An Implanted Sensor May Reverse Opioid Overdoses
In 2023, more than 100,000 Americans perished as a result of opioid overdoses. The most effective technique to save someone who has overdosed is to inject naloxone; however, a first responder or witness may not be able to reach the individual in time.
Researchers at MIT and Brigham and Women’s Hospital have created a novel device that they think will help minimize these delays and perhaps save the lives of overdose victims. The device, approximately the size of a stick of gum, can be implanted beneath the skin to monitor heart rate, breathing rate, and other vital indications. When it detects an overdose, it quickly administers Naloxone.
In a study published today in the journal Gadget, researchers demonstrated that the gadget can successfully reverse overdoses in animals. With further study, the researchers hope that this strategy will provide a new alternative for preventing overdose deaths in high-risk individuals, such as those who have previously survived an overdose.
“This could really address a significant unmet need in the population that suffers from substance abuse and opiate dependency to help mitigate overdoses, with the initial focus on the high-risk population,” says Giovanni Traverso, an associate professor of mechanical engineering at MIT, a gastroenterologist at Brigham and Women’s Hospital, and the senior author of the study.
The paper’s lead authors are Hen-Wei Huang, a former MIT visiting scientist and currently an assistant professor of electrical and electronic engineering at Nanyang Technological University in Singapore; Peter Chai, an associate professor of emergency medicine physician at Brigham and Women’s Hospital; SeungHo Lee, a research scientist at MIT’s Koch Institute for Integrative Cancer Research; and Tom Kerssemakers and Ali Imani, former master’s students at Brigham
An implanted device
Naloxone is an opioid antagonist, which means it can bind to opioid receptors and inhibit the effects of other opioids like heroin and fentanyl. The medicine, which can be provided via injection or nasal spray, can restore normal breathing within a few minutes.
However, many victims overdose alone, and they may not obtain help in time to save their lives. Furthermore, with a new wave of synthetic, more potent opioids sweeping the United States, opioid overdoses can occur more quickly and unexpectedly. To address this, several researchers are developing wearable devices that can detect an overdose and dispense naloxone, but none of them have yet been successful. The MIT/BWH team set out to create an implanted device that is less bulky, delivers naloxone directly into the subcutaneous tissue, and eliminates the need for the patient to remember to wear it.
The researchers developed a gadget with sensors that can measure heart rate, breathing rate, blood pressure, and oxygen saturation. In an animal study, the researchers utilized the sensors to analyze all of these signals and see how they changed following a fentanyl overdose. This resulted in a novel algorithm that improves the device’s sensitivity for accurately detecting opioid overdose and distinguishing it from other conditions when breathing is reduced, such as sleep apnea.
This study found that fentanyl causes a reduction in heart rate, followed by a slowing of breathing. By analyzing how these signals altered, the researchers were able to determine when naloxone should be administered.
“The most challenging aspect of developing an engineering solution to prevent overdose mortality is simultaneously addressing patient adherence and willingness to adopt new technology, combating stigma, minimizing false positive detections, and ensuring the rapid delivery of antidotes,” according to Huang. “Our proposed solution tackles these unmet needs by developing a miniaturized robotic implant equipped with multisensing modalities, continuous monitoring capabilities, on-board decision-making, and an innovative micropumping mechanism.”
The device also has a small reservoir that holds up to 10 milligrams of naloxone. When an overdose is detected, a pump is activated, releasing the naloxone within roughly 10 seconds.
In animal trials, the researchers discovered that administering this medicine could reverse the symptoms of an overdose 96% of the time.
“We designed a closed-loop system that can identify the onset of the opiate overdose and then release the antidote, and then you see that recovery,” Traverso explains.”
Preventing Overdoses
The researchers hope that this technology can be used to assist patients who are at the highest risk of overdose, beginning with those who have previously overdosed. They now intend to research ways to make the device as user-friendly as feasible, including variables such as the best placement for implantation.
“Providing naloxone to people at critical moments of risk is an important component of combating the opioid epidemic. Our objective for this device is for it to be integrated into the cascade of harm-reduction methods to rapidly and safely dispense naloxone, reducing opioid overdose deaths and offering the opportunity to support patients with opioid use disorder,” says Chai.
The researchers intend to test the device on humans in the next three to five years. They are currently working on further miniaturizing the gadget and optimizing the on-board battery, which can give power for up to two weeks.
Novo Nordisk, the McGraw Family Foundation at Brigham and Women’s Hospital, and the MIT Department of Mechanical Engineering all provided funding for the study.
