iMStrong: Deployment of a Biosensor System to Detect Cocaine Use

Abstract

Biosensor systems are increasingly promoted for use in behavioral interventions. Portable biosensors might offer advancement over self-report use and can provide improved opportunity for detection and intervention in patients undergoing drug treatment programs. Fifteen participants wore a biosensor wristband capable of detecting multiple physiologic markers of sympathetic nervous system (SNS) arousal for 30 days. Urine drug screening and drug use self-report were obtained twice per week. A parameter trajectory description method was applied to capture abrupt changes in magnitude of three measures of SNS activity: Electrodermal activity (EDA), skin temperature and motion. Drug use events detected by the biosensor were verified using a triad of parameters: the biosensor data, urine drug screens, and patient self-report of substance use. Twelve positive cocaine urine screens were identified. Thirteen self-reported episodes of cocaine use were recorded. Distinct episodes with biometric parameters consistent with cocaine use were identified on biosensor data. Eleven potential cocaine use episodes were identified by biosensors that were missed by both self-report and drug screening. Study participants found mobile biosensors to be acceptable, and compliance with the protocol was high. Episodes of cocaine use, as measured by supraphysiologic changes in biophysiometric parameters, were detected by analysis of biosensor data in instances when self-report or drug screening or both failed. Biosensors have substantial potential in detecting substance abuse, in understanding the context of use in real time, and in evaluating the efficacy of behavioral interventions for drug abuse.

Wearable Biosensors to Detect Physiologic Change During Opioid Use

“…Similar devices have been utilized to monitor multiple physiologic and pathophysiologic conditions known to involve robust SNS changes such as stress, post-traumatic stress disorder (PTSD), and epilepsy [6][7][8]. They have also been applied to compliance monitoring for drug adherence and suicide risk [9,10] and are able to detect cocaine use in natural environments [11].…”

Wearable Devices and Biosensing: Future Frontiers

“…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.…”

“…As bedside diagnosticians who care for a wide variety of patients in person and remotely, our experience evaluating biosensor data can improve our ability to care for our patients, anticipate adverse events, and monitor medication safety [3,4,6,9]. Capitalizing on these experiences provides a good opportunity for research evaluating and helping to develop new devices.…”

“…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.…”

“…Advanced algorithms and improving technology can provide a noninvasive, yet accurate understanding of real-time substance abuse and relapse. This knowledge may help toxicologists tailor substance abuse counseling, by understanding real-time triggers of tolerance, addiction, sobriety, and relapse [9]. …”