More than 115 people died from opioid overdose each day in the United States in 2018—a grim statistic that highlights the overwhelming public health crisis that has gripped much of the country. One possible way to save lives may come from simple wearables designed to detect overdoses among people addicted to the powerful and potentially deadly opioid painkillers.
Several companies have been investigating how devices similar to wristbands or watches could track certain health measures that may indicate an opioid overdose. One such device developed by Carnegie Mellon University students—called the HopeBand—can sound an alarm, flash red lights, and send out a text message alert with the wearer’s current location if it detects low blood oxygen levels. An early alert could give enough time for people to administer life-saving naloxone and reverse the overdose.
“Imagine having a friend who is always watching for signs of overdose; someone who understands your usage pattern and knows when to contact [someone] for help and make sure you get help,” says Rashmi Kalkunte, a software engineering student at Carnegie Mellon University in Pittsburgh. “That's what the HopeBand is designed to do.”
The rate of U.S. drug overdose deaths more than tripled between 1999 and 2016, according to a report from the U.S. Centers for Disease Control and Prevention. During that time period, the synthetic opioid painkiller known as fentanyl rose to become the drug responsible for the largest number of overdose deaths. By 2017, fentanyl—or designer drugs mimicking fentanyl—accounted for almost 30,000 deaths among the more than 72,000 estimated drug overdose deaths.
That public health crisis has spurred a number of companies and universities to develop possible technological solutions. Researchers from the MIT-IBM Watson AI Lab have begun using machine learning techniques to study patterns in opioid addiction and usage that could change how opioids are prescribed.
The U.S. Food and Drug Administration also recently selected eight medical devices from among more than 250 applications for its innovation challenge regarding the opioid epidemic. Some of the devices aim to carefully control the dispensing of opioid prescriptions in order to reduce the risk of addiction. Others stimulate the brain with magnetic fields to treat opioid addiction, or offer alternative forms of pain relief through virtual reality therapy.
One medical device selected by the FDA aims to help detect opioid overdoses, as the HopeBand does. Developed by Masimo Corporation, the monitoring system seems to be more of a hospital-based setup for patients who must stay in bed and take painkillers after surgery or other medical procedures.
That’s different from the Carnegie Mellon University team’s focus on a cheap wearable to track the health of people wherever they go. The students began developing a mobile solution after being approached and sponsored by Pinney Associates, a pharmaceutical consulting firm. Their efforts eventually won third place in the finals of the Robert Wood Johnson Foundation's Opioid Challenge during the Health 2.0 Conference held in Santa Clara, California in September.
The team decided on a watch-style solution after choosing pulse oximetry as “the most reliable indicator of an overdose,” says Soham Donwalkar, a software engineering student at Carnegie Mellon.
Pulse oximetry sensors can monitor the oxygen levels in blood by shining light from LEDs through the skin and detecting changes in light absorption. If oxygen levels drop low enough to signal possible overdose, the device monitors the situation for 10 seconds before sounding the alarm. But the team still faces a tough challenge in validating whether or not the HopeBand actually works in detecting overdoses with real people.
“The challenge is that we cannot actually just test the device on a human subject,” says Puneetha Ramachandra, a master’s degree candidate in software engineering at Carnegie Mellon. “We have been able to test it in our lab on simulated inputs and the tests look good so far.”
The team plans to start by freely distributing HopeBand to opioid users through needle exchange programs such as Prevention Point Pittsburgh. If that works out, a commercialized version could eventually begin selling at the team’s target price point of between US $16 and $20 (current prototypes cost between $26 and $30).
“Our solution, at the moment, only focuses on preventing overdose deaths,” Ramachandra says. “We do plan to incorporate more helpful features into our device in the future to aid in the addiction aspects of the problem.”