This App Tracks Breathing to Identify Opioid Overdoses Before They Turn Deadly

Every day, opioid overdoses claim the lives of some 115 to 130 Americans. But the majority of these deaths could be prevented if victims received treatment—namely a rapid reversal agent called naloxone—in time. Now, Second Chance, a new app developed by researchers at the University of Washington, aims to capitalize on this life-saving medication by connecting opioid users with emergency personnel or friends and family before overdoses pass the point of no return.

As Maria Temming reports for Science News, the app, recently detailed in Science Translational Medicine, transforms users’ smartphones into sonar systems, drawing on devices’ speakers and microphones to emit sound waves that bounce off of a potential victim’s chest. If sensors detect key signs of an impending overdose—including slow breathing or no breathing whatsoever—Second Chance then alerts relevant emergency contacts.

Currently, the technology is still in experimental stages. But initial testing has yielded positive results: According to Dennis Thompson of U.S. News & World Report, the team conducted trial research at Insite, a supervised injection facility in Vancouver where drug users are monitored by medical professionals equipped to perform overdose intervention.

Of 94 test participants who agreed to inject opioids while the app was tracking their movements, 47 reached “dangerously low” breathing levels of seven or fewer breaths per minute, while 49 completely stopped breathing for a significant period of time. Two overdosed to such an extent that they required oxygen, ventilation and/or naloxone reversal treatment. Overall, Second Chance correctly identified breathing patterns indicative of overdose 90 percent of the time.

Next, the researchers coordinated with anesthesiologists at the University of Washington’s Medical Center to test the app’s response to actual overdose events. As senior researcher Jacob Sunshine, a University of Washington anesthesiologist, tells CNBC’s Barbara Booth, individuals under anesthesia experience “much of the same physiology” as those experiencing overdoses.

“Nothing happens when people experience this event in the operating room, because they're receiving oxygen and they are under the care of an anesthesiology team,” Sunshine says. “But this is a unique environment to capture difficult-to-reproduce data to help further refine the algorithms for what it looks like when someone has an acute overdose."

Sunshine and his colleagues tracked patients’ breathing upon administration of standard anesthetics. When the medication triggered 30 seconds of slower or absent breathing, the app equated this signal with an overdose. Of 20 simulated scenarios, Second Chance’s algorithm performed correctly in all but one case—according to Booth, this instance involved a patient whose breathing rate was just above the app’s threshold.

In addition to measuring breath patterns, Second Chance is capable of tracking small movements such as a slumping head. This allows the app to gain a clearer portrait of a user’s current state.

“People aren't always perfectly still while they're injecting drugs, so we want to still be able to track their breathing as they're moving around,” lead author Rajalakshmi Nandakumar notes in a press release. “We can also look for characteristic motions during opioid overdose, like if someone's head slumps or nods off."

The app, which can track users’ breathing from up to 3 feet away, could function in a number of ways: If it detects slowed or stopped breathing, U.S. News & World Report’s Thompson writes, it will sound an alarm that asks the user to signal whether they’re in need of assistance. If an individual “stops” the alarm, the app won’t take further action, but if they fail to do so, it will contact either a loved one with access to naloxone or emergency services.

Although the app remains in early stages, Kristin House of Futurism points out that it remains uncertain whether opioid users will even be willing to use it. As House asks, “Would someone injecting opioids ... download an app that would link them to illegal activity, even if it might save their life?”

Study author Nandakumar believes the answer is yes. Speaking with MIT Technology Review’s Charlotte Jee, he explains that Second Chance has proven popular with drug users in follow-up studies because it doesn’t require camera access or stored recordings.

“The vast majority of people we ask want to use it,” Nandakumar adds. “Do they engage in high-risk behavior? Yes. But they want to do it in a safe manner.”

Meilan Solly | | READ MORE

Meilan Solly is Smithsonian magazine's associate digital editor, history.