{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T21:35:59Z","timestamp":1788816959534,"version":"build-2803163510"},"reference-count":48,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n For over a decade, drug overdose has been the leading cause of injury and accidental death in the United States. Most fatal overdoses involve opioids and occur during solitary drug use events when no one is available to initiate lifesaving responses (eg, naloxone). While there is a growing interest in devices providing early overdose detection and automated responses, little research has engaged end users in a device design process.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to describe user experience, perceived harms and benefits, and the acceptability of a shoulder-mounted wearable sensor among people who inject drugs who wore a device prototype for 7 days and to explore real-time responses that could be incorporated into a next-generation sensor.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Individuals aged \u226518 years reporting past week injection drug use were recruited from a walk-in substance use disorder clinic in Camden, New Jersey. Participants completed a brief survey assessing sociodemographics and recent drug use and were assigned a sensor prototype that they were asked to wear near-continuously for 7 days. At endline, they completed semistructured interviews exploring acceptability, usability, and form and function preferences for next-generation devices with integrated automated response options. Structured field notes and transcripts were analyzed to identify key themes and design considerations.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Participants (n=23) had a median age of 41 years. Most were primarily non-Hispanic White (65%) males (61%), experiencing homelessness (57%) who reported daily injection drug use (74%) within 3 months and receipt of opioid use disorder medication within a month (74%). A total of 16 people completed an exit interview. They found the concept of a shoulder-mounted overdose detection device acceptable and unanimously endorsed the need for long-lasting discreet devices. They emphasized the importance of having multiple response options that wearers could tailor to their individual circumstances and preferences, noting some might prefer an automatic call to emergency services, while others might prefer to alert a peer. Participants expressed a preference for solutions that alert first responders over automated biomedical solutions, such as naloxone injection, because of concerns about device error (eg, false positives) leading to precipitated withdrawal.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n After wearing a shoulder-mounted prototype, this small group of participants found the idea acceptable and provided feedback to improve usability and design. Data suggest that a variety of devices with differing functions, sizes, and capacities will be needed to meet user needs and increase the likelihood of adoption once devices come to market.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/73566","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T05:00:59Z","timestamp":1747717259000},"page":"e73566-e73566","source":"Crossref","is-referenced-by-count":2,"title":["Use of a Shoulder-Mounted Wearable Sensor Prototype Designed to Detect Opioid-Related Overdose: A Qualitative User Experience Study"],"prefix":"10.2196","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7884-6901","authenticated-orcid":false,"given":"Alexis M","family":"Roth","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1477-6364","authenticated-orcid":false,"given":"Ally K","family":"D'Angelo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9557-7405","authenticated-orcid":false,"given":"David","family":"Gordon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2982-8456","authenticated-orcid":false,"given":"Benjamin","family":"Cocchiaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8438-6104","authenticated-orcid":false,"given":"Anush","family":"Lingamoorthy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2026-6796","authenticated-orcid":false,"given":"Rose","family":"Laurano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8277-4928","authenticated-orcid":false,"given":"Matthew","family":"Salzman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8437-0161","authenticated-orcid":false,"given":"Jacob S","family":"Brenner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0124-1415","authenticated-orcid":false,"given":"Cameron","family":"Baston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,7,28]]},"reference":[{"key":"R1","unstructured":"Ahmad FB Cisewski JA Rossen LM Sutton P , National Center for Health Statistics. Provisional drug overdose death counts. 