A harm-reduction app from Vancouver-based company Lifeguard Digital Health is gaining traction in Canada among drug users.
The Lifeguard app’s core feature is a timer, which users set themselves before ingesting their drug of choice. When the timer expires, the user must click a button indicating they haven’t overdosed. If they don’t, the app automatically contacts emergency responders on the user’s behalf.
Since March 2020, the app has saved 69 lives, founder and CEO Jeff Hardy told Canadian Affairs.
But some experts question whether harm-reduction tools like Lifeguard really serve the needs of users.
‘Saving a life was pretty special’
Hardy is a recovering addict himself, now eight years sober. “I had lost everything. My daughter told me on her 16th birthday that she wouldn’t even come to my funeral,” he said. That was the last day Jeff had a drink.
Shortly after that, he went to rehab and became close friends with Evan, another recovering addict. While on a work trip outside of the facility, Evan fatally overdosed on fentanyl.
This experience inspired Jeff to create Lifeguard, which he designed while in rehab. The company is now proudly “powered by Evan.”
On the first day of Lifeguard’s pilot program, the first drug user who was given access to the app ended up overdosing. Emergency services were called and the user’s life was saved, Hardy said.
“The feeling that what had been built worked was a great feeling. Besides my kids being born, saving a life was pretty special.”
App uptake has varied across provinces
Lifeguard first introduced its app in 2019 as a pilot program run in partnership with BC’s Provincial Health Services Authority (PHSA) and regional health authorities. The app has now been fully adopted by the PHSA, which pays Lifeguard an annual license fee. Users of the app in British Columbia can in turn use the app for free.
In other provinces, including Ontario, governments have resisted adopting the app and integrating it with emergency services because of a different “political outlook,” Hardy says.
But in northwestern Ontario, a group of nonprofits came together to get funding to bring Lifeguard to their region. The app works within a geofenced region.
Users elsewhere can still download Lifeguard and use its ancillary functions, like finding nearby addiction services.
In 2021, the government of Alberta began rolling out an app called the Digital Overdose Response System, which is very similar to Lifeguard.
‘This is all downstream medicine’
Some health experts question the effectiveness of Lifeguard, as well as other harm-reduction strategies for addiction.
“This is all downstream medicine,” said Dr. Leonora Regenstreif, an assistant clinical professor in family medicine at McMaster University.
In Regenstreif’s view, most harm reduction strategies are ultimately palliative: they keep people alive for a little while longer. “If the app saved 69 people recently, where are they now?” she asks.
Canadian Affairs spoke with a man named Andrew, who has overdosed twice and was revived twice by paramedics that were called through the Lifeguard app. He downloaded the app while sober, on the advice of his counselor, never thinking he would end up using it.
“The possibility of death never really crosses your mind, you don’t think it’s going to happen to you,” Andrew said. Knowing that the app could possibly save him didn’t change his calculation about whether to use fentanyl or not, he said. “I think people are going to use anyway, whether they have the app or not.”
Harm reduction tools like Lifeguard give users the message that “the entire emergency health system — 911, paramedics, air transport vehicles, emergency departments — are all just poised and the resources to rescue you are infinite and fully prepared to save you every time you use,” Regenstreif said.
The BC government has failed to act on a growing body of evidence that its strategy for addiction is wrong, says Dr. Julian Somers, a clinical psychologist at Simon Fraser University.
“I applaud the innovators behind the Lifeguard app and all others who are motivated to act compassionately toward people who are living without a pathway to increased recovery,” Somers said. But “the reason we’re deliberating the merits of emergency measures is because we are neglecting opportunities to eliminate emergencies.”
Correction: A prior version of this article incorrectly referred to Dr. Leonora Regenstreif as a clinical psychiatrist and family physician at the University of Toronto.
Leave a comment