Dove: Shoulder-Based Opioid Overdose Detection and Reversal Device

Naloxone is a life-saving drug capable of reversing a fatal opioid overdose. Although this drug has existed for over 50 years, opioid overdose-related deaths have consistently risen and surpassed 120,000 globally in 2021. Opioids induce respiratory depression by activating $\mu\text{-opioid}$ receptors at specific sites in the central nervous system. This results in overdose deaths caused by slow and shallow breathing, also known as opioid-induced respiratory depression. 1.6 million individuals suffer from opioid use disorder annually, making them at high risk of overdose, primarily due to the increasing prevalence of Fentanyl. Over 52% of these deaths occur when the individual is alone. Immediate response to an overdose by delivering naloxone can save the individual's life. To solve this problem, we developed a closed-loop sensor-driven auto-injector that can determine a fatal overdose and inject naloxone. 76% of this population is willing to wear such a device on the shoulder, a canonical injection site. This paper presents the DOVE, a shoulder-based opioid overdose detection and reversal device. It noninvasively measures the subject's motion state and changes in blood oxygen levels (SpO2) along with the respiration state. These biomarkers are measured from the shoulder using an optical sensor and accelerometer to determine if a fatal overdose occurred. We evaluated our DOVE device against an FDA-cleared commercial pulse oximeter by inducing apneic events as they have very similar SpO2 trends to an overdose. Results show that SpO2 can be measured on the shoulder across different skin tones with an accuracy of 96.8% and a high Pearson correlation of 0.766 (p < 0.0001).