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 (SpO
2
) 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 SpO
2
trends to an overdose. Results show that SpO
2
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).