Opioid analgesic use is a major cause of morbidity and mortality in the US, yet effective treatment programs have a limited ability to detect relapse. The utility of current drug detection methods is often restricted due to their retrospective and subjective nature. Wearable biosensors have the potential to improve detection of relapse by providing objective, real time physiologic data on opioid use that can be used by treating clinicians to augment behavioral interventions.
Thirty emergency department (ED) patients who were prescribed intravenous opioid medication for acute pain were recruited to wear a wristband biosensor. The biosensor measured electrodermal activity, skin temperature and locomotion data, which was recorded before and after intravenous opioid administration. Hilbert transform analyses combined with paired t-tests were used to compare the biosensor data A) within subjects, before and after administration of opioids; B) between subjects, based on hand dominance, gender, and opioid use history.
Within subjects, a significant decrease in locomotion and increase in skin temperature were consistently detected by the biosensors after opioid administration. A significant change in electrodermal activity was not consistently detected. Between subjects, biometric changes varied with level of opioid use history (heavy vs. nonheavy users), but did not vary with gender or type of opioid. Specifically, heavy users demonstrated a greater decrease in short amplitude movements (i.e. fidgeting movements) compared to non-heavy users.
A wearable biosensor showed a consistent physiologic pattern after ED opioid administration and differences between patterns of heavy and non-heavy opioid users were noted. Potential applications of biosensors to drug addiction treatment and pain management should be studied further.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price includes VAT (USA)
Tax calculation will be finalised during checkout.
Center for Disease Control and Prevention. (Last updated January 9, 2015). Prescription overdose in the United States: fact sheet. Retrieved 14 Jan 2015 from http://www.cdc.gov/homeabdrecreationalsafety/overdose/facts.html (2015).
Fletcher R, Tam S, Omojola O, Redemske R, Kwan J. Wearable sensor platform and mobile application for use in cognitive behavioral therapy for drug addiction and PTSD. Conf Proc IEEE Eng Med Biol Soc. 2011;1802–5. doi:10.1109/IEMBS.2011.6090513.
Services DOHH. Addressing prescription drug abuse in the United States. 2014, p. 1–36.
Principles of Drug Addiction Treatment [Internet]. 2012. 44 p. Available from: http://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment
Fishman SM, Wilsey B, Yang J, Reisfield GM. Adherence monitoring and drug surveillance in chronic opioid therapy. J Pain Symptom Manag. 2000;20(4):293–307.
Poh M-Z, Swenson NC, Picard RW. A wearable sensor for unobtrusive, long-term assessment of electrodermal activity. IEEE Trans Biomed Eng. 2010;57(5):1243–52.
Fletcher R, Tam S, Omojola O, Redemske R, Kwan J. Wearable sensor platform and mobile application for use in cognitive behavioral therapy for drug addiction and PTSD. 2011, p. 1–4.
Boyer EW, Fletcher R, Fay RJ, Smelson D, Ziedonis D, Picard RW. Preliminary efforts directed toward the detection of craving of illicit substances: the iHeal project. J Med Toxicol. 2012;8(1):5–9.
Boyer EW, Smelson D, Fletcher R, Ziedonis D, Picard RW. Wireless technologies, ubiquitous computing and mobile health: application to drug abuse treatment and compliance with HIV therapies. J Med Toxicol. 2010;6(2):212–6.
Indic P, Murray G, Maggini C, Amore M, Meschi T, Borghi L, et al. Multi-scale motility amplitude associated with suicidal thoughts in major depression. de Erausquin GA, editor. PLoS ONE. 2012;7(6):e38761.
Carreiro S, Fang H, Zhang J, Wittbold K, Weng S, Mullins R, et al. iMStrong: deployment of a Biosensor System to Detect Cocaine Use. J Med Syst. 2015.
Hahn S. “The instantaneous complex phase and complex frequency” in Hilbert transforms in signal processing. Boston, MA: Arthech House; 1996. p. 48.
Johnson NL, Kotz S, Balakrishnan N. “Order statistics” in continuous univariate distributions. 2nd ed. Wiley series in probability and statistics. New York, NY: Wiley and Sons; 1994. p 10.
Johnston DW, Nicholls MER, Shah M, Shields MA. Nature’s experiment? Handedness and early childhood development. Demography. 2009;46(2):281–301.
Center for Substance Abuse Treatment. Appendix B Assessment and Screening Instruments. Rockville, MD: Substance Abuse and Mental Health Services Administration (US); 2004. Available from: http://www.ncbi.nlm.nih.gov/books/NBK64244/
Jang E-H, Park B-J, Park M-S, Kim S-H, Sohn J-H. Analysis of physiological signals for recognition of boredom, pain, and surprise emotions. J Phys Anthropol. 2015;34:25.
Kyle BN, McNeil DW. Autonomic arousal and experimentally induced pain: a critical review of the literature. Pain Res Manag. 2014;19(3):159–67.
Hwang SH, Seo S, Yoon HN, Jung, DW, Baek, HJ, Cho, J, et al. Sleep period time estimation based on electrodermal activity. IEEE J Biomed Health Inform. 2015. doi:10.1109/JBHI.2015.2490480.
Sano A, Picard RW, Stickgold R. Quantitative analysis of wrist electrodermal activity during sleep. Int J Psychophysiol. 2014;94(3):382–9.
Fiordelli M, Diviani N, Schulz PJ. Mapping mHealth research: a decade of evolution. J Med Internet Res. JMIR Publications Inc., Toronto, Canada2013;15(5):e95.
Steinhubl SR, Muse ED, Topol EJ. The emerging field of mobile health. Sci Transl Med. Am Assoc Adv Sci. 2015;7(283):283rv3–283rv3.
Carreiro S, Smelson D, Ranney M, Horvath KJ, Picard RW, Boudreaux ED, et al. Real-time mobile detection of drug use with wearable biosensors: a pilot study. J Med Toxicol. 2014;11(1):1–7.
This work was generously supported by NIH National Institute on Drug Abuse grant R01DA033769-01 (EWB), the NIH National Institute on Drug Abuse Loan Repayment Program L30 DA038357 (SC), and partly supported by NIH National Institute on Drug Abuse grant 1R01DA033323-01 (JF) and NIH National Center for Advancing Translational Sciences 5UL1TR000161-04 pilot study award (UMass CTCS).
NIH NIDA R01DA033769-01, L30 DA038357, NIH NIDA 1R01DA033323-01, and NIH NCATS 5UL1TR000161-04.
Conflicts of Interest
The authors have no conflicts to disclose.
About this article
Cite this article
Carreiro, S., Wittbold, K., Indic, P. et al. Wearable Biosensors to Detect Physiologic Change During Opioid Use. J. Med. Toxicol. 12, 255–262 (2016). https://doi.org/10.1007/s13181-016-0557-5
- Signal Processing