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Frequently Asked Questions

Table of contents

Who did this and why?

Doesn't this sort of thing encourage drug use?

I want to use the game in locations where there's no net access - can I get a standalone version?

Got any stickers, flyers, posters or anything like that?

The game doesn't seem to work on my computer.

How does the game work?

But I've seen the same player action produce different results. What's going on there?

How does the 'call ambulance' thing work?

Why don't you just tell people to call an ambulance straight away every time?

You have 'use Narcan' as an option, but almost no drug users have access to it. That's kind of a nasty tease.

Your game has people able to do bad things like shoot people with salt water - and has these actions having good effects!

Privacy

The future

Copyright


Who's responsible for this?

The overdose game is derived from an original concept by Peter Davidson and John Day.

Jon Rogers drew the original artwork, designed the web interface and the underlying database, and generally implemented the whole thing. Alas, the holiday afforded Jon by the collapse of the dotcom economy appears to be at an end, so unless someone wants to pay us in something more substantial than beer and coffee, the game is unlikely to sprout any amazing new features in the near future. Sigh.

Peter Davidson provided game structure, text and gameflow, based on research done over the past five years on fatal and non-fatal heroin-related overdose in Perth, Australia and San Francisco, USA. He is currently project director of the UFO Study, a study of hepatitis C, HIV and STDs among young injecting drug users run by the department of Medicine at the University of California, San Francisco.


Doesn't this sort of thing encourage drug use?

We don't believe that teaching people how to respond to a medical emergency encourages drug use. We believe that discussing overdose with injecting drug users has the effect of encouraging people to think realistically about their drug use and its possible consequences. In our experience, such contemplation has many effects, but encouraging drug use isn't really one of them.


I want to use the game in locations where there's no net access - can I get a standalone version?

Unfortunately no, not at this point. The game itself is running on linux, a variant of the unix operating system. The web-based stuff is just the human friendly front end. To turn the game into something that would run by itself on a Macintosh or Windows computer would require a complete rewrite from the ground up. Given that we're both rather tied up with other work at the moment, we're unlikely to be able to take on such a major project in the near future. Sorry.


Got any stickers, flyers, posters or anything like that?

We have stickers. Go here for downloadable PDFs which print to Avery adhesive address labels of various US Letter and Metric A4 sizes.


The game doesn't seem to work on my computer.

The game requires that you have a browser that has javascript and cookies enabled. That covers pretty much all graphical browsers released in the past two or three years, as long as you haven't turned these functions off deliberately. The only recent browser we know of which should work which doesn't is Opera 5.0 running on MacOS 9.1. And we're working on that.

If you're running a browser with javascript and cookies enabled and are still having problems, please let us know .


How does the game work?

The game revolves around a sequence of possible biomedical states, ranging from full consciousness to death. These states are defined in terms of respiration rates, airway status and the presence or absence of a pulse. Player actions are matched against the state at any given point and an output state generated. Eventually the victim will either recover or die.


But I've seen the same player action produce different results. What's going on there?

Player actions (the choices presented on the buttons) are mapped against underlying effects, and these effects are mapped in turn against the current biomedical state of the victim. Both of these mapping processes may have multiple possible outcomes. For example, the player action 'slap the person' has an 80% chance of producing the underlying effect of stimulating the victim, and a 20% chance of having no effect. The underlying effect 'stimulate' may in turn have a 90% possibility of bringing a semi-conscious victim to consciousness, and a 10% possibility of having no effect.

Different underlying actions will also have different effects for different states, even apparently similar ones - doing mouth-to-mouth on someone who isn't breathing will have a markedly lower chance of success if the airway is blocked with vomit, for example. The tables which drive the game are available in pdf form here for those interested in the fine detail.


How does the 'call ambulance' thing work?

If you click 'call ambulance', the game will finish in another three 'moves'. As long as the victim still has a pulse in three moves, you win. We're planning to add a whole module to the game that lets the player walk through making an ambulance call, to show people how to make a call in North America in a way which makes the whole process of having emergency services attend be as painless as possible. Anyone in a position to loan us a copy of the standard flipchart used by emergency operators in the USA is urged to contact us. For that matter, if you can loan us a copy of any equivalent flowchart device used by emergency service phone operators in another jurisdiction, we'd love to be able to produce region-specific versions of this game at a later date.


