Patent Publication Number: US-2021161465-A1

Title: Kit for opioid overdose monitoring

Description:
INCORPORATION BY REFERENCE TO ANY PRIORITY APPLICATIONS 
     This application is a non-provisional of U.S. Provisional Application No. 62/947,673, filed Dec. 13, 2019, titled “KIT FOR OPIOID OVERDOSE MONITORING,” incorporated herein by reference in its entirety. Any and all applications for which a foreign or domestic priority claim is identified in the Application Data Sheet as filed with the present application are hereby incorporated by reference under 37 CFR 1.57. 
    
    
     FIELD 
     The present disclosure relates generally to the field of detecting an opioid overdose, and in particular, to detecting low saturation of oxygen in the blood of an opioid user, and automatically notifying a responder. 
     BACKGROUND 
     Substance abuse disorders impact the lives of millions of people. An opioid overdose can occur when a person overdoses on an illicit opioid drug, such as heroin or morphine. Many controlled substances are prescribed by physicians for medical use. Patients can accidentally take an extra dose or deliberately misuse a prescription opioid. Mixing a prescription opioid with other prescription drugs, alcohol, or over-the-counter-medications can cause an overdose. Children are particularly susceptible to accidental overdoses if they take medication that is not intended for them. Opioid overdose is life-threatening and requires immediate emergency attention. 
     SUMMARY 
     An opioid overdose is toxicity due to an excess or opioids. Symptoms of an opioid overdose include marked confusion, delirium, or acting drunk; frequent vomiting; pinpoint pupils; extreme sleepiness, or the inability to wake up; intermittent loss of consciousness; breathing problems, including slowed or irregular breathing; respiratory arrest (absence of breathing); respiratory depression (a breathing disorder characterized by slow and ineffective breathing); and cold, clammy skin, or bluish skin around the lips or under the fingernails. 
     Depressed breathing is the most dangerous side effect of opioid overdose. Lack of oxygen to the brain can not only result in permanent neurologic damage, but may also be accompanied by the widespread failure of other organ systems, including the heart and kidneys. If a person experiencing an opioid overdose is left alone and asleep, the person could easily die as their respiratory depression worsens. 
     Oximetry can be used to detect depressed breathing. Oximetry utilizes a noninvasive optical sensor to measure physiological parameters of a person. In general, the sensor has light emitting diodes (LEDs) that transmit optical radiation into a tissue site and a detector that responds to the intensity of the optical radiation after absorption (e.g., by transmission or transreflectance) by, for example, pulsatile arterial blood flowing within the tissue site. Based on this response, a processor can determine measurements for peripheral oxygen saturation (SpO 2 ), which is an estimate of the percentage of oxygen bound to hemoglobin in the blood, pulse rate, plethysmograph waveforms, which indicate changes in the volume of arterial blood with each pulse beat, and perfusion quality index (e.g., an index that quantifies pulse strength at the sensor site), among many others. 
     It is noted that “oximetry” as used herein encompasses its broad ordinary meaning known to one of skill in the art, which includes at least those noninvasive procedures for measuring parameters of circulating blood through spectroscopy. Moreover, “plethysmograph” as used herein (commonly referred to as “photoplethysmograph”), encompasses its broad ordinary meaning known to one of skill in the art, which includes at least data representative of a change in the absorption of particular wavelengths of light as a function of the changes in body tissue resulting from pulsing blood. 
     An oximeter that is compatible with a hand held monitor, such as a mobile computing device, can be used to monitor physiological parameters. The oximeter can detect decreased oxygen saturation in the blood of the user. Decreased oxygen saturation in the blood of the user is an indication of respiratory distress, which can be an indication of opioid overdose. Once the oxygen saturation of the user falls below an acceptable threshold, a software application in the mobile computing device can alert others to provide emergency help. The threshold can be set to provide an early indication of an overdose event. If the overdose is caught early, emergency treatment can be provided before irreparable harm occurs. 
     A system to monitor for indications of opioid overdose and to deliver therapeutic drugs can comprise a sensor wearable by a user configured to obtain data indicative of at least one physiological parameter of the user; a signal processor configured to process the data to provide the at least one physiological parameter; and a drug delivery apparatus wearable by the user and configured to deliver one or more doses of a therapeutic drug. The drug delivery apparatus can comprise a delivery device that includes a dose of a therapeutic drug stored in a reservoir, a drug delivery channel, a dispensing device to dispense the therapeutic drug from the reservoir through the drug delivery channel, and activation circuitry to activate the dispensing device. 
     The system can further comprise a medical monitoring hub configured to monitor the at least one physiological parameter. The medical monitoring hub can comprise memory storing instructions and one or more computer processors configured to execute the instructions to at least compare the at least one physiological parameter to a threshold that is indicative of opioid overdose; determine that an overdose event is occurring or likely to occur based on the comparison; and send at least one activation signal to the drug delivery apparatus to dispense at least one dose of the therapeutic drug based on the determination. 
     The one or more computer processors of the medical monitoring hub can be further configured to provide an alarm in response to determining that the overdose event is occurring or likely to occur; wait a period of time after providing the alarm before sending the at least one activation signal; where receiving user input during the period of time stops the sending of the at least one activation signal. The one or more computer processors of the medical monitoring hub can be further configured to receive an indication of medical distress of the user; and send a notification of the medical distress to one or more contacts, wherein the one or more contacts include medical professionals, relatives, friends, and neighbors. 
     The system can further comprise a housing that houses the sensor, the signal processor, and the drug delivery device. The drug delivery apparatus can further include a first antenna and a first processor in communication with the first antenna, where the sensor can further include a second antenna and a second processor in communication with the second antenna, and where the first and second processors can be configured to provide wireless communication between the drug delivery device and the sensor. The drug delivery apparatus can be a single use drug delivery apparatus. The drug delivery device can further include an antenna to receive an activation signal. The drug delivery apparatus can include at least two drug delivery devices. 
     The medical monitoring hub can be in communication with a remote server comprising a user database, memory storing instructions, and one or more computing devices configured to execute the instructions to cause the remote server to access user information associated with the user in the user database. The user information can include contact information of contacts to notify with overdose status of the user. 
     The one or more computing devices of the remote server can be further configured to send notification of the overdose event to at least one contact. The notification can include one or more of a location of the user, a location of an opioid receptor antagonist drug, and an indication of the at least one physiological parameter. The notification can be one or more of a text message, an email, a message on social media, and a phone call. 
     The system can further comprise a smart device in communication with the signal processor to receive the at least one physiological parameter and in communication with the medical monitoring hub. The smart device can comprise memory storing instructions, and one or more microprocessors configured to execute the instructions to at least compare the at least one physiological parameter to the threshold that is indicative of opioid overdose; determine that the overdose event is occurring or likely to occur based on the comparison; determine that the medical monitoring hub failed to send the at least one activation signal; and send the at least one activation signal to the drug delivery apparatus to dispense at least one dose of the therapeutic drug in response to the determination that that the medical monitoring hub failed to send the at least one activation signal. The memory of the smart device can further store the contact information and the one or more microprocessors of the smart device can be further configured to notify the contacts of the overdose event. 
