Evanston addiction counselor creates smartphone app to thwart overdoses — ‘a foolproof way to stay alive,’ he says

In his dozen years of heroin use, Lucien Izraylov took pains to avoid detection. He was ashamed of what he was doing, so he almost always shot up alone.

It’s a risky behavior that can lead to a fatal overdose, especially at a time when drugs are commonly tainted with the powerful synthetic opioid fentanyl. But Izraylov, who says he now has years of sobriety behind him, thinks he has figured out a way to help.

He has created a smartphone app called Harmredux that will connect drug users with volunteers who will meet them, overdose-reversing medication in hand, to make sure they survive their use. The app recently became available for both Android and iPhones.

“Not everyone will use it, but it’s nice to have an option,” he said. “It’s a foolproof way to stay alive.”

Izraylov, 41, joins other tinkerers who have tried to attack overdoses through technology. One app, released in 2016 but apparently no longer available, alerted an emergency contact if users didn’t push a button on their smartphone once a timer elapsed.

Another one, still in development, turns a smartphone’s microphone and speaker into a mini-sonar system that can detect a person’s breathing. If respiration appears to slow significantly or stop altogether — hallmarks of an opioid overdose — the phone alerts emergency responders.

Izraylov, who also runs an Evanston-based addiction and mental health counseling service, isn’t taking such a high-tech approach. His app simply connects drug users with volunteers via phone, email or text chat, and they make arrangements on where to meet (Izraylov said about 90 minutes lead time is necessary).

The app has yet to serve its first customer, but Izraylov said it is set up to work like this:

Trained volunteers, who generally will work in pairs, observe the drug consumption, and if the person appears to be in distress — something that could happen within minutes — they use the overdose-stopping medication naloxone and call 911. If the person seems to be OK after using, the volunteers go on their way, though they can also make a referral if the person is seeking treatment.

The service is free of charge and users can remain anonymous, Izraylov said. Volunteers have no role in the person acquiring or using the drugs.

“It’s strictly to stay there and make sure they don’t die,” he said. “Just to be within eyesight. If (an overdose) happens, we intervene.”

He said that limited involvement should keep volunteers on the right side of the law. The state’s drug overdose prevention statute allows non-doctors to administer naloxone in emergencies without risk of civil or criminal liability.

But Chicago defense attorney Shay Allen, a former Cook County prosecutor, preached caution. He said the interpretation of the law might not cover situations where a volunteer arranges in advance to witness someone’s drug use.

“It could put the volunteers in a precarious legal situation,” he said.

The app is the latest local attempt to advance harm reduction, a philosophy aimed at keeping drug users alive and as healthy as possible, without making abstinence the central goal. It’s the same rationale behind needle exchanges and easily obtainable naloxone.

But one harm reduction staple in other countries still isn’t available in the United States. Safe consumption sites — places where trained staffers monitor drug use and take action should an overdose occur — are still illegal under federal law, though some cities say they want to open them anyway (Chicago mayoral candidate Toni Preckwinkle said she was open to the idea and opponent Lori Lightfoot didn’t respond to a survey).

Izraylov said his app could serve a similar function until safe consumption sites are legal, but even then, he thinks it could be a valuable alternative.

“From my own experience, I would rather call someone instead of going to a site,” he said. “I would be afraid of seeing someone there who I would know, who would tell somebody. I don’t want to discourage (safe consumption sites) because I think they’re important. But I think we need as much as we can out there to keep people alive so they can recover.”

Cook County saw more than 1,300 drug overdoses in 2018, the vast majority of them opioid-related. That number likely will rise as more autopsies are finalized.

Others in Chicago’s harm reduction community see promise in Izraylov’s creation. Geoff Bathje, a psychologist who works with the Drug Users Health Collective, said it’s reminiscent of a program called the Zendo Project, which travels to music festivals to care for people having bad reactions to psychedelic drugs.

Bathje said people who work with drug users strongly push the message that they shouldn’t use alone, a message users are increasingly heeding because of the fentanyl crisis. Still, he said that because heroin users often take drugs several times a day, it could become logistically unwieldy for volunteers to respond.

Vilmarie Narloch of Students for Sensible Drug Policy said another complication is that some drug users don’t have smartphones (Izraylov said volunteers are also available through the toll-free number 844-HARMRDX).

Overall, though, she thinks the app will be helpful.

“I think that if the app is successful, and people feel they can trust it, it’ll be a way for people to be there when (heroin users) otherwise might be using alone,” she said.

jkeilman@chicagotribune.com

Twitter @JohnKeilman