App could save lives of those who OD alone

It mon­i­tors move­ment and breath­ing pat­terns

The Day - - FRONT PAGE - By LIND­SAY BOYLE Day Staff Writer

Re­searchers at the Univer­sity of Wash­ing­ton in Seat­tle have de­vel­oped a smart­phone app that can de­tect opi­oid over­dose and could save the lives of those who use alone.

Called Sec­ond Chance, the app sends in­audi­ble sound waves from the phone to a per­son’s chest to sense breath­ing pat­terns. When a per­son is tak­ing seven or fewer breaths per minute — a rate that com­monly leads to bed­side vis­its in hos­pi­tals — the app is trig­gered.

Re­searchers said the app still is be­ing tweaked, but the goal is for it to then ask whether a per­son is OK. Ab­sent a re­sponse, the app will in­struct the phone to ei­ther call 911 or the emer­gency con­tact of a per­son’s choice.

“Our vi­sion is that peo­ple, if they’re go­ing to use, should use in the safest man­ner pos­si­ble,” said co-cor­re­spond­ing au­thor Dr. Ja­cob Sun­shine, an as­sis­tant pro­fes­sor of anes­the­si­ol­ogy and pain medicine in the School of Medicine. “A lot who end up dy­ing are us­ing alone. This is to help par­tic­u­larly those peo­ple, but could also be use­ful for peo­ple us­ing with oth­ers as well.”

The Cen­ters for Dis­ease Con­trol and Pre­ven­tion said 70,237 peo­ple died by over­dose in 2017. About 47,600 of them had at least one opi­oid in their sys­tem.

Rajalakshmi Nan­daku­mar, a doc­toral stu­dent in UW’s Allen School who took the lead in de­vel­op­ing the app, said re­searchers chose to har­ness sound waves be­cause they’re so widely avail­able.

“The speak­ers and mi­cro­phones present in off-the-shelf de­vices … can de­tect even minute mo­tion,” she said. “One of the is­sues with new hard­ware is get­ting peo­ple to adopt it. If you use ex­ist­ing de­vices, it’s eas­ier.”

Sec­ond Chance, which works up to 3 feet away, also de­tects move­ment. Some­one who’s mov­ing likely hasn’t over­dosed, re­searchers said. The op­po­site is true for some­one whose head has slumped.

Nan­daku­mar trav­eled with some col­leagues to the In­site su­per­vised in­jec­tion fa­cil­ity in Van­cou­ver, Canada, to test the app.

Ninety-four peo­ple agreed to par­tic­i­pate, wear­ing mon­i­tors on their chests as they pre­pared their drugs and for five min­utes after­ward — the win­dow when over­dose symp­toms typ­i­cally oc­cur.

Of the par­tic­i­pants, 47 took seven or fewer breaths per minute, 49 stopped breath­ing, and two re­quired oxy­gen, ven­ti­la­tion and/or nalox­one, an over­dose-re­ver­sal drug. The app cor­rectly iden­ti­fied their breath rates 90 per­cent of the time, re­searchers said.

Nan­daku­mar said the par­tic­i­pants, once they un­der­stood the app used sonar rather than a cam­era, didn’t have pri­vacy con­cerns.

“In gen­eral, peo­ple at the in­jec­tion site were re­ally ex­cited and sup­port­ive of our app,” she said. “They were asked sep­a­rately if they would use it when it’s avail­able and most were in­ter­ested.”

“If you look at ad­dic­tion as a med­i­cal is­sue, these peo­ple gen­er­ally want help — they come to safe in­jec­tion sites be­cause they can en­gage in med­i­cal su­per­vi­sion,” Nan­daku­mar said. “The United States doesn’t have any such fa­cil­ity cur­rently … but this app could pro­vide sim­i­lar pro­tec­tion.”

Nan­daku­mar and Sun­shine said they’re work­ing with a Cal­i­for­nia group to get ap­proval from the U.S. Food and Drug Ad­min­is­tra­tion. They aren’t sure when that may hap­pen but are hop­ing their ap­pli­ca­tion will be ex­pe­dited be­cause of the se­ri­ous­ness of the opi­oid epi­demic.

Re­searchers said the app, while it only has been tested on those who in­ject, likely can be used for all forms of opi­oid use.

Sun­shine said re­searchers, whose work was funded by the UW Al­co­hol and Drug Abuse In­sti­tute and the Na­tional Sci­ence Foun­da­tion, haven’t tested whether the app de­tects slowed breath­ing faster than a per­son could.

“But as a clin­i­cian I can tell you … it’s not as straight­for­ward as you might think,” he said. “There’s lit­er­a­ture on this that fea­tures med­i­cal staff of var­i­ous lev­els of train­ing try­ing to es­ti­mate the rate and, com­pared to a mon­i­tor, the per­for­mance is not as good as you might think.”

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