     The drug delivery apparatus can comprises a patch and can include an adhesive layer for adhesion to the user. The at least one physiological parameter can comprise one or more of oxygen saturation, heart rate, respiration rate, pleth variability, and perfusion index. The medical monitoring hub can further comprise an input to receive user input, a speaker, and alarm circuitry, and where the one or more computer processors of the medical monitoring hub can be further configured to produce an alarm based on the determination. Volume of the alarm can increase until user input is received. A kit can comprising any of the systems disclosed herein. 
     A medical monitoring hub to monitor for indications of opioid overdose can comprise memory storing instructions and one or more computer processors configured to execute the instructions to at least receive data indicative of at least one physiological parameter of a user that is obtained by a user-wearable sensor; process the data to provide the at least one physiological parameter; compare the at least one physiological parameter to a threshold that is indicative of opioid overdose; determine that an overdose event is occurring or likely to occur based on the comparison; and send at least one activation signal to a drug delivery apparatus to dispense at least one dose of the therapeutic drug based on the determination. The drug delivery apparatus wearable by the user can be configured to deliver one or more doses of a therapeutic drug. 
     The drug delivery apparatus can comprises a delivery device that includes a dose of a therapeutic drug stored in a reservoir, a drug delivery channel, a dispensing device to dispense the therapeutic drug from the reservoir through the drug delivery channel, and activation circuitry to activate the dispensing device. The drug delivery apparatus can comprise one or more delivery devices. Each drug delivery device can comprise a dose of a therapeutic drug stored in a reservoir, a drug delivery channel, a dispensing device to dispense the therapeutic drug from the reservoir through the drug delivery channel, activation circuitry to activate the dispensing device, and an antenna to receive the at least one activation signal. Each antenna can be tuned to receive a corresponding activation signal at a different frequency. The one or more computer processors can be further configured to send two or more activation signals. Each of the two or more activation signals can have the different frequencies to cause corresponding two or more activation circuitry to activate to dispense two or more doses of the therapeutic drug at approximately the same time. 
     A method to monitor for indications of opioid overdose and to deliver therapeutic drugs can comprise obtaining, from a sensor wearable by a user, data indicative of at least one physiological parameter of the user; processing, with a signal processor, the data to provide the at least one physiological parameter; and delivering, from a drug delivery apparatus wearable by the user, one or more doses of a therapeutic drug. The delivering can comprise activating a dispensing device that is configured to dispense through a drug delivery channel a dose of therapeutic drug stored in a reservoir; and dispensing with the activated dispensing device, the dose of the therapeutic drug from the reservoir through the drug delivery channel. 
     The method can further comprise monitoring, with a medical monitoring hub that can comprise one or more computing devices, the at least one physiological parameter. The monitoring can comprise comparing the at least one physiological parameter to a threshold that is indicative of opioid overdose; determining that an overdose event is occurring or likely to occur based on the comparison; and sending at least one activation signal to the drug delivery apparatus to activate the dispensing device based on the determination. The method can further comprise providing an alarm in response to determining that the overdose event is occurring or likely to occur; and waiting a period of time after providing the alarm before sending the at least one activation signal, where receiving user input during the period of time can stop the sending of the at least one activation signal. The method can further comprise receiving an indication of medical distress of the user; and sending a notification of the medical distress to one or more contacts, wherein the one or more contacts include medical professionals, relatives, friends, and neighbors. 
     The sensor, the signal processor, and the drug delivery device can be housed in a single housing. The drug delivery apparatus can further include a first antenna and a first processor in communication with the first antenna, where the sensor can further include a second antenna and a second processor in communication with the second antenna. The first and second processors can be configured to provide wireless communication between the drug delivery device and the sensor. The drug delivery apparatus can be a single use drug delivery apparatus. The drug delivery device can further include an antenna to receive an activation signal. The drug delivery apparatus can include at least two drug delivery devices. 
     The medical monitoring hub can be in communication with a remote server that can comprise a user database, memory storing instructions, and one or more computing devices configured to execute the instructions to cause the remote server to access user information associated with the user in the user database. The user information can include contact information of contacts to notify with overdose status of the user. 
     The method can further comprise sending, with the remote server, notification of the overdose event to at least one contact. The notification can include one or more of a location of the user, a location of an opioid receptor antagonist drug, and an indication of the at least one physiological parameter. The notification can be one or more of a text message, an email, a message on social media, and a phone call. 
     A smart device can be in communication with the signal processor to receive the at least one physiological parameter and can be in communication with the medical monitoring hub. The smart device can comprise memory storing instructions, and one or more microprocessors configured to execute the instructions to at least compare the at least one physiological parameter to the threshold that is indicative of opioid overdose; determine that the overdose event is occurring or likely to occur based on the comparison; determine that the medical monitoring hub failed to send the at least one activation signal; and send the at least one activation signal to the drug delivery apparatus to dispense at least one dose of the therapeutic drug in response to the determination that that the medical monitoring hub failed to send the at least one activation signal. The memory of the smart device can further store the contact information and the one or more microprocessors of the smart device are can be further configured to notify the contacts of the overdose event. 
     The drug delivery apparatus can comprise a patch and can include an adhesive layer for adhesion to the user. The at least one physiological parameter can comprise one or more of oxygen saturation, heart rate, respiration rate, pleth variability, and perfusion index. The medical monitoring hub can further comprise an input to receive user input, a speaker, and alarm circuitry, where the one or more computer processors of the medical monitoring hub can be further configured to produce an alarm based on the determination. The method can further comprises increasing volume of the alarm until user input is received. 
     A method to monitor for indications of opioid overdose can comprise receiving data indicative of at least one physiological parameter of a user that is obtained by a user-wearable sensor; processing the data to provide the at least one physiological parameter; comparing the at least one physiological parameter to a threshold that is indicative of opioid overdose; determining that an overdose event is occurring or likely to occur based on the comparison; and sending at least one activation signal to a drug delivery apparatus to dispense at least one dose of a therapeutic drug based on the determination. The drug delivery apparatus wearable by the user can be configured to deliver one or more doses of the therapeutic drug. 
     The drug delivery apparatus can comprise a delivery device that includes a dose of a therapeutic drug stored in a reservoir, a drug delivery channel, a dispensing device to dispense the therapeutic drug from the reservoir through the drug delivery channel, and activation circuitry to activate the dispensing device. The drug delivery apparatus can comprise one or more delivery devices. Each drug delivery device can comprise a dose of a therapeutic drug stored in a reservoir, a drug delivery channel, a dispensing device to dispense the therapeutic drug from the reservoir through the drug delivery channel, activation circuitry to activate the dispensing device, and an antenna to receive the at least one activation signal. 
     The method can further comprise sending two or more activation signals, where each antenna can be tuned to receive a corresponding activation signal at a different frequency, and where each of the two or more activation signals can have the different frequencies to cause corresponding two or more activation circuitry to activate to dispense two or more doses of the therapeutic drug at approximately the same time. 