2025. URL: https:\/\/www.cdc.gov\/nchs\/nvss\/vsrr\/drug-overdose-data.htm [Accessed 15-01-2025]"},{"issue":"50","key":"R2","doi-asserted-by":"publisher","first-page":"1740","DOI":"10.15585\/mmwr.mm7050e3","article-title":"Trends in and characteristics of drug overdose deaths involving illicitly manufactured fentanyls - United States, 2019-2020","volume":"70","author":"O\u2019Donnell","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"6","key":"R3","doi-asserted-by":"publisher","first-page":"L930","DOI":"10.1152\/ajplung.00251.2024","article-title":"Hypoxic effects of heroin and fentanyl and their basic physiological mechanisms","volume":"327","author":"Kiyatkin","journal-title":"Am J Physiol Lung Cell Mol Physiol"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.2147\/SAR.S101700","article-title":"Intranasal naloxone and related strategies for opioid overdose intervention by nonmedical personnel: a review","volume":"8","author":"Lewis","journal-title":"Subst Abuse Rehabil"},{"issue":"3","key":"R5","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1111\/add.14508","article-title":"Dying alone: the sad irrelevance of naloxone in the context of solitary opiate use","volume":"114","author":"Wojcicki","journal-title":"Addiction"},{"issue":"3","key":"R6","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1080\/10826084.2023.2280534","article-title":"The need to rethink harm reduction for people using drugs alone to reduce overdose fatalities","volume":"59","author":"Deo","journal-title":"Subst Use Misuse"},{"key":"R7","unstructured":"Illicit drug overdose deaths in BC: findings of coroners\u2019 investigations. British Columbia Coroners Service. Ministry of Public Safety and Solicitor General; 2019. URL: https:\/\/tinyurl.com\/yc85bdan [Accessed 19-06-2025]"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.108838","article-title":"Neurocognitive impairments and brain abnormalities resulting from opioid-related overdoses: A systematic review","volume":"226","author":"Winstanley","journal-title":"Drug Alcohol Depend"},{"issue":"26","key":"R9","doi-asserted-by":"publisher","first-page":"721","DOI":"10.15585\/mmwr.mm7226a4","article-title":"Illicitly manufactured fentanyl-involved overdose deaths with detected xylazine - United States, January 2019-June 2022","volume":"72","author":"Kariisa","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"R10","unstructured":"Drug checking \u2013 quarterly report (Q1 and Q2 2023). Center for Forensic Science Research and Education. 2023. URL: https:\/\/tinyurl.com\/ma4n6tzv [Accessed 19-06-2025]"},{"issue":"30","key":"R11","doi-asserted-by":"publisher","first-page":"672","DOI":"10.15585\/mmwr.mm7330a3","article-title":"Notes from thefield: detection of medetomidine among patients evaluated in emergency departments for suspected opioid overdoses - Missouri, Colorado, and Pennsylvania, September 2020-December 2023","volume":"73","author":"Schwarz","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"15","key":"R12","doi-asserted-by":"publisher","first-page":"266","DOI":"10.15585\/mmwr.mm7415a2","article-title":"Notes from the Field: Suspected Medetomidine Withdrawal Syndrome Among Fentanyl-Exposed Patients - Philadelphia, Pennsylvania, September 2024-January 2025","volume":"74","author":"Huo","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2023.1280289","article-title":"\u201cTranq-dope\u201d overdose and mortality: lethality induced by fentanyl and xylazine","volume":"14","author":"Smith","journal-title":"Front Pharmacol"},{"issue":"6","key":"R14","doi-asserted-by":"publisher","first-page":"1501","DOI":"10.1111\/jcpt.13462","article-title":"Overdoses due to fentanyl and its analogues (F\/FAs) push naloxone to the limit","volume":"46","author":"Pergolizzi","journal-title":"J Clin Pharm Ther"},{"issue":"3","key":"R15","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1097\/ALN.0000000000004622","article-title":"Opioid overdose: limitations in naloxone reversal of respiratory depression and prevention of cardiac arrest","volume":"139","author":"van Lemmen","journal-title":"Anesthesiology"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1346109","article-title":"Fact vs. fiction: naloxone in the treatment of opioid-induced respiratory depression in the current era of synthetic opioids","volume":"12","author":"Dahan","journal-title":"Front Public Health"},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2023.104154","article-title":"Xylazine in the drug supply: Emerging threats and lessons