Mass electrician develops technology to prevent fatal overdoses
“It’s like a little time machine,” King said while performing a routine maintenance check on one of his systems. “It gives you the opportunity to turn back the clock a few minutes and save someone’s life.”
The systems use ultrasonic and infrared motion sensors with timers that can detect the slightest body movements from the time a person enters the room until they exit. If the monitor does not pick up movement for a specified period of time, an alarm sounds and emergency medical personnel can respond.
The life-saving monitoring devices can go anywhere, though they have proven particularly effective in public restrooms, which have long served as convenient sites for illicit drug use. These toilets are accessible, but isolated and devoid of surveillance cameras, among the few public places where drug users are out of sight when they get high. However, the isolation of the bathrooms also makes them deadly: People who collapsed from respiratory failure can remain unnoticed for hours, say harm reduction specialists and front-line health workers.
King installed his first system in a Boston health clinic nearly seven years ago, thinking it was a one-time project. Since then, however, the illicit drug supply in New England and across the country has become increasingly dangerous, with the powerful opioid fentanyl leading to a record number of overdose deaths year after year. In 2022, overdose deaths in Massachusetts reached 2,359, the highest number on record and more than triple the number from a decade ago.
As overdoses increased, so did the demand for King’s monitoring devices and technical know-how.
The growing popularity of these devices reflects the dire nature of the relentless overdose crisis that is claiming the lives of about 300 Americans every day, and the lack of safe and sanitary spaces for users. “It’s a desperate and terrible solution,” said Jessie Gaeta, a physician and former medical director of Boston Healthcare for the Homeless, an early adopter of motion-sensing systems. “Of course this is better than not having sensors, but it is far less than what people deserve and need.”
This technology has long been used in commercial alarm systems, and is easy to operate.
Install a motion sensor approximately the size of a fire alarm on the bathroom ceiling. As soon as someone enters the room and closes the door, the motion detector is triggered. If it detects no movement for 2 minutes and 45 seconds, it sounds a high-pitched alarm and flashes a strobe light above the door, alerting people nearby of a possible overdose. Trained personnel can then force open the door and administer naloxone, overdose reversal medications, and other emergency care, according to a recent video and description of the so-called “safe bathroom” devices by STAT News, a sister publication of Globe Science and Technology.
False alarms are inevitable. King noted that it is common in homeless shelters for people to feel so exhausted when they return from the elements that they sleep in the bathrooms, setting off alarms. Other times, people pass out from drinking alcohol or simply sit still on the toilet for so long, reading or watching their phones, that the sensors fail to pick up the motion, King said.
But with each new installation, more lives are saved. The Boston Public Health Commission estimates that at least 75 potentially fatal overdoses in homeless shelter bathrooms have been reversed since last April thanks to alarms set off by King Systems, which costs between $8,000 and $9,000 per bathroom for both equipment and installation.
“It’s a vital tool,” said Gregory Grace Thomas, director of the Office of Homeless Services at the Boston Public Health Commission, which has equipped three of its shelters with King’s systems. “We can never be 100% aware of what is happening in all of our spaces, especially when people are homeless and have few options for private space.”
Now others, inspired by King’s work, are looking for ways to expand the technology. Brave Technology Co-Op, based in Vancouver, British Columbia, has installed similar displays in more than 50 locations across North America, and recently received a contract from the state of Rhode Island to deploy the equipment in up to 100 locations across the state, including Areas identified as “hotspots” for overdoses. Brave has deployed sensors in a range of settings, including restrooms in public libraries, transit hubs, cafes, and shopping malls.
“My dream is to have these sensors in every public bathroom at every gas station, A&W, Tim Horton’s and McDonald’s across the continent,” said Oona Craig, Chief Operating Officer at Brave Technology. “When you look at the number of people who are using (drugs) on a daily basis, and that they are doing it alone and at risk, it’s a no-brainer.”
Gentle but sharp, King said he became “obsessed” with making the technology work after a visit to the South End Health Clinic run by Boston Healthcare for the Homeless in 2016. He had just finished a routine electrical job when the facility’s manager told him he pulled him aside. He asked him if he knew of a way to wire the bathrooms to detect overdoses, which were occurring an average of five times a week at the clinic.
King poured himself into the project. He outfitted the basement of his Andover home with motion sensors and electrical relay circuits, equipment he once used in alarm systems he installed in banks. Then talk to doctors, nurses, and guardians to understand what happens to the person who overdoses, and even act out the experience at his work site in the basement.
He said no one died of an overdose once the alarms were raised.
Over the years, King has fine-tuned equipment to respond to the growing power of street drugs. At first, he thought four minutes would be a long enough period of inaction to trigger the alarm. However, with fentanyl, respiratory failure can occur sooner. In response, King gradually lowered the alarm system to detect overdoses in less than two minutes.
However, even now, years after installing his first system, King is haunted by a tragic incident one winter’s day two years ago. A clinic in Boston asked King to install sensors in cafeteria bathrooms, but he was finishing up another job at a hospital in Worcester and couldn’t get there right away. Meanwhile, a man died in one of the bathrooms due to an overdose.
Now he rarely waits long when receiving an order, sometimes arriving at the job site to make repairs within 24 hours.
“I remember thinking to myself: ‘Oh my God, this (death) could have been prevented if I had been there sooner…'” he said. “But I can’t be everywhere at once.”
Chris Serres can be reached at email@example.com. follow him @Chris Siris.