     A system to monitor a user for an opioid overdose event can comprise software instructions storable on a memory of a mobile computing device that includes one or more hardware processors, a touchscreen display, and a microphone. The software instructions can cause the one or more hardware processors to receive sounds from the microphone; determine an opioid overdose event is occurring or will soon occur based on the received sounds; present a request for user input on the touchscreen display based on the determination; and transmit wirelessly notifications of the opioid overdose event to one or more recipients based on a failure to receive user input. 
     The mobile computing device can further comprise a camera, and the one or more hardware processors can be further configured to receive images from the camera, and determine the opioid overdose event is occurring or will soon occur based on the received sounds and images. The one or more hardware processors can be further configured to receive monitoring data from a monitoring service that monitors the user and an environment local to the user; and transmit the notification of the opioid overdose event to the monitoring service. The monitoring service can be a security alarm service. 
     The monitoring data can include user data associated with a state of the user and environmental data associated with the environment local to the user. The one or more recipients can include friends and family having contact information stored in the memory of the mobile computing device. The one or more recipients can include one or more of a first responder, an emergency service, a local fire station, an ambulance service, a rehabilitation center, an addiction treatment center, and a rideshare network. The notification can include one or more of a text message, a phone call, and an email. The notification can include directions to a location of the mobile computing device. 
     The one or more hardware processors can further analyze representations of the sounds from the microphone to determine respiratory distress of the user local to the mobile computing device. The one or more hardware processors can further analyze representations of the images from the camera to determine respiratory distress of the user in the images. The one or more hardware processors can further analyze representations of the images from the camera to determine an unconscious state of the user in the images. The one or more processors further can cause the touchscreen display to display care instructions to care for a victim of an opioid overdose. 
     The mobile computing device can further comprise a speaker and the one or more hardware processors further can cause the speaker to output an audible alarm based on the determination. The one or more hardware processors can further cause the touchscreen display to flash, cause the touchscreen display to display directions to a location of the mobile computing device, or cause a speaker of the mobile computing to provide audible directions to the location of the user. 
     A system to monitor a user for an opioid overdose event can comprise software instructions storable on a memory of a mobile computing device that includes one or more hardware processors, a touchscreen display, and a camera, the software instructions causing the one or more hardware processors to receive images from the camera; determine an opioid overdose event is occurring or will soon occur based on the received images; present a request for user input on the touchscreen display based on the determination; and transmit wirelessly notifications of the overdose event to one or more recipients based on a failure to receive user input. 
     The one or more hardware processors can be further configured to receive monitoring data from a monitoring service that monitors the user and an environment local to the user; and transmit the notification of the opioid overdose event to the monitoring service. The monitoring service can be a security alarm service. The monitoring data can include user data associated with a state of the user and environmental data associated with the environment local to the user. The one or more recipients can include friends and family having contact information stored in the memory of the mobile computing device. The one or more recipients can include one or more of a first responder, an emergency service, a local fire station, an ambulance service, a rehabilitation center, an addiction treatment center, and a rideshare network. The notification can include one or more of a text message, a phone call, and an email. The notification can include directions to a location of the mobile computing device. 
     The one or more hardware processors can further analyze representations the sounds from the microphone to determine respiratory distress of the user local to the mobile computing device. The one or more hardware processors can further analyze representations of the images from the camera to determine respiratory distress of the user in the images. The one or more hardware processors can further analyze representations of the images from the camera to determine an unconscious state of the user in the images. The one or more processors further can cause the touchscreen display to display care instructions to care for a victim of an opioid overdose. The mobile computing device can further comprise a speaker and the one or more hardware processors further can cause the speaker to output an audible alarm based on the determination. The one or more hardware processors can further cause the touchscreen display to flash, cause the touchscreen display to display directions to a location of the mobile computing device, or cause a speaker of the mobile computing to provide audible directions to the location of the user. 
     A system to monitor a user for an opioid overdose event can comprise one or more sensors configured to sense indications of an overdose condition of a user from an environment local to the user; and a mobile computing device comprising a touchscreen display, memory storing software instructions, and one or more hardware processors configured to execute the software instructions to at least receive the sensed indications from the one or more sensors; determine an opioid overdose event is occurring or will soon occur based on the received indications; present a request for user input on the touchscreen display based on the determination; and transmit wirelessly notifications of the overdose event to one or more recipients based on a failure to receive user input. 
     The one or more hardware processors can be further configured to receive monitoring data from a monitoring service that monitors the user and an environment local to the user; and transmit the notification of the opioid overdose event to the monitoring service. The monitoring service is a security alarm service. The monitoring data can include user data associated with a state of the user and environmental data associated with the environment local to the user. The one or more recipients can include friends and family having contact information stored in the memory of the mobile computing device. The one or more recipients can include one or more of a first responder, an emergency service, a local fire station, an ambulance service, a rehabilitation center, an addiction treatment center, and a rideshare network. The notification can include one or more of a text message, a phone call, and an email. The notification can include directions to a location of the mobile computing device. 
     The one or more hardware processors can further analyze representations of the sounds from the microphone to determine respiratory distress of the user local to the mobile computing device. The one or more hardware processors can further analyze representations of the images from the camera to determine respiratory distress of the user in the images. The one or more hardware processors can further analyze representations of the images from the camera to determine an unconscious state of the user in the images. The one or more processors further can cause the touchscreen display to display care instructions to care for a victim of an opioid overdose. The mobile computing device can further comprise a speaker and the one or more hardware processors further can cause the speaker to output an audible alarm based on the determination. The one or more hardware processors can further cause the touchscreen display to flash, cause the touchscreen display to display directions to a location of the mobile computing device, or cause a speaker of the mobile computing to provide audible directions to the location of the user. 
     A method to monitor a user for an opioid overdose event can comprise receiving sounds from a microphone of a mobile computing device; determining, with one or more hardware processors of the mobile computing device, an opioid overdose event is occurring or will soon occur based on the received sounds; presenting, with one or more hardware processors, a request for user input on a touchscreen display of the mobile computing device, the request based on the determination; and transmitting wirelessly, with the mobile computing device, notifications of the overdose event to one or more recipients based on a failure to receive user input. 
     The method can further comprise receiving images from a camera of the mobile computing device; and determining, with the one or more hardware processors of the mobile computing device, the opioid overdose event is occurring or will soon occur based on the received sounds and images. The method can further comprise receive monitoring data from a monitoring service that monitors the user and an environment local to the user; and transmit the notification of the opioid overdose event to the monitoring service. The monitoring service is a security alarm service. The monitoring data can include user data associated with a state of the user and environmental data associated with the environment local to the user. The one or more recipients can include friends and family having contact information stored in the memory of the mobile computing device. The one or more recipients can include one or more of a first responder, an emergency service, a local fire station, an ambulance service, a rehabilitation center, an addiction treatment center, and a rideshare network. The notification can include one or more of a text message, a phone call, and an email. The notification can include directions to a location of the mobile computing device. 
