Real-Time Mobile Detection of Drug Use with Wearable Biosensors: A Pilot Study

Abstract

While reliable detection of illicit drug use is paramount to the field of addiction, current methods involving selfreport and urine drug screens have substantial limitations that hinder their utility. Wearable biosensors may fill a void by providing valuable objective data regarding the timing and contexts of drug use. This is a preliminary observational study of four emergency department patients receiving parenteral opioids and one individual using cocaine in a natural environment. A portable biosensor was placed on the inner wrist of each subject, to continuously measure electrodermal activity (EDA), skin temperature, and acceleration. Data were continuously recorded for at least 5 min prior to drug administration, during administration, and for at least 30 min afterward. Overall trends in biophysiometric parameters were assessed. Injection of opioids and cocaine use were associated with rises in EDA. Cocaine injection was also associated with a decrease in skin temperature. Opioid tolerance appeared to be associated with a blunted physiologic response as measured by the biosensor. Laterality may be an important factor, as magnitude of response varied between dominant and nondominant wrists in a single patient with bilateral wrist measurements. Changes in EDA and skin temperature are temporally associated with intravenous administration of opioids and cocaine; the intensity of response, however, may vary depending on history and extent of prior use.

Wearable Biosensors to Detect Physiologic Change During Opioid Use

“…Non-invasive, wearable devices are rapidly becoming popular due to commercially available versions marketed as health tracking tools [20,21]. Various patient populations have reported the devices as acceptable for wear in both controlled and natural environments, further supporting their feasibility for use in outpatient therapy [8,22]. The sensors are small and user friendly and provide continuous data streams that can be stored for retrieval and review at a later time point or transmitted wirelessly for real-time review and analysis.…”

Wearable Devices and Biosensing: Future Frontiers

“…From rolodexes and telephones to head mounted computers, advanced biosensing, and ingestible sensors, toxicologists have always been pioneers leveraging advanced technologies to solve problems [1,2]. As smartphones, fitness monitors, and connected devices become ubiquitous, toxicologists are naturally equipped with advanced tools that augment our bedside exam of poisoned patients.A new generation of toxicologists continually pushes the boundaries of technology in an effort to facilitate improved patient care and access to our expertise [1][2][3][4][5]. Head-mounted wearable computers can provide a toxicologist with a firstperson view of a poisoned patient, while a wrist-mounted sensor can stream key biometric data (e.g., heart rate, respiratory rate, skin temperature, and electrodermal activity).…”

“…Head-mounted wearable computers can provide a toxicologist with a firstperson view of a poisoned patient, while a wrist-mounted sensor can stream key biometric data (e.g., heart rate, respiratory rate, skin temperature, and electrodermal activity). Ingestible biosensors can provide historical records of medication ingestion, and linked webcams can stream toxicology lectures to centers seeking expertise on the poisoned patient [2][3][4]6].In an era of integrated care and bundled payments, toxicologists and fellows in training have a unique opportunity to develop novel technology-based methods that respond to a need in our specialty. Creating novel applications using everyday technology requires a contemporary approach-integration of patients, physicians, engineers, and software developers into a multidisciplinary research team.…”

“…Integration of a suite of devices can provide a comprehensive profile of the poisoned patient which, when evaluated remotely, provides increased precision and effectiveness of toxicologists [8]. Changes in heart rate using a wearable biosensor in a patient at a critical access hospital may signal worsening calcium channel blocker toxicity; a wearable camera may help a toxicologist guide the bedside clinician in the administration of physostigmine for the anticholinergic patient, and the virtual assessment of an altered patient can change a toxicologist's recommendation to triage a patient to an inpatient bed or emergency department observation period [3].Much like endocrinologists use insulin pump data in diabetics, toxicologists who practice substance abuse treatment can use biosensor data to discover episodes of relapse and tolerance [4,9]. Advanced algorithms and improving technology can provide a noninvasive, yet accurate understanding of real-time substance abuse and relapse.…”

“…A new generation of toxicologists continually pushes the boundaries of technology in an effort to facilitate improved patient care and access to our expertise [1][2][3][4][5]. Head-mounted wearable computers can provide a toxicologist with a firstperson view of a poisoned patient, while a wrist-mounted sensor can stream key biometric data (e.g., heart rate, respiratory rate, skin temperature, and electrodermal activity).…”