From Lab to Lifesaver: Rethinking How We Detect and Respond to Opioid Overdose

Researchers from our NIHR Maudsley BRC Pain and Addictions theme are conducting innovative new studies on opioid overdose to assess the use of remote monitoring technology and novel approaches to improve the accessibility of antidotes. Research Associate, Dr Mariana Gonzalez Utrilla discusses these innovations in this blog which covers a new paper published in the British Journal of Hospital Medicine.

Innovation in medicine is often about discovering new drugs or high-tech hospital equipment. But what if life-saving change could come from a small wearable device or a strip of 10 dissolvable wafers small enough to fit in your wallet like a credit card?

For those of us working to prevent opioid overdose deaths, that’s exactly the kind of innovation we’re now exploring, and we recently published a new paper in the British Journal of Hospital Medicine that outlined these new approaches.

More than 125,000 people die globally each year from opioid overdose,including over 3,000 in the UK alone, where opioid-related deaths now outnumber those from road traffic accidents. Despite this shocking figure, overdose prevention has long remained an area of "undone science", a term used to describe topics neglected by research, not because they lack importance, but because of stigma, structural barriers, or a simple failure of imagination.

For too long, opioid overdose prevention has lacked investment in innovation. And we feel now is the time for that to change.

From ‘undone science’ to new solutions

At King’s College London and the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre, we’ve been investigating how wearable sensors, motion tracking, and ultra-portable naloxone formulations could transform overdose response, bringing interventions out of the laboratory and into the everyday lives of those at risk.

Today, we can study overdose in the lab with ethical approval and clinical precision. We can detect the earliest signs of breakdown in respiratory function. We can investigate life-saving medication in forms people are willing to carry and use. And perhaps most importantly, we’re embedding lived experience into every step.

What if overdose could be detected like a heart attack?

Our research team has developed a laboratory model where we can safely observe heroin-induced respiratory depression in real time. Under carefully controlled conditions, with volunteer participants already prescribed heroin for treatment, we can measure breathing, oxygen levels, and motion while they self-administer their heroin.

The findings are eye-opening: respiratory arrest can occur without visible distress, sometimes for up to a minute, unnoticed by the person themselves.

That’s where wearable technology comes in. Devices like chest sensors, smart rings, or watches, already used to monitor sleep or heart health, can be adapted to detect the tell-tale signs of overdose. We're currently testing whether a new wearable device - Pneumowave’s chest sensor - can reliably recognise patterns of breathing (or the lack of it) that signal an emergency. If they can, they could automatically alert a family member, outreach worker, or ambulance, just like fall alerts for older adults.

Motion signatures and naloxone carriage: Meeting people where they are

Another surprising innovation? Detecting injecting behaviour through unique motion patterns. Using accelerometers, we can recognise the specific movements involved in preparing and administering a drug injection. This could be used not to monitor in a punitive way, but to build smart, respectful alert systems that activate only when truly needed or perhaps to trigger an interrupting text message to avert breakdown of a New Year’s resolution.

And what about naloxone, the medication that reverses an overdose?

Although widely recommended, real-world usage remains a challenge. People may be trained and willing, but if they don’t carry it, it can’t help. Current kits are bulky and don’t pass what we call the “jeans pocket test”: if it doesn’t fit in your pocket, it won’t be there when you need it.

That’s why we’re working on a wafer-thin naloxone strip, small enough to slide into your wallet or phone case. Early feedback from people who use drugs, frontline workers, and families has been positive. In fact, over 85% of participants in a recent survey said they’d feel comfortable carrying and using the buccal wafer, compared to just 25% for injectable naloxone.

Breaking the cycle

Technology alone won’t solve this crisis. But by designing tools that are discreet, intuitive, and developed with lived experience, we can create systems that genuinely support people.

These innovations also offer new ways to engage people with services. If a wearable device tells someone they've had multiple apnoeic (non-breathing) episodes during drug use, that insight might prompt a life-changing conversation with a clinician or support worker. The data could even be used anonymously to improve public health responses.

Reimagining overdose response

The opioid crisis is complex, but part of the solution lies in simple, thoughtful design. It's about recognising that overdose often happens not in clinical settings, but in homes, hostels, or on the street, and that most of the time, crucially, someone else is there. Equipping that someone, be it a peer, a parent, or a passer-by, with the right tools, right there in the moment, can mean the difference between life and death. This means that we’re no longer only asking if we can improve overdose response but we’re showing how it can be done.

Want to find out more?

In September 2025, researchers from the Department of Addiction Sciences and NIHR Maudsley BRC hosted a conference, Naloxone Innovations and Other Strategies to Detect and Prevent Opioid Overdose Deaths, where the research discussed in this blog was presented.

Photo by Sergey Sukhov on Unsplash. The "homeless statue" in Brugge, Belgium is a bronze sculpture by Canadian sculptor Timothy Schmalz