     The method can further comprise analyzing representations of the sounds from the microphone to determine respiratory distress of the user local to the mobile computing device. The method can further comprise analyzing representations of the images from the camera to determine respiratory distress of the user in the images. The method can further comprise analyzing representations of the images from the camera to determine an unconscious state of the user in the images. The method can further comprise causing the touchscreen display to display care instructions to care for a victim of an opioid overdose. The method can further comprise outputting, from the mobile computing device, an audible alarm based on the determination. 
     The method can further comprise causing the touchscreen display to flash, cause the touchscreen display to display directions to a location of the mobile computing device, or cause a speaker of the mobile computing to provide audible directions to the location of the user. 
     A method to monitor a user for an opioid overdose event can further comprise receiving images from a camera of a mobile computing device; determining, with one or more hardware processors of the mobile computing device, an opioid overdose event is occurring or will soon occur based on the received images; presenting, with one or more hardware processors, a request for user input on a touchscreen display of the mobile computing device, the request based on the determination; and transmitting wirelessly, with the mobile computing device, notifications of the overdose event to one or more recipients based on a failure to receive user input. 
     The method can further comprise receiving monitoring data from a monitoring service that monitors the user and an environment local to the user; and transmitting the notification of the opioid overdose event to the monitoring service. The monitoring service can be a security alarm service. The monitoring data can include user data associated with a state of the user and environmental data associated with the environment local to the user. The one or more recipients can include friends and family having contact information stored in the memory of the mobile computing device. The one or more recipients can include one or more of a first responder, an emergency service, a local fire station, an ambulance service, a rehabilitation center, an addiction treatment center, and a rideshare network. The notification can include one or more of a text message, a phone call, and an email. The notification can include directions to a location of the mobile computing device. The method can further comprise analyzing representations the sounds from the microphone to determine respiratory distress of the user local to the mobile computing device. 
     A method to monitor a user for an opioid overdose event can comprise receiving sensed indications of an overdose condition of a user from one or more sensors configured to sense an environment local to the user; determine an opioid overdose event is occurring or will soon occur based on the received indications; present a request for user input on the touchscreen display based on the determination; and transmit wirelessly notifications of the overdose event to one or more recipients based on a failure to receive user input. 
     The method can further comprise receiving monitoring data from a monitoring service that monitors the user and an environment local to the user; and transmitting the notification of the opioid overdose event to the monitoring service. The monitoring service can be a security alarm service. The monitoring data can include user data associated with a state of the user and environmental data associated with the environment local to the user. The method can further comprise analyzing representations of the images from the camera to determine respiratory distress of the user in the images. 
     The method can further comprise analyzing representations of the images from the camera to determine an unconscious state of the user in the images. The method can further comprise causing the touchscreen display to display care instructions to care for a victim of an opioid overdose. The method can further comprise outputting, from the mobile computing device, an audible alarm based on the determination. 
     A system to monitor for indications of opioid overdose event can comprise software instructions storable in memory of a first mobile computing device. The software instructions executable by one or more hardware processors of the first mobile computing device can cause the one or more hardware processors to continuously receive data indicative of one or more physiological parameters of a first user that is being monitored by one or more sensors; continuously compare each of the one or more physiological parameters with a corresponding threshold; determine an opioid overdose event is occurring or will soon occur based on the comparisons; trigger an alarm on the first mobile computing device based on the determination; and notify a second user of the alarm by causing a display of a second mobile computing device associated with the second user to display a status of an alarming physiological parameter of the first user. 
     The one or more hardware processors can further cause a display of the first mobile computing device to continuously update graphical representations of the one or more physiological parameters in response to the continuously received data. The one or more hardware processors can further display a user-selectable input to view additional information associated with the first user. 
     Selecting the user-selectable input can cause the display of the second mobile computing device to display one or more of trends and current value of the alarming physiological parameter. Selecting the user-selectable input can cause the display of the second mobile computing device to display a location of the first mobile computing device on a map. Selecting the user-selectable input can cause the display of the second mobile computing device to display a time of an initial alarm. Selecting the user-selectable input can cause the display of the second mobile computing device to provide access to directions to the first mobile computing device from a location of the second mobile computing device. Selecting the user-selectable input can cause the display of the second mobile computing device to provide access to call the first mobile computing device. 
     The one or more physiological parameters can be represented as dials on the display. The one or more physiological parameters can include one or more of oxygen saturation, heart rate, respiration rate, pleth variability, perfusion index, and respiratory effort index. The alarm can be an audible and visual alarm. Each of the corresponding thresholds can be adjustable based on characteristics of the first user to inhibit false-positive alarms. 
     The one or more hardware processors can further transmit indications of the one or more physiological parameters to a remote server. The one or more hardware processors can further transmit indications of the one or more physiological parameters to a medical monitoring hub for storage in memory of the medical monitoring hub. The one or more hardware processors can communicate wirelessly with a local Internet of Things connected device to receive additional data for use in the determination of the opioid overdose event. The one or more hardware processors can further notify emergency services of the alarm. The first and second mobile computing devices can be smart phones. 
     A method to monitor for indications of an opioid overdose event can comprise continuously receiving, with a first mobile computing device, data indicative of one or more physiological parameters of a first user that is being actively monitored by one or more sensors; continuously comparing, with the first mobile computing device, each of the one or more physiological parameters with a corresponding threshold; determining, with the first mobile computing device, an opioid overdose event is occurring or will soon occur based on the comparisons; triggering, with the first mobile computing device, an alarm on the first mobile computing device based on the determination; and notifying, with the first mobile computing device, a second user of the alarm by causing a display of a second mobile computing device associated with the second user to display a status of an alarming physiological parameters of the first user. 
     The method can further comprise causing a display of the first mobile computing device to continuously update graphical representations of the one or more physiological parameters in response to the continuously received data. The method can further comprising displaying a user-selectable input to view additional information associated with the first user. 
     Selecting the user-selectable input can cause the display of the second mobile computing device to display one or more of trends and current value of the alarming physiological parameter. Selecting the user-selectable input can cause the display of the second mobile computing device to display a location of the first mobile computing device on a map. Selecting the user-selectable input can cause the display of the second mobile computing device to display a time of an initial alarm. Selecting the user-selectable input can cause the display of the second mobile computing device to provide access to directions to the first mobile computing device from a location of the second mobile computing device. Selecting the user-selectable input can cause the display of the second mobile computing device to provide access to call the first mobile computing device. 
     The one or more physiological parameters can be represented as dials on the display. The one or more physiological parameters can include one or more of oxygen saturation, heart rate, respiration rate, pleth variability, perfusion index, and respiratory effort index. The alarm can be an audible and visual alarm. Each of the corresponding thresholds can be adjustable based on characteristics of the first user to inhibit false-positive alarms. 