learned in areas with high levels of adulteration","volume":"120","author":"Quijano","journal-title":"Int J Drug Policy"},{"issue":"10","key":"R18","doi-asserted-by":"publisher","first-page":"1644","DOI":"10.1111\/add.13027","article-title":"Naloxone--does over-antagonism matter? Evidence of iatrogenic harm after emergency treatment of heroin\/opioid overdose","volume":"110","author":"Neale","journal-title":"Addiction"},{"key":"R19","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2024.104587","article-title":"A call for compassionate opioid overdose response","volume":"133","author":"Russell","journal-title":"Int J Drug Policy"},{"issue":"2","key":"R20","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20021230","article-title":"Overdose detection technologies to reduce solitary overdose deaths: a literature review","volume":"20","author":"Lombardi","journal-title":"Int J Environ Res Public Health"},{"issue":"7","key":"R21","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1001\/jamapsychiatry.2023.0546","article-title":"Overdose detection technologies-a new frontier in preventing solitary drug overdose deaths","volume":"80","author":"Park","journal-title":"JAMA Psychiatry"},{"key":"R22","unstructured":"Masimo. Opioid Halo. URL: https:\/\/shop.masimo.com\/en-us\/product\/shop-opioid-safety\/137733.html [Accessed 05-03-2025]"},{"issue":"1","key":"R23","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-021-00522-3","article-title":"Willingness to use a wearable device capable of detecting and reversing overdose among people who use opioids in Philadelphia","volume":"18","author":"Kanter","journal-title":"Harm Reduct J"},{"issue":"474","key":"R24","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.aau8914","article-title":"Opioid overdose detection using smartphones","volume":"11","author":"Nandakumar","journal-title":"Sci Transl Med"},{"issue":"1","key":"R25","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-01990-0","article-title":"Closed-loop wearable naloxone injector system","volume":"11","author":"Chan","journal-title":"Sci Rep"},{"issue":"10","key":"R26","doi-asserted-by":"publisher","DOI":"10.1016\/j.device.2024.100517","article-title":"An implantable system for opioid safety","volume":"2","author":"Huang","journal-title":"Device"},{"key":"R27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jconrel.2019.05.041","article-title":"Simple minimally-invasive automatic antidote delivery device (A2D2) towards closed-loop reversal of opioid overdose","volume":"306","author":"Dhowan","journal-title":"J Control Release"},{"issue":"Pt A","key":"R28","doi-asserted-by":"publisher","first-page":"109138","DOI":"10.1016\/j.drugalcdep.2021.109138","article-title":"Wearable biosensors have the potential to monitor physiological changes associated with opioid overdose among people who use drugs: A proof-of-concept study in a real-world setting","volume":"229","author":"Roth","journal-title":"Drug Alcohol Depend"},{"issue":"1","key":"R29","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1111\/dar.13737","article-title":"What impacts the acceptability of wearable devices that detect opioid overdose in people who use opioids? A qualitative study","volume":"43","author":"Tas","journal-title":"Drug Alcohol Rev"},{"key":"R30","doi-asserted-by":"publisher","DOI":"10.3389\/fdgth.2022.969642","article-title":"Perceptions on wearable sensor-based interventions for monitoring of opioid therapy: A qualitative study","volume":"4","author":"Chapman","journal-title":"Front Digit Health"},{"issue":"4","key":"R31","doi-asserted-by":"publisher","first-page":"1893","DOI":"10.1007\/s11135-017-0574-8","article-title":"Saturation in qualitative research: exploring its conceptualization and operationalization","volume":"52","author":"Saunders","journal-title":"Qual Quant"},{"key":"R32","doi-asserted-by":"crossref","unstructured":"Lingamoorthy A Watson A Gordon D et al. DOVE: noninvasive shoulder-based opioid overdose detection device. Presented at: 2022 IEEE\/ACM Conference on Connected Health: Applications, Systems and Engineering Technologies (CHASE); Jun 21-23, 2023; Orlando, FL, USA. [doi: 10.1145\/3580252.3586973]","DOI":"10.1145\/3580252.3586973"},{"issue":"8","key":"R33","doi-asserted-by":"publisher","first-page":"2185","DOI":"10.1007\/s10461-018-02387-3","article-title":"Debrief reports to expedite the impact of qualitative research: do they accurately capture data from in-depth interviews?","volume":"23","author":"Simoni","journal-title":"AIDS Behav"},{"issue":"Suppl 3","key":"R34","doi-asserted-by":"publisher","first-page":"S242","DOI":"10.1097\/MLR.0000000000001553","article-title":"Applied