Opioid addicts become “first responders” to their own overdose
It’s almost unbearable to watch the nightly news reports of another death, or cluster of deaths, from an opioid overdose. First responders are increasingly equipped with doses of naloxone to reverse the opioid effects until a patient can be medically treated. We have a better solution: Let the opioid addict be his or her own “first responder” — through a wearable/implantable device that senses the danger signals given off by the body and automatically administers the life-saving drug, even if the addict is incapacitated.
It’s hard to wrap your arms around the scale of the crisis. According to statistics from the Centers for Disease Control and Prevention and the National Institute on Drug Abuse, two out of three drug overdose deaths involve an opioid. Overdose deaths from opioids, including prescription opioids, heroin, and synthetic opioids like fentanyl, have increased almost six times since 1999; from 1999 to 2017, nearly 400,000 people died from an overdose. Overdoses involving opioids killed more than 47,000 people in 2017; some 130 Americans die every day from an opioid overdose. The Midwest alone saw a 70 percent increase in opioid overdoses from July 2016 to September 2017. The economic burden is estimated to be greater than $78.5 billion.
Opioid users face a variety of challenges. Elderly patients who suffer from chronic pain rely on these types of medications, but they are sometimes forgetful and can accidentally overdose without realizing they’ve taken their pain medications. Chronic pain sufferers who become addicted might no longer be able to obtain prescription opioids so resort to illegal opioids (e.g., heroin) that are frequently laced with fentanyl. These users are often alone when they overdose, unable to self-administer the life-saving antidote or call for help.
Leveraging our expertise in implantable and wearable technologies, we formed a team of researchers (myself, Drs. Chi Hwan Lee, Jacqueline Linnes and Craig Goergen) to engineer a solution to this problem. Our approach has a number of advantages over current solutions. The “auto-injector” device that’s currently on the market is not really an automatic injection device. It makes self-injection easier, but it still requires an alert person to administer the drug — which doesn’t help if you are incapacitated. The other delivery device (Narcan nasal spray) similarly requires someone else to deliver the drug.
We want to automate this process with the simple combination of a wearable and a minimally invasive device. Our solution works by detecting respiratory failure via a wearable sensor, which triggers a drug-delivery device that has been placed beneath the skin and can release naloxone within 10 seconds. The sensor detects an electrocardiogram reading and converts it into respiratory information. When the respiration rate dips below a certain threshold, it activates a portable device that applies a high-frequency magnetic field over the implanted capsule. The capsule contains a heating element that heats a temperature-sensitive valve; at 42°C, it melts the valve and releases the naloxone.
This immediate and automatic administration of the drug will give emergency services technicians more time before the patient relapses, allowing them to get medical attention. The dosage is also larger than that contained within other naloxone products on the market, increasing its effectiveness in staving off relapse. We anticipate it will be less costly to manufacture — vital, as the CDC reports that prescriptions for naloxone have doubled from 2017 to 2018.
We also want to embed communications capability within the wearable to save more time by automatically alerting emergency services of an overdose. We continue to evaluate the system in testing and have launched a company called Rescue Biomedical to further develop and launch our device.
Hyowon “Hugh” Lee
Assistant Professor of Biomedical Engineering
Purdue University College of Engineering