Smart sensors for pain assessment, virtual reality, and video games are just some of what we can expect in the future. Join medical analyst Dolev Vaknin for a review of the latest technologies and results for dealing with the opioid crisis.
In light of the severity of the epidemic, the US FDA declared the opioid situation as a “public health emergency” in 2017, due to particularly high addiction and mortality rates. This declaration promoted the development of medical devices for the prevention and treatment of opioid use disorders, and an FDA innovation challenge was also launched for the development and approval of technologies in this area, as a response to the emergency.
Virtual reality changes the rules of the game
The best way to contend with opioid addiction is preventing it to begin with. Opioids are administered following major surgeries as painkillers, but it is possible to reduce their use and thus their addictive potential. An article from 2022 published in the journal JAMA Otolaryngology included 29 patients who underwent head and neck surgeries, and examined the use of Virtual Reality (VR) as part of post-operative pain management. Patients were divided into two groups – the trial group (that used VR) and the control group (that used a smartphone) – who played interactive video games using a mobile device or VR. The study found that the VR group demonstrated significantly lower opioid use compared to the control group during the first few hours following the operation, as can be seen in the figure. Why do VR games affect pain perception? The thought behind the trial and its results is that virtual reality games are characterized by a deep, immersive experience due to the high degree of sensory stimulation, which diverts the patients’ attention from the pain, thus changing the experiences of pain and opioid use.
Pain assessment in the 21st century
Currently, the main instrument used for pain assessment is the pain scale, a patient-reported assessment ranking the severity of pain on a scale of 1 to 10. There is no doubt that this is an outmoded, inconsistent, and non-objective tool, as its use began in 1940 and it is based on individual assessment. The pain threshold varies between individuals – for instance, there are many stories about patients who experienced a heart attack and described it only as mild pain, as opposed to the more common scenario where patients described the pain as excruciating. Pain severity is highly significant, as it has implications for the manner and quantity of use of painkillers such as opioids, which may lead to future addiction – and therefore, a new method is required to assess pain accurately and objectively, as can be expected from 21st century medicine. An article from 2022 presents the use of various models and sensors for assessing pain physiologically and objectively. The system uses facial expressions, EEG, eye movements, respiration rate and more, as can be seen in the image. The system manages to correctly identify whether the patient is experiencing pain, and to classify it into three different levels of severity by aggregating data from the sensors.
Another study from April 2024 examined a model with similar principles, which correctly identified pain with 82% accuracy, and correctly classified its severity with 52% accuracy. While these accuracy levels may be far from perfect, by improving the model, it will be possible to assess the severity of pain accurately and objectively in the future, thus preventing use of opioids in cases where it is not necessary to do so.
In summary, the opioid epidemic is a concerning health condition that has taken many lives and requires immediate intervention, including the adoption of new technologies for contending with this phenomenon. The FDA promoted such moves and technologies through objective and accurate pain assessment, the use of VR for reducing opioid consumption, and many other technologies that are currently picking up speed. These are expected to reduce opioid dependency and the risk of developing an addiction, and provide hope for the long-term struggle against this phenomenon.
