Digital biomarker applications across the spectrum of opioid use disorder

ABSTRACT

Opioid use disorder (OUD) is one of the most pressing public health problems of the past decade, with over eighty thousand overdose-related deaths in 2021 alone. Digital technologies to measure and respond to disease states encompass both on- and off-body sensors. Such devices can be used to detect and monitor end-user physiologic or behavioral measurements (i.e. digital biomarkers) that correlate with events of interest, health or pathology. Recent work has demonstrated the potential of digital biomarkers to be used as a tools in the prevention, risk mitigation and treatment of OUD. Multiple physiologic adaptations occur over the course of opioid use and represent potential targets for digital biomarker-based monitoring strategies. This review explores the current evidence (and potential) for digital biomarkers monitoring across the spectrum of opioid use. Technologies to detect opioid administration, withdrawal, hyperalgesia and overdose will be reviewed. Driven by empirically-derived algorithms, these technologies have important implications for supporting the safe prescribing of opioids, reducing harm in active opioid users and supporting those in recovery from OUD.

KEYWORDS:

• opioid use disorder
• addiction
• digital biomarker
• wearable sensors
• opioid withdrawal

Abbreviations

AUC, Area Under the Curve; DSM, Diagnostic and Statistical Manual of Mental Disorders; apps, (mobile) applications; ED, Emergency Department; HER: Electronic health record; HIV, Human Immunodeficiency Virus; JITA, Just-in-time Adaptive Interventions; IV, Intravenous; mHealth, mobile Health; NIH, National Institutes of Health; NIDA, National Institute on Drug Abuse; NMDA, N-methyl-D-aspartate; OIH, Opioid-induced Hyperalgesia; OUD, Opioid Use Disorder; QST, quantitative sensory testing; ROC, Receiver Operator Characteristic; RFID, Radiofrequency identification; US, United States

Acknowledgments

Dr. Carreiro is funded by National Institutes of Health(NIH)/National Institute on Drug (NIDA, K23DA045242). Dr Chai is funded by NIH/NIDA(K23DA044874).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Funding

The work was supported by the National Institutes of Health [K23DA044874] and [K23DA044874].

Data sharing statement

Data sharing is not applicable to this article as no new data were created or analyzed in this study.