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Technology Development Initiative – Paper of the Month – April 2022

Nalaxone injector system

Nalaxone injector system. Image copyright – Scientific Reports.

Closed-loop wearable naloxone injector system

Published in Scientific Reports.

Authors: Justin Chan, Vikram Iyer, Anran Wang, Alexander Lyness, Preetma Kooner, Jacob Sunshine & Shyamnath Gollakota

Paper presented by Dr. Albert Burgess-Hull and selected by the NIDA TDI Paper of the Month Committee

Summary

Opioid overdose deaths in the US are the highest they have ever been in history.  Although the opioid antagonist Naloxone can rapidly reverse an opioid overdose, a bystander/partner still needs to be present to administer the lifesaving drug.  Chan et al. (2021) have developed a wearable device to detect and reverse an opioid overdose by automatically injecting naloxone to a person who has stopped breathing and moving. The small device is worn on the stomach, much like an automated insulin pump. This proof-of-principal technology has wide-ranging clinical and commercial potential, including helping to reduce the number of fatal opioid overdoses that could have been prevented if naloxone was available.


Chan, Justin; Iyer, Vikram; Wang, Anran; Lyness, Alexander; Kooner, Preetma; Sunshine, Jacob; Gollakota, Shyamnath

Closed-loop wearable naloxone injector system Journal Article

In: Sci Rep, vol. 11, no. 1, pp. 22663, 2021, ISSN: 2045-2322.

Abstract | Links

@article{pmid34811425,
title = {Closed-loop wearable naloxone injector system},
author = {Justin Chan and Vikram Iyer and Anran Wang and Alexander Lyness and Preetma Kooner and Jacob Sunshine and Shyamnath Gollakota},
url = {https://pubmed.ncbi.nlm.nih.gov/34811425/},
doi = {10.1038/s41598-021-01990-0},
issn = {2045-2322},
year = {2021},
date = {2021-01-01},
urldate = {2021-01-01},
journal = {Sci Rep},
volume = {11},
number = {1},
pages = {22663},
abstract = {Overdoses from non-medical use of opioids can lead to hypoxemic/hypercarbic respiratory failure, cardiac arrest, and death when left untreated. Opioid toxicity is readily reversed with naloxone, a competitive antagonist that can restore respiration. However, there remains a critical need for technologies to administer naloxone in the event of unwitnessed overdose events. We report a closed-loop wearable injector system that measures respiration and apneic motion associated with an opioid overdose event using a pair of on-body accelerometers, and administers naloxone subcutaneously upon detection of an apnea. Our proof-of-concept system has been evaluated in two environments: (i) an approved supervised injection facility (SIF) where people self-inject opioids under medical supervision and (ii) a hospital environment where we simulate opioid-induced apneas in healthy participants. In the SIF (n = 25), our system identified breathing rate and post-injection respiratory depression accurately when compared to a respiratory belt. In the hospital, our algorithm identified simulated apneic events and successfully injected participants with 1.2 mg of naloxone. Naloxone delivery was verified by intravenous blood draw post-injection for all participants. A closed-loop naloxone injector system has the potential to complement existing evidence-based harm reduction strategies and, in the absence of bystanders, help make opioid toxicity events functionally witnessed and in turn more likely to be successfully resuscitated.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}

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Overdoses from non-medical use of opioids can lead to hypoxemic/hypercarbic respiratory failure, cardiac arrest, and death when left untreated. Opioid toxicity is readily reversed with naloxone, a competitive antagonist that can restore respiration. However, there remains a critical need for technologies to administer naloxone in the event of unwitnessed overdose events. We report a closed-loop wearable injector system that measures respiration and apneic motion associated with an opioid overdose event using a pair of on-body accelerometers, and administers naloxone subcutaneously upon detection of an apnea. Our proof-of-concept system has been evaluated in two environments: (i) an approved supervised injection facility (SIF) where people self-inject opioids under medical supervision and (ii) a hospital environment where we simulate opioid-induced apneas in healthy participants. In the SIF (n = 25), our system identified breathing rate and post-injection respiratory depression accurately when compared to a respiratory belt. In the hospital, our algorithm identified simulated apneic events and successfully injected participants with 1.2 mg of naloxone. Naloxone delivery was verified by intravenous blood draw post-injection for all participants. A closed-loop naloxone injector system has the potential to complement existing evidence-based harm reduction strategies and, in the absence of bystanders, help make opioid toxicity events functionally witnessed and in turn more likely to be successfully resuscitated.

Close

  • https://pubmed.ncbi.nlm.nih.gov/34811425/
  • doi:10.1038/s41598-021-01990-0

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