Overdose detection among high-risk opioid users via a wearable chest sensor in a Supervised Injecting Facility (OD-SEEN)
Background: Opioid overdose is a global health crisis, affecting over 27 million individuals worldwide, with more than 100,000 drug overdose deaths in the USA in 2022-2023. Many of these deaths occur when individuals use opioids alone, and/or where there is a lack of support or response. Recent international research has sought to develop and evaluate wearable electronic devices that can independently detect, and potentially intervene during, an opioid overdose. Overarchingly, OD-SEEN aims to develop and validate the PneumoWave DC biosensor, a small wearable chest device designed to detect respiratory depression in real-time among those injecting opioids through measurement of chest wall movement. The study objective is to differentiate opioid-induced respiratory depression (OIRD) from non-fatal patterns of breathing that occur after opioid use in order to develop and refine an overdose detection algorithm and assess acceptability of the sensor by a subset of participants.
Methods: The PneumoWave DC biosensor is attached to consenting participants while injecting opioids at one of two Medically Supervised Injecting Facilities in Sydney and Melbourne, Australia.
Injecting characteristics, including potential overdose and response is recorded by on-site staff. Biosensor data is securely streamed to a cloud and analysed to refine an overdose detection algorithm. Aside from wearing the biosensor, all other participant interactions with the injecting facility, including acute event/overdose response is as per standard facility practice. Feedback surveys will ask participants about biosensor acceptability.
Results: With data collection still underway, by 25 January 2024, 47 participants have been enrolled, and 1,145 injecting visits have been captured at our first study site in Sydney (average age: 45 years (range: 20-65); 30 male/17 female). This has included 75 occasions where a level of clinical concern was raised within which there were 10 significant adverse events. The study is expected to be finalised by March 2024, and we will report on the biosensor’s sensitivity and false alarm rate of the algorithm under test. In parallel, we are gathering survey results and will report on acceptability of the device.
Conclusions: The study will provide data on a highly innovative intervention to detect opioid overdose by measuring chest wall movement. Opioid overdose is an intractable cause of global mortality among people who inject drugs, OD-SEEN will contribute crucial insights into OIRD and its associated response, potentially progressing the development of devices to intervene during opioid overdose and reduce avoidable fatalities.
