JMIR Publications

ABSTRACT

Background:

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 (e.g., rescue breathing or naloxone).​ There is a growing interest in overdose detection technologies that detect and enable rapid, automated responses. However, little user experience research has been conducted to inform device design.​

Objective:

This qualitative study explores user experience and key features driving device acceptability among people who inject drugs who wore a shoulder-mounted sensor for one week.

Methods:

We recruited individuals ≥18 years reporting past week injection drug use from a walk-in substance use disorder clinic. Participants were assigned a prototype sensor to wear on their upper arm for one week. At baseline, they completed a brief survey assessing socio-demographic and behavioral information. At exit, they completed semi-structured interviews that explored experiences and preferences for next-generation sensors. Structured field notes and transcripts were analyzed to identify perceived benefits and harms, and key design considerations important to improve the acceptability of the sensor prototype.

Results:

Participants (n=23) were predominantly middle-aged (median age 41 years), non-Hispanic White (65%), and male (61%). The majority engaged in polysubstance use (57%) and reported an average of 5 daily injection events over the past three months. Of the participants, 70% returned an intact prototype and completed an exit interview. Overall, participants found wearable overdose detection and response devices acceptable, with perceived benefits outweighing potential harms. They unanimously supported the need for small, discreet devices that wouldn’t be noticeable to others. However, most participants emphasized that no single device could fully address end users’ needs, suggesting the importance of offering multiple, customizable response options. Concerns about false positives were also raised, as they could hinder adoption once devices are available on the market.

Conclusions:

Interviews with a small group of potential users show that wearable overdose technologies are generally well-received, especially when they are tailored to users’ preferences for design, functionality, and accuracy. Continuously refining the design with feedback from end users is key to creating a device that truly meets their needs and enhances their overall experience.