     The method can further comprise transmitting indications of the one or more physiological parameters to a remote server. The method can further comprise transmitting indications of the one or more physiological parameters to a medical monitoring hub for storage in memory of the medical monitoring hub. The method can further comprise communicating wirelessly with a local Internet of Things connected device to receive additional data for use in the determination of the opioid overdose event. The method can further comprise notifying emergency services of the alarm. The first and second mobile computing devices can be smart phones. 
     A kit for use in monitoring at least one physiological parameter to detect opioid overdose can comprise a sensor assembly to collect data associated with the at least one physiological parameter; and a base station to determine that an opioid overdose event is occurring or is likely to occur based on the collected data. 
     The kit can further comprise a cord and charger plug associated with the base station. The kit can further comprise one or more spare sensors. A prescription may not be needed to purchase the kit. The kit can further comprise a self-administrating medication applicator that includes at least one dose of an opioid receptor antagonist. The opioid receptor antagonist can be naloxone. A prescription can be used to purchase the kit. The sensor assembly can comprise a sensor dongle, a sensor, and a signal processing device. The sensor assembly can comprise a sensor dongle and a sensor. The sensor can be a fingertip sensor. The sensor can be configured to be placed around a finger. The sensor can be a fingertip pulse oximeter sensor, an electroencephalograph, a capnometer or a capnograph, an acoustic respiratory monitor sensor, applied to a toe, worn as a glove, a disposable sensor, or a an air sensor. 
     The sensor can communicate the collected data wirelessly to the base station. The base station can include a processor and memory storing instructions that when executed cause the processor to process data from the sensor to provide the at least one physiological parameter. The processor can be further caused to compare a value of the at least one physiological parameter to a threshold that is indicative of the opioid overdose event and to determine that the overdose event is occurring or is likely to occur based on the comparison. The processor can be further caused to cause an alarm when the overdose event is determined. The alarm can include one or more of causing an audible or vibratory alarm, notify first responders, notify friend and family, a text message indicating a location of a person associated with the overdose event. 
     The at least one physiological parameter can be oxygen saturation of blood. The at least one physiological parameter can be blood oxygen information comprising one or more of oxygen content (SpOC), oxygen saturation (SpO 2 ), blood glucose, total hemoglobin (SbHb), methemoglobin (SbMet), carboxyhemoglobin (SpCO), bulk tissue property measurements, water content, pH, blood pressure, respiration related information, cardiac information, perfusion index (PI), or pleth variability indices (PVI). The kit can further comprise one or more doses of an opioid receptor antagonist. The opioid receptor antagonist can be naloxone. The kit can further comprise a self-administrating medication applicator that includes the one or more doses of the opioid receptor antagonist. A prescription can be used to purchase the kit. 
     A kit for use in monitoring at least one physiological parameter to detect opioid overdose can comprise a sensor assembly including a sensor that is configured to sense the at least one physiological parameter; and a base station that includes a processor and memory storing instructions that when executed cause the processor to process data from the sensor to provide the at least one physiological parameter, to compare a value of the at least one physiological parameter to a threshold that is indicative of an opioid overdose event, and to determine that the overdose event is occurring or is likely to occur based on the comparison. The kit can further comprise a cord and charger plug associated with the base station. The sensor assembly can comprise a sensor dongle and a sensor. The kit can further comprise one or more spare sensors. The sensor can be a fingertip sensor. The at least one physiological parameter can be oxygen saturation of blood. 
     The at least one physiological parameter can be blood oxygen information such as oxygen content (SpOC), oxygen saturation (SpO 2 ), blood glucose, total hemoglobin (SbHb), methemoglobin (SbMet), carboxyhemoglobin (SpCO), bulk tissue property measurements, water content, pH, blood pressure, respiration related information, cardiac information, perfusion index (PI), or pleth variability indices (PVI). The kit can further comprise one or more doses of an opioid receptor antagonist. The opioid receptor antagonist can be naloxone. The kit can further comprise a self-administrating medication applicator that includes at least one dose of an opioid receptor antagonist. A prescription can be used to purchase the kit. A prescription may not be needed to purchase the kit. 
     A kit for use in monitoring at least one physiological parameter to detect opioid overdose can comprise a sensor assembly including a sensor that is configured to sense the at least one physiological parameter; a base station that includes a processor and memory storing instructions that when executed cause the processor to process data from the sensor to provide the at least one physiological parameter and to determine an opioid overdose event based on the at least one physiological parameter; a self-administrating medication applicator having an injector and a dose of an opioid receptor antagonist; and a housing having molded depressions to hold at least the base station and the sensor assembly. The kit can further comprise a cord and charger plug associated with the base station. The housing can have additional molded depressions to hold a cord and charger plug. The housing can have additional depressions to hold the self-administrating medication applicator. The housing can comprise a tray having an upper section and a lower section. The tray can comprise paper pulp. The tray can be molded. The housing can comprise a top section that is configured to fold over a bottom section to form a lid. the lid can be configured to enclose at least the sensor assembly and the base station when the top section of the housing is folded over the bottom section of the housing. 
     For purposes of summarizing the disclosure, certain aspects, advantages and novel features are discussed herein. It is to be understood that not necessarily all such aspects, advantages or features will be embodied in any particular embodiment of the invention, and an artisan would recognize from the disclosure herein a myriad of combinations of such aspects, advantages or features. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Various embodiments will be described hereinafter with reference to the accompanying drawings. The drawings and the associated descriptions are provided to illustrate embodiments of the present disclosure and do not limit the scope of the claims. In the drawings, similar elements have similar reference numerals. 
         FIG. 1A  is an overview of an example opioid use monitoring system. 
         FIG. 1B  is a diagrammatic representation of an example network associated with monitoring opioid. 
         FIG. 1C  is an overview of another example opioid use monitoring system. 
         FIG. 2A  is a block diagram of an example physiological monitoring system. 
         FIG. 2B  is a flow chart of an example process to monitor physiological parameters for opioid use and provide notifications. 
         FIGS. 3A-3E  illustrate various example software applications to provide information, notifications, and alerts to opioid users, first responders, medical personnel, and friends. 
         FIG. 4  is a flow chart of an example process to monitor for opioid overdose. 
         FIGS. 5A-5F  illustrate various example software applications to trigger an alarm and notify a friend when an opioid overdose is indicated. 
         FIGS. 6A-6J  illustrate various examples of physiological parameter sensors and signal processing devices. 
         FIG. 7A  is a block diagram of an example opioid user system environment and an example cloud environment. 
         FIG. 7B  is a block diagram illustrating example components of a cloud environment. 
         FIG. 7C  is a block diagram illustrating example components of an opioid user system of an example opioid user system environment. 
         FIG. 8  is a flowchart of an example process to notify an opioid user&#39;s notification network of the status of the opioid user. 
         FIG. 9A  is a block diagram of an example physiological monitoring and medication administration system. 
         FIGS. 9B and 9C  are schematic diagrams of example self-administrating medication applicators. 
         FIG. 10  is a flow diagram of an example process to monitor for opioid overdose and to apply medication to reverse the effects of an overdose. 