Why don't you just tell people to call an ambulance straight away every time?

In the USA, calling emergency services for a drug-related overdose can lead to arrest, eviction, violation of probation and subsequent incarceration and other extremely negative effects. The chances of these negative outcomes vary enormously depending in what city or town you happen to be in, but the net effect is many drug users are extremely reluctant to use emergency services as a first response to an overdose, no matter how desirable that is from a medical perspective. We do encourage calling emergency services as a first response, but are attempting to deal with the reality that many people will try other things first. One of the aims of this game is to show people what the most effective 'things to try' are, and to show people how to monitor the condition of the victim so they are better equipped to recognize when a situation is beyond the abilities of those present – before it's really too late for paramedics to help.


You have 'use Narcan' as an option, but almost no drug users have access to it. That's kind of a nasty tease.

In the US it's legal for doctors to prescribe Narcan (naloxone hydrochloride), but most won't out of fear of legal liability if it gets used on someone for whom it wasn't prescribed and they die anyway or suffer (rare) complications. However, the state of New Mexico has recently changed the law so doctors who prescribe it are better protected. A recent formal trial of Narcan distribution to couples in San Francisco may lead to a larger scale distribution project. Narcan has also been distributed sporadically in the US through 'underground' methods over the past few years. The legal and 'on the street' availability of Narcan outside the US varies widely, but in some places it's a lot easier to get than in the US. You know who you are : )

So while most drug users can't access Narcan, some can. And we felt that it's worth including it as an option to remind people that it exists and to help continue the debate over whether it can and should be distributed more widely and systematically.


Your game has people able to do bad things like shoot people with salt water - and has these actions having good effects!

It's true, injecting someone with saline or cocaine or speed is a bad idea. So is dumping them in a cold bath, or sticking ice cubes up their butt. However, many heroin users have done these things, and many have reported people recovering or improving after they've done them. And these things often do work, but not always for the reasons people expect. Adding saline to someone's bloodstream doesn't do anything amazing - but having some panicked person digging around in your arm with a needle trying to find a vein is going to hurt, and moderate pain can help bring someone in a heavy nod back to semi or full consciousness. So we've chosen to depict these actions as sometimes having good outcomes, but have included text describing why it worked, what might go wrong and what else could do instead to get the same effect without the potential negative consequences.


I'm getting this message saying your site wants to store a cookie on my computer. What gives?

We use cookies for two things. The first is simply to give the game software a way to keep track of things from earlier in the game it needs to know in order to calculate the effects of your actions - for example, whether you've already cleared all the vomit out of the airway of the victim (and if the victim had vomit in the airway to start with). The second reason we use cookies is because at the end of the game, the cookie has in it a record of every situation the player was presented with and how they responded to it. By collecting these cookies back, we're accumulating information about what sorts of things players commonly try in different situations. This may help us improve the game, and might also help us with designing overdose education packages for both injecting drug users and those who provide services to them.

While we're on the privacy disclosure bender, like every other web page in existence, our server logs the IP address of the computer you're using to play the game. We use this to count how many people are playing the game, and also to tell us something about what countries people are accessing the game from. If the idea that every web site on earth can do this bothers you, you might want to check out an IP anonymizing service. There is a list here.

If you contact us by email, we will not use your email address to send you junk mail, nor will we give or sell it to anyone else for any purpose. We're far too lazy, quite apart from the ethical issues. You can also use the feedback link at the top of every page to leave messages or feedback anonymously if you prefer.


What's next?

We have a number of things we'd like to add to the game at some point, such as dealing with substances other than heroin and giving a more detailed breakdown of the 'call an ambulance' option. Now that we've had a pile of requests for a standalone version for those without net access, we'd like to do that too. However, we're about at the limit of what we can realistically do without any funding. Anyone with suggestions for possible funding sources available to people or organizations in North America to develop this kind of resource should definitely contact us : )


Statement of copyright and ownership:

Portions of the overdose game, including but not limited to original artwork, software, scripts and data tables are © 2002 Jon Rogers and Peter Davidson. Use of copyright materials without the written permission of the copyright owners is forbidden.


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