First Ever Smartphone App to Identify Opioid Overdose

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Highlights:

• About 115 persons die in the US due to opioid overdose and injectable illegal opioids are the most common cause of drug overdose-related deaths
• A person who has overdosed can be saved if detected in a timely fashion since there is an antidote called naloxone
• The SecondChance smartphone App accurately detects opioid overdose in about 90% cases and could try and call a close relative or friend or the emergency services to come to the person's rescue

The SecondChance smartphone App accurately detects opioid overdose by monitoring the user's breath from as far as three feet away and also picks up slowing or absence of movement and can potentially save the person's life according to a team of scientists at the Washington University who developed the SecondChance App.

The App works on the principle of sonar (sound navigation and ranging) to monitor the drug user's breathing. The findings of the study appear in the journal Science Translational Medicine.

‘By detecting opioid overdose, the SecondChance App helps to save the person's life since the opioid effect can be reversed by the drug naloxone given at the earliest.’

Efficacy of SecondChance App in Detecting Decreased Breathing

• For the study, the team worked with users at the Insite supervised injection facility in Vancouver, Canada. Interestingly, Insite is the first legal site that allows consumption of opiates in North America.
• The two parameters that the team was looking to identify included when the breathing rate dropped to 7/ minute and when it stopped. Typically in a hospital health personnel will hurry to see if a patient is okay if the breath rate dropped to below 8/minute
• During the study, participants at Insite wore monitors on their chests that tracked breathing rates
• The participants were advised to prepare the drugs for use routinely and the team monitored the persons one minute prior to injection to get a baseline breathing rate for their algorithm
• After this, the team monitored the participants during the injection and for five minutes after since that is the most usual time for symptoms of overdose to occur
• Out of the 94 volunteers who tried out the SecondChance algorithm, 47 had a breathing rate of 7/ minute or slower, 49 stopped breathing for a considerable period, and two people had an overdose event that needed oxygen, ventilation and/or naloxone treatment.

Overall the SecondChance App accurately identified breathing issues preceding overdose opioid 90% of the time.

Testing If SecondChance App Detects Actual Opioid Overdose

The team also wished to check if the App could detect actual overdose as these were not encountered commonly at InSite facility

• For this, the team worked with anesthesia teams at University of Washington Medical Center to artificially �simulate' overdoses in an operating room, while the App monitored the patient's breathing and detected an overdose event

"When patients undergo anesthesia, they experience much of the same physiology that people experience when they're having an overdose," Sunshine said. "Nothing happens when people experience this event in the operating room because they're receiving oxygen and they are under the care of an anesthesiology team. But this is a unique environment to capture difficult-to-reproduce data to help further refine the algorithms for what it looks like when someone has an acute overdose."

• The team enlisted otherwise healthy participants undergoing planned surgery and after getting their consent they were given standard anesthetic medications that caused cessation or slowing of breathing for 30 seconds and the App tracked these episodes
• The algorithm correctly identified 19 out of the 20 simulated overdose events. In the one case it was incorrect, the patient's rate of breathing was just above the algorithm's threshold

Making the App Interactive

• Right now, the Second Chance is only monitoring the people who use it and the team would like the app to interact with them, eventually
• In future, when the App detects decreased breathing it should send an alarm to the person to try and make him respond
• If there is no response, the phone should alert the emergency services for help to come and administer naloxone and other emergency aid

The team is applying for FDA approval and plan to make the technology available commercially through a UW spinout called Sound Life Sciences, Inc. The App can be used to identify all forms of opioid Overdose, but the team cautioned that they have only tested illegal injectable opioid use since deaths due to this overdose is the most common.

"We're experiencing an unprecedented epidemic of deaths from opioid use, and it's unfortunate because these overdoses are completely reversible phenomena if they're detected in time," Sunshine said. "The goal of this project is to try to connect people who are often experiencing overdoses alone to known therapies that can save their lives. We hope that by keeping people safer, they can eventually access long-term treatment."

How Does the SecondChance App Work?

• The SecondChance App works on the principle of SONAR (sound navigation and ranging). It sends silent sound waves from the phone to the person's chest and then monitors the reflected sound waves and looks for specific breathing patterns.

• Also, it monitors the movement of the person to track their breathing as they keep shifting
• The App can also detect certain characteristic movements that may occur with opioid overdose such as slumping forward of the head

Summary

The SecondChance App can potentially save the lives of opioid users by detecting overdose quickly so that opioid effects can be reversed with naloxone.

Reference:

1. Opioid overdose detection using smartphones - (http://stm.sciencemag.org/content/11/474/eaau8914)

Source: Medindia

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