         FIGS. 11A-11C  are schematic diagrams of example needle-free injection multi-dose self-administrating medication applicators. 
         FIGS. 12A and 12B  are schematic diagrams of example injection multi-dose self-administrating medication applicators having a hypodermic needle for injection. 
         FIG. 13  is a schematic diagram of an example wearable self-administrating medication applicator. 
         FIG. 14  is a block diagram of example activation circuitry for multi-dose self-administrating medication applicators. 
         FIG. 15  is a flow diagram of an example process to administer medication from a self-administrating medication applicator. 
         FIGS. 16A and 16B  are flow diagrams of example processes to administer multiple doses of medication from a self-administrating medication applicator. 
         FIG. 17  is a schematic diagram of another example wearable self-administrating medication applicator. 
         FIG. 18A  is a block diagram of an example opioid use monitoring system. 
       FIGS.  18 A 1 - 18 A 25  illustrate various example software applications to trigger an alarm and notify a friend when an opioid overdose is indicated. 
         FIG. 18B  is a flow diagram of an example process to administer the opioid receptor antagonist using the system of  FIG. 18A . 
         FIG. 19  is an example of a medical monitoring hub device used on the opioid use monitoring system of  FIG. 18 . 
         FIGS. 20A and 20B  are schematic diagrams of example prescription and non-prescription opioid overdose monitoring kits. 
         FIG. 20C  illustrates an example of an opioid overdose monitoring kit. 
         FIG. 21  illustrates an example tray for use in an opioid overdose monitoring kit. 
         FIG. 22A  illustrates a top, front, and right side perspective view of a tray or kit housing embodying a new design. 
         FIG. 22B  illustrates a front view of the tray or kit housing of  FIG. 22A . 
         FIG. 22C  illustrates a back view of the tray or kit housing of  FIG. 22A . 
         FIG. 22D  illustrates a left side view of the tray or kit housing of  FIG. 22A . 
         FIG. 22E  illustrates a right side view of the tray or kit housing of  FIG. 22A . 
         FIG. 22F  illustrates a top view of the tray or kit housing of  FIG. 22A . 
         FIG. 22G  illustrates a bottom view of the tray or kit housing of  FIG. 22A . 
     
    
    
     DETAILED DESCRIPTION 
     Although certain embodiments and examples are described below, this disclosure extends beyond the specifically disclosed embodiments and/or uses and obvious modifications and equivalents thereof. Thus, it is intended that the scope of this disclosure should not be limited by any particular embodiments described below. 
     Overview 
     An application for a mobile computing device that is used in conjunction with a physiological parameter monitoring assembly to detect physiological parameters of an opioid user can comprise determining a physiological condition of the opioid user based at least in part on the physiological parameters, and providing notifications based at least in part on the physiological condition of the opioid user. The physiological parameter monitoring assembly can be a pulse oximeter that includes a sensor and a signal processing device. Examples of physiological parameters that can be monitored are peripheral oxygen saturation (SpO 2 ), respiration, and perfusion index (PI). The application can determine the physiological condition of the user based on the SpO 2  alone, respiration alone, PI alone, a combination of the SpO 2  and respiration, a combination of the SpO 2  and PI, a combination of the respiration and the PI, or a combination of the SpO 2 , respiration, and PI. 
     The application can request user input and determine the physiological condition of the user based at least in part on the received user input and the physiological parameters from the pulse oximeter. The determination of the user&#39;s condition can be based on the user input and one or more of peripheral oxygen saturation (SpO 2 ), respiration, and perfusion index (PI). The application can learn, based at least in part on stored physiological parameters, trends in user&#39;s the physiological reaction to opioid use to better anticipate overdose events of the user. 
     The application can notify one or more of caregivers, loved ones, friends, and first responders of an overdose event. The application can provide “everything OK” notifications upon request or periodically to concerned family and friends. The application can provide detailed care instructions to first responders. The application can provide the location of the user, the location of the closest medication to reverse the effects of an opioid overdose, or the location of the closest medical personnel. The application can provide one or more of visual, audible, and sensory (vibration) alerts to the user with increasing frequency and intensity to the user. 
     An application for a mobile computing device that is used in conjunction with a sensor and a signal processing device to detect abnormally low blood oxygen saturation that is indicative of an overdose event in a user can comprise triggering an alarm, and notifying others of the overdose event. This increases the likelihood that opioid users, their immediate personal networks, and first responders are able to identify and react to an overdose by administrating medication to reverse the effects of the overdose. Such medication can be considered an opioid receptor antagonist or a partial inverse agonist. Naloxone or Narcan® is a medication that reverses the effect of an opioid overdose and is an opioid receptor antagonist. Buprenorphine or Subutex® is an opioid used to treat opioid addiction. Buprenorphine combined with naloxone or Suboxone® is a medication that may also be used to reverse the effect of an opioid overdose. Other example medications are naltrexone, nalorphine, and levallorphan. Administration can be accomplished by intravenous injection, intramuscular injection, and intranasally, where a liquid form of the medication is sprayed into the user&#39;s nostrils. Administration of the medication can also occur via an endotracheal tube, sublingually, where a gel or tablet of the medication is applied under the tongue, and transdermally, where the medication can be a gel applied directly to the skin or within a transdermal patch applied to the skin. 
     A system to monitor a user for an opioid overdose condition can comprise a sensor configured to monitor one or more physiological parameters of a user, a signal processing device configured to receive raw data representing the monitored one or more physiological parameters and to provide filtered parameter data; and a mobile computing device configured to receive the one or more physiological parameters from the signal processing device. The mobile computing device comprises a user interface, a display, network connectivity, memory storing an application as executable code, and one or more hardware processors. The application monitors the physiological parameters to determine a condition of the user and provides notifications to the user, to a crowd-sourced community of friends, family, and other opioid users that have also downloaded the application onto their computing devices, and to emergency providers and medical care personnel. 
     Home pulse oximetry monitoring systems for opioid users can include a pulse oximeter, such as a Masimo Rad-97 Pulse CO-Oximeter®, for example, and sensors, such as Masimo LNCS® adhesive sensors and the like, to detect blood oxygen levels and provide alerts and alarms when the opioid user&#39;s blood oxygen level drops below a threshold. The home monitoring system can provide alarm notifications that can alert a family member, remote caregiver, and a first responder, for example, to awaken the opioid user and to administer the antidote for an opioid overdose, such as an opioid receptor antagonist. 
     The mobile computing device can be configured to receive the filtered parameter data from the signal processing device; display representations of the filtered parameter data on the display, where the filtered parameter data includes at least oxygen saturation data for the oxygen level in the blood of the user; compare a current oxygen saturation value to a minimum oxygen saturation level; trigger an alarm when the current oxygen saturation value is below the minimum oxygen saturation level; and provide notifications over a network to another when the current oxygen saturation value is below the minimum oxygen saturation level. 
