A few people have asked me about yesterday’s post. What’s the idea? I intentionally didn’t include it then for two reasons. First, it wasn’t the point of the post. Second, I was still personally considering how to bring it to market. Last night, however, I considered something Elon Musk said in a recent interview with Stephen Colbert. For those who don’t know, Elon is a founder of Paypal, SpaceX, Tesla Motors, and Solar City. If you don’t know those companies, I suggest you look them up, and discover why I consider Elon one of the greatest visionaries of our generation. During the conversation with Stephen, it was pointed out that Tesla Motors recently released their key patents for open use to anyone who wanted them. When asked, “Why?” Elon’s response was priceless. I’m paraphrasing, “It seems to be that we’re all on the same sinking ship, and we’re vigorously bailing out water. Now if I have a design for a better bucket, isn’t it my responsibility to share it with everyone?”
So with that in mind. Here’s the idea.
First the problem. According to the CDC, “113 people die (daily) as a result of drug overdose, and another 6,748 are treated in emergency departments (ED) for the misuse or abuse of drugs.” It goes on to specifically to call out opioids (common pain killer Vicodin, Percocet, etc.) as the primary source of overdose deaths. “Of the 22,810 deaths relating to pharmaceutical overdose in 2011, 16,917 (74%) involved opioid analgesics.” Keep in mind these numbers don’t include those who die from heroin overdose, which is simply a more potent form of the same mechanism. Interestingly, there is a pretty straight forward diagnosis and treatment for opioid overdose. The treatment, naloxone, has been around for many years as a single injection to reverse the effects of opioids. In fact, a new device, Evzio, just earned fast-track FDA approval for treatment of opioid overdose. It functions with an auto-injector that you can stab in someone’s thigh when you believe they have OD’d. It’s a great product, and there’s a lot of discussion about making it available over the counter, so that more deaths can be prevented. It does have two fatal flaws. First, it requires someone to recognize that a drug overdose is taking place. Second, it requires a person to administer it. As you know, that’s often not the case. Just look at high profile celebrity deaths of Heath Ledger and Phillip Seymour Hoffman. They could have had 10 injectors in their possession. Without someone to recognize overdose and administer it, the device is useless.
Now we’re getting close to my idea. So, let’s talk about the first problem of Evzio. Diagnosis. There are different factors that can be used for opioid overdose diagnosis, but I’m proposing these three as sufficient. You’ll see why in a minute.
1. Exposure to opioid. Common sense, right? The person suffering the OD is aware before, during, and after the event they have been exposed to an opioid substance.
2. A resting respiration rate less than 8 breaths per minute. This is ultimately what kills in opioid overdose, and is the hallmark feature.
3. Impaired consciousness. For my device, I’m using the Pasereo Opioid-Induced Sedation Scale (POSS). There are others, but I chose this one and you’ll see why soon. For information on the different scales you can look HERE.
So, how do we make diagnosis easy? We can automate the whole thing. Here’s how:
1. Exposure to opioid. By applying the device and activating the accompanying phone app, the user has indicated they have been, or soon will be, exposed to opioid substances. That one is easy.
2. Resting rate. The non-app part of the device affixes to the skin, (you’ll see why in a second) and contains piezolectric sensor,s which can utilize the lung sounds to determine respiratory rate. This technology was validated by some researchers from Poland in 2008 and is available as a commercial product today.
3. Assessment on the POSS scale. This is accomplished by increasing alert levels of a smart phone. Level one is detected by response to a simple ping and vibration. Level 2 is indicated by response to a more consistent vibration and soft sound. Level 3 is indicated by a response to a consistent vibration and a loud alarm. Level 4 is indicated by no response.
There. Now we’ve detected a probable opioid overdose without a person’s intervention. So how do we stop it? Simple. The device, as I mentioned, is affixed to the persons skin. In addition to the piezoelectric sensors, it contains a self-administration set of naloxone. Again, this is not new technology. The best technology I can compare to is omnipod.
Here’s a photo of the device. It is for automated insulin delivery. It could simply be reconfigured for naloxone delivery. The device inserts a catheter into the skin and delivers the appropriate dose, all without human intervention. Configuring this to interact with the sensors and the app could present the solution to opioid overdose without a second person’s intervention.
There area few more tweaks I would propose to make this the ideal solution, but I’ll stop there because the post is already running long. I’d love to hear what you think.
P.S. I named the device ODefense. If someone else makes it, I’d appreciate the courtesy.