drugs at the time. Thankfully the result was positive.

Whilst only one part of the puzzle, we hope that it provides an additional way people who use drugs can do so safer.

 

[DrPetro]

And it was Cranstoun who kicked my best mate off his Meth script, he had been on the afghan #3 for 12 years & went over to Legal meth to try & get clean, the moment he missed a single doctors slot you lot removed his meth script & let him go sick.

Now his bang at it again with a bigger gear habit than before & is smoking 5-7 bags per day just to stop being sick, Id suggest BEFORE you go making apps you get your house in order in regard to making people go back to heroin!!!!!!!

There's no service in the world that won't kick you off a script if they don't see you, unfortunately for us Methadone prescribing is very tightly regulated. This is for a variety of reasons ,but most annoyingly because the rules are set up around the most idiotic person out there on a script. Every time some idiot gives a baby some methadone or someone goes over with a high level of methadone in their system it gets ratcheted a bit tighter. I've been on various sorts of OST (not diamorphine sadly) and I've never had a medically attended overdose and yet I'm still having to go to the bloody chemist 3x a week.

I think that the Buddy Up App is an interesting idea to try and address the higher risk of solo O.D. Unfortunately those at greatest risk are those with the least concern about whether they'll survive their next hit but an App is worth a go.

 

[Zopiclone bandit]

t most annoyingly because the rules are set up around the most idiotic person out there on a script.

Sad but True.

I'd not trust 99% of Bagheads with a Plastic Spoon.