     The display can display the representations of the filtered parameter data as dials indicating acceptable and acceptable ranges. The filtered parameter data can include one or more of heart rate data, respiration rate data, pleth variability data, perfusion index data, and respiratory effort index data. The application can provide notifications to the user and can provide notifications to others. The notification can be one or more of a text message, an email, and a phone call. The notification can include a current value of oxygen saturation and a graph indicting a trend of the oxygen saturation levels. The notification can further include one or more of a phone number of the user, a location of the user, directions to the location of the user, a closest location of naloxone or other medication used to reverse the effects of an opioid overdose. The notification can be an automatic call to emergency responders. 
     A system to monitor a user for an opioid overdose condition can comprise one or more computing devices associated with an opioid overdose monitoring service. The opioid overdose monitoring service can be configured to identify opioid monitoring information from at least one physiological monitoring system associated with a user, where the opioid monitoring information comprises one of an overdose alert and a non-distress status, retrieve over a network notification information associated with the user, where the notification information includes first contact information associated with the overdose alert and second contact information associated with the non-distress status, send an overdose notification using the first contact information in response to the opioid monitoring information that indicates the overdose alert, and send a non-distress notification using the second contact information in response to the opioid monitoring information that indicates the non-distress status. 
     The system can further comprise a physiological monitoring system comprising a sensor configured to monitor one or more physiological parameters of the user and a signal processing board configured to receive raw data representing the monitored one or more physiological parameters and to provide filtered parameter data, and a mobile computing device comprising a display, network connectivity, memory storing executable code, and one or more hardware processors. The mobile computing device can be configured to receive the filtered parameter data from the signal processing board, display representations of the filtered parameter data on the display, where the filtered parameter data includes at least oxygen saturation data for the oxygen level in the blood of the user, compare a current oxygen saturation value to a minimum oxygen saturation level, and trigger an alarm when the current oxygen saturation value is below the minimum oxygen saturation level. 
     The mobile computing device can be configured to receive the filtered parameter data from the signal processing board, generate the opioid monitoring information based on the filtered parameter data, and send the opioid monitoring information over a network to the opioid overdose monitoring service. The filtered parameter data can include one or more of a current oxygen saturation value, heart rate data, respiration rate data, pleth variability data, perfusion index data, and respiratory effort index data. The overdose and non-distress notifications can comprise one or more of a text message, an email, and a phone call. The overdose and non-distress notifications can include a current value of oxygen saturation and a graph indicting a trend of the oxygen saturation levels. The overdose notification can comprise one or more of a phone number of the user, a location of the user, directions to the location of the user, a closest location of naloxone or other medication used to reverse the effects of an opioid overdose. The overdose notification can automatically calls emergency responders. The network can be the Internet. 
     A kit for monitoring for an opioid overdose event can comprise a sensor to sensor physiological parameters and a medical monitoring hub device to receive indications of the sensed physiological parameters and to receive an indication of an opioid overdose event. The kit can further comprise a delivery device to deliver medication in response to the indication of the opioid overdose event. The delivery device can automatically administers an opioid receptor antagonist in response to the indication of an opioid overdose event. The delivery device can comprise a patch that includes a reservoir with the medication, a needle, and a battery. The hub device can comprise memory for storage of the indication of the sensed physiological parameters. The hub device can receive and store data from monitoring devices other than the sensor. The data from the monitoring devices can comprise data associated with a well-being of a user. The kit may be available without a prescription. 
       FIG. 1A  is an overview of an example opioid use monitoring/notification system. The opioid users&#39; support network can include friends, family, emergency services, care providers, and overdose care networks, for example that communicate over a network, such as the Internet. The support network receives notifications and/or status updates of the opioid user&#39;s condition. An optional monitoring device can monitor the opioid user&#39;s respiration and other biological parameters, such as heart rate, blood oxygen saturation, perfusion index, for example, and provides the parameters to the smart device. An application running on the smart device can determine whether an opioid overdose event is imminent and/or occurring. The application can also provide additional information, such as care instructions, patient trends, medical opioid information, care instruction, user location, the location of naloxone, buprenorphine, buprenorphine in combination with naloxone, or other medication used to reverse the effects of an opioid overdose, and the like. The support network, after receiving a notification, can communicate with a central server to obtain the additional information. 
       FIG. 1B  is a diagrammatic representation of an example support network associated with monitoring opioid use. The diagram illustrates an example of an opioid use support network. An opioid user may want to notify friends, family, and caregivers when they are in need of emergency care due to indications that an opioid overdose is imminent or occurring. The diagram illustrates an example of an opioid use support network. Subnetworks within the support network may receive different notifications. For example, caregivers, such as emergency 911 services, rideshare services, such as Uber® and Lyft®, for example, treatment centers, prescribing caregivers, specialty caregivers, ambulance services can receive possible overdose alerts in order to provide the immediate life-saving care to the user; an on-site caregiver can receive care instructions; friends and family can receive periodic status messages indicating no overdose event occurring; and transportation services can receive messages with the location of medications used to reverse the effects of an opioid overdose, such as naloxone, buprenorphine, a combination of buprenorphine and naloxone, and the like. Other subnetworks receiving different notifications are possible. 
       FIG. 1C  is an overview of another example opioid use monitoring system. As illustrated above in  FIG. 1A , the opioid users&#39; support network can include friends, family, emergency services, care providers, and overdose care networks, for example, that communicate over a network, such as the Internet. The support network receives notifications and/or status updates of the opioid user&#39;s condition. A monitoring device including a sensor can monitor the opioid user&#39;s respiration and other biological parameters, such as heart rate, blood oxygen saturation, perfusion index, for example, and provide the parameters to a HUB device that can communicate over the network. An example of a HUB device is illustrated in  FIG. 6H . The HUB device receives the sensor data from the sensor. The HUB device can send the sensor data over the network to the server. The HUB device can at least partially processes the sensor data and sends that at least partially processed sensor data to the server. The server processes the sensor data or the at least partially processed sensor data and determines whether an overdose event is imminent and/or occurring. When an overdose event is imminent and/or occurring, the server notifies the support network and the mobile application on the opioid user&#39;s mobile device. 
     Instrumentation-Sensor and Signal Processing Device 
       FIG. 2A  illustrates an example physiological monitoring system  100 . The illustrated physiological monitoring system  100  includes a sensor  102 , a signal processing device  110 , and a mobile computing device  120 . 
     The sensor  102  and the signal processing device  110  can comprise a pulse oximeter. Pulse oximetry is a noninvasive method for monitoring a person&#39;s oxygen saturation. The sensor  102  is placed on the user&#39;s body and passes two wavelengths of light through the body part to a photodetector. The sensor  102  can provide raw data  104  to the signal processing device  110 , which determines the absorbance&#39;s of the light due to pulsating arterial blood. The pulse oximeter generates a blood-volume plethysmograph waveform from which oxygen saturation of arterial blood, pulse rate, and perfusion index, among other physiological parameters, can be determined, and provides physiological parameters  118  to the mobile computing device  120 . 