rapid qualitative analysis to develop a contextually appropriate intervention and increase the likelihood of uptake","volume":"59","author":"Lewinski","journal-title":"Med Care"},{"key":"R35","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2023.110878","article-title":"Electronic harm reduction interventions for drug overdose monitoring and prevention: A scoping review","volume":"250","author":"Loverock","journal-title":"Drug Alcohol Depend"},{"issue":"6","key":"R36","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1016\/j.cpr.2014.06.002","article-title":"Client preferences affect treatment satisfaction, completion, and clinical outcome: a meta-analysis","volume":"34","author":"Lindhiem","journal-title":"Clin Psychol Rev"},{"issue":"10","key":"R37","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0223823","article-title":"Post-overdose interventions triggered by calling 911: Centering the perspectives of people who use drugs (PWUDs)","volume":"14","author":"Wagner","journal-title":"PLoS ONE"},{"issue":"2","key":"R38","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1016\/j.drugalcdep.2005.01.010","article-title":"Circumstances of witnessed drug overdose in New York City: implications for intervention","volume":"79","author":"Tracy","journal-title":"Drug Alcohol Depend"},{"key":"R39","doi-asserted-by":"publisher","DOI":"10.21037\/mhealth.2017.10.01","article-title":"Potential benefits of using ecological momentary assessment to study high-risk polydrug use","volume":"3","author":"Roth","journal-title":"Mhealth"},{"issue":"1","key":"R40","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-024-02377-1","article-title":"Characteristics of attrition within the SuperMIX cohort of people who inject drugs: a multiple event discrete-time survival analysis","volume":"24","author":"Abdelsalam","journal-title":"BMC Med Res Methodol"},{"issue":"2","key":"R41","doi-asserted-by":"publisher","first-page":"228","DOI":"10.5811\/westjem.2022.11.57179","article-title":"Optimizing recruitment and retention in substance use disorder research in emergency departments","volume":"24","author":"Worth","journal-title":"West J Emerg Med"},{"issue":"25","key":"R42","doi-asserted-by":"publisher","first-page":"567","DOI":"10.15585\/mmwr.mm7325a1","article-title":"Treatment for opioid use disorder: population estimates - United States, 2022","volume":"73","author":"Dowell","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"R43","doi-asserted-by":"crossref","unstructured":"Dasgupta N Bell A Visnich M et al. Trends and characteristics during 17 years of naloxone distribution and administration through a harm reduction program in pittsburgh, pennsylvania. Public and Global Health. [doi: 10.1101\/2024.11.21.24317731]","DOI":"10.1101\/2024.11.21.24317731"},{"key":"R44","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000001500","article-title":"Medetomidine-associated opioid overdoses in Chicago, Illinois: a report of 3 cases","volume":"PMID","author":"Nayani","journal-title":"J Addict Med"},{"issue":"1","key":"R45","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-024-01143-2","article-title":"Managing xylazine-involved overdoses in a community harm reduction setting: lessons from Tijuana, Mexico","volume":"22","author":"Bufanda","journal-title":"Harm Reduct J"},{"issue":"8","key":"R46","doi-asserted-by":"publisher","first-page":"1164","DOI":"10.1080\/10826084.2025.2491768","article-title":"\u201cAll You Can Do is What You Know to Do\u201d: Naloxone knowledge and uncertainty among people who use drugs in maryland amid a volatile drug market","volume":"60","author":"Sisson","journal-title":"Subst Use Misuse"},{"key":"R47","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2017.03.008","article-title":"No evidence of compensatory drug use risk behavior among heroin users after receiving take-home naloxone","volume":"71","author":"Jones","journal-title":"Addict Behav"},{"issue":"8","key":"R48","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.27319","article-title":"Injection drug use frequency before and after take-home naloxone training","volume":"6","author":"Colledge-Frisby","journal-title":"JAMA Netw Open"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jmir.org\/2025\/1\/e73566","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:04:20Z","timestamp":1782842660000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2025\/1\/e73566"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,28]]},"references-count":48,"URL":"https:\/\/doi.org\/10.2196\/73566","relation":{},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,28]]},"article-number":"v27i50e73566"}}