Naloxone, one of the most accessible and life-saving treatments for heroin overdoses also happens to be one of the most difficult and confusing to administer. In light of the growing epidemic of opioid and heroin-related drug abuse in the United States, San Francisco design firm Frog has used 3D printing to re-design the standard naloxone nasal spray, making it more user-friendly and therefore more likely to save lives in emergency situations.
Though I wouldn’t wish it on anyone, imagine being either the victim of or witness to a heroin overdose. The scene would most likely be frantic and high-stress, with reduced motor skills and even consciousness making everything seem foggy and distant, even as every second without help could lead to fatal consequences.
Now imagine that a life-saving drug was within reach, one that is affordable and could reverse the overdose almost immediately. The only catch is that to administer it, you would need to focus long enough to assemble a seven-part kit of tiny components, get it at just the right angle, and then quickly release the drug not once, but twice into each nostril. It’s not impossible to do, but given the circumstances, it’s highly unlikely. And yet that is the reality for the nearly 2.5 million people sufferingfrom substance abuse disorders relating to prescription opioids and heroin in the United States alone.
The treatment drug in question is called naloxone. A cheap and extremely effective emergency antidote, naloxone, also known by its brand name Narcan, bonds with opioid receptors in the brain, blocking and/or reversing their effects. It can be administered in a few ways, but the most common is via a nasal atomizer spray. Unfortunately, it is currently only available in the complicated, multi-part kit described above.
Current multi-step process for administering Narcan, the brand-name version of naloxone
When Jonathan Grossman, an industrial designer at San Francisco-based design firm Frog, learned about this issue, he chose to see it not as a frustratingly illogical and life-threatening problem—which it certainly is—but rather, as a mere “user experience” issue, the kind he was trained to solve.
There were, indeed, many user experience problems to tackle. First of all, the device cannot be carried pre-assembled, but can only be put together on-the-spot, when users are least likely to be in a calm state of mind. The medicine itself is housed in a glass vial that is prone to breaking, and, even if users do get past these assembly issues, there’s the question of proper administration: the atomizer must be held at just the right angle when inserted into each nostril, lest the medicine spray out the side.
Grossman got his team at Frog on board and set out to design a user-friendly, one-step process for administering naloxone during overdose situations. Critical features would include a pre-assembled, durable design as well as a nearly ‘foolproof’ symmetrical injector that could be inserted from various angles. Think of it as the “EpiPen for heroin,” in reference to the ubiquitous Epinephrine autoinjector that is currently used by millions of allergy sufferers–including children–worldwide.
Using cost-effective 3D printing to rapidly prototype various iterations, Grossman was able to combine several key features and experiment with new ones, resulting in several versions of the medical device that could suit various purposes, including ones designed specifically for nurses and others for non-medically trained users.
A major breakthrough in the design process was to connect two syringes that could disperse the drug into both nostrils simultaneously, making delivery even faster and easier. To see if it would work, Grossman actually tested his dual-syringe device on himself. The result? Uncomfortable, to be sure, but it worked…and nobody said heroin overdoses were supposed to be pretty.
Grossman’s 3D printed prototype also features two distinct materials: plastic for the main body, and rigid rubber on the both the plunger lid and plunger itself. In a real-world scenario, when the user may or may not be able to properly see or understand what is going on, the tactile grip of the rubber would provide an instant, intuitive clue, telling them which end of the device to hold and comfortably push down on.
The National Institute of Drug Abuse has reported that from 1999 to 2014, the number of unintentional overdose deaths from prescription opioid pain relievers had more than quadrupled—and that’s not even counting street-based heroin use. The issue is becoming a growing health epidemic both in the United States and abroad.
As a treatment, naloxone is already accessible and affordable. With Frog’s 3D printed, user-friendly prototype, it can finally be usable, too.
Frog is currently looking for partners in the pharmaceutical or health care industries, and is hoping to go through the required federal approval processes to bring the dual-nasal naloxone atomizer to market. As a treatment for the growing issue of opioid overdoses, it could be a game changer. From a design perspective, is also an excellent case study to show how creative thinking and rapid prototyping can be used to rethink everyday or taken-for-granted design issues with life-changing results.
Posted in 3D Printing Application
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As a counselor in a syringe exchange, narcan training is an essential part of what I do on a daily basis. I agree the nasal are cumbersome, but not for the reasons listed here. I personally much prefer the intramuscular which, to a non-user, might be unappealing, but the overdoses I’ve witnessed and brought people back from have been in non-optimal circumstances. To use the nasal – ANY version – the person has to have their nasal cavity accessible. Several people I worked with had fallen forward and were bleeding from the nose. One person had been in the fetal position with hair, mucous, scarves obstructing their passage and they were much too heavy for me to lift. Another person was wedged in a small area facing away from me and I was terrified I was going to hurt their neck with how much I had to virtually manhandle them to get the spray to “stick” because if the head isn’t far enough back that solution will drip out. The proposed new design is a lovely one, of course, but not practical considering the length and bulkiness if someone is in a very tight space (as people often are when they don’t have a safe place to inject). This is a great option for parents or care providers who might have a loved one in their home, but out on the street where 90% of doses are used, intramuscular is much more practical.