     The pulse oximeter can be transmissive, where the sensor  102  is placed across a thin part of the user&#39;s body, such as a fingertip or earlobe, for example, or reflective, where the sensor  102  can be placed on the user&#39;s forehead, foot, or chest, for example. 
     The sensor  102  and the signal processing device  110  can be packaged together. The sensor  102  can be not packaged with the signal processing device  110  and communicates wirelessly or via a cable with the signal processing device  110 . 
     Examples of pulse oximeters are the MIGHTYSAT RX fingertip pulse Oximeter®, the Rad-57® handheld pulse CO-oximeter, and the Rainbow® CO-oximeter, all by Masimo Corporation, Irvine, Calif., which are capable of being secured to a digit, such as a finger. 
     Because opioid users may want to be discrete when monitoring opioid use for indications of an overdose event, sensors  102  that are not visible may provide additional confidentiality for the user. The sensor  102  can be applied to a toe and the signal processing device  110  can comprise an ankle brace. The sensor  102  can be a ring on the user&#39;s finger or a bracelet on the user&#39;s wrist, and the signal processing device  110  can be within an arm band hidden under the user&#39;s sleeve. The sensor  102  or the sensor  102  and the signal processing device  110  can be integrated into a fitness device worn on the user&#39;s wrist. Such pulse oximeters can be reflective or transmissive. The sensor  102  can be an ear sensor that is not readily visible. 
     Other varieties of sensors  102  can be used, for example adhesive sensors, combination reusable/disposable sensors, soft and/or flexible wrap sensors, infant or pediatric sensors, multisite sensors, or sensors shaped for measurement at a tissue site such as an ear. 
     Other sensors  102  can be used to measure physiological parameters of the user. For example, a modulated physiological sensor can be a noninvasive device responsive to a physiological reaction of the user to an internal or external perturbation that propagates to a skin surface area. The modulated physiological sensor has a detector, such as an accelerometer, configured to generate a signal responsive to the physiological reaction. A modulator varies the coupling of the detector to the skin so as to at least intermittently maximize the detector signal. A sensor processor controls the modulator and receives an effectively amplified detector signal, which is processed to calculate a physiological parameter indicative of the physiological reaction. A modulated physiological sensor and corresponding sensor processor are described in U.S. Publication No. 2013/0046204 to Lamego et al., filed Feb. 21, 2013, titled “MODULATED PHYSIOLOGICAL SENSOR” and assigned to Masimo Corporation, Irvine, Calif., which is hereby incorporated by reference herein. 
     The sensor  102  can include an electroencephalograph (“EEG”) that can be configured to measure electrical activity along the scalp. The sensor  102  can include a capnometer or capnograph that can be configured to measure components of expired breath. 
     An acoustic sensor  102  can be used to determine the user&#39;s respiration rate. An acoustic sensor utilizing a piezoelectric device attached to the neck is capable of detecting sound waves due to vibrations in the trachea due to the inflow and outflow of air between the lungs and the nose and mouth. The sensor outputs a modulated sound wave envelope that can be demodulated so as to derive respiration rate. An acoustic respiration rate sensor and corresponding sensor processor is described in U.S. Publication No. 2011/0125060 to Telfort et al., filed Oct. 14, 2010, titled “ACOUSTIC RESPIRATORY MONITORING SYSTEMS AND METHODS” and assigned to Masimo Corporation, Irvine, Calif., which is hereby incorporated by reference herein. 
     The mobile computing device  120  can include an accelerometer that is configured to detect motion of the mobile computing device  120 . When the user holds the mobile computing device  120  or attaches the mobile computing device  120  to his clothing in such a way that the accelerometer detects motion of the user, then the accelerometer can be used to detect lack of motion of the user. The lack of user motion can be used to determine the user&#39;s condition, as described below. 
     When the user holds the mobile computing device  120 , the accelerometer can sense vibrations from the user indicative of the user&#39;s heart rate. A lack of vibrations sensed by the accelerometer can indicate no heart rate and reduced occurrences of vibrations sensed by the accelerometer can indicate cardiac distress. The indications of cardiac activity sensed by the accelerometer in the mobile computing device can be used to determine the user&#39;s condition, as described below. 
     The sensor  102  can be a centroid patch worn by the user that includes an accelerometer. Data indicative of the movement of the accelerometer can be transmitted wirelessly to the mobile computing device  120 . Based on movement detected by the accelerometer, the application detects the respiration rate of the user. An oxygen sensor configured to monitor the user&#39;s breath can wirelessly transmit an indication of the oxygen present in the user&#39;s exhaled breath. 
     The physiological sensor  102  and the mobile computing device  120  can be connected via a cable or cables and the signal processing device  110  can be connected between the sensor  102  and the mobile computing device  120  to conduct signal processing of the raw data  104  before the physiological parameters  118  are transmitted to the mobile computing device  120 . A mobile physiological parameter monitoring system is described in U.S. Pat. No. 9,887,650 to Muhsin et al., issued on Jan. 30, 2018, titled “PHYSIOLOGICAL MONITOR WITH MOBILE COMPUTING DEVICE CONNECTIVITY”, and assigned to Masimo Corporation, Irvine, Calif., which is hereby incorporated by reference herein. 
     In various oximeter examples, the sensor  102  provides data  104  in the form of an output signal indicative of an amount of attenuation of predetermined wavelengths (ranges of wavelengths) of light by body tissues, such as, for example, a digit, portions of the nose or ear, a foot, or the like. The predetermined wavelengths often correspond to specific physiological parameter data desired, including for example, blood oxygen information such as oxygen content (SpOC), oxygen saturation (SpO 2 ), blood glucose, total hemoglobin (SbHb), methemoglobin (SbMet), carboxyhemoglobin (SpCO), bulk tissue property measurements, water content, pH, blood pressure, respiration related information, cardiac information, perfusion index (PI), pleth variability indices (PVI), or the like, which can be used by the mobile computing device  120  to determine the condition of the user. Sensor data  104  can provide information regarding physiological parameters  118  such as EEG, ECG, heart beats per minute, acoustic respiration rate (RRa), breaths per minute, end-tidal carbon dioxide (EtCO 2 ), respiratory effort index, return of spontaneous circulation (ROSC), or the like, which can be used to determine the physiological condition of the user. 
     Referring to  FIG. 2A , the sensor  102  can transmit raw sensor data  104  to the signal processing device  110 , and the signal processing device  110  can convert the raw sensor data  104  into data representing physiological parameters  118  for transmission to the mobile computing device  120  for display, monitoring and storage. The sensor data  104  can be transmitted wirelessly, using Bluetooth®, near field communication protocols, Wi-Fi, and the like or the sensor data  104  can be transmitted to the signal processing device  110  through a cable. 
     The sensor data  104  can be corrupted by noise due to patient movement, electromagnetic interference, or ambient light, for example. The physiological parameter monitoring system  100  can apply noise filtering and signal processing to provide the physiological parameters  118  for analysis and display on the mobile computing device  120 . Such complex processing techniques can exceed the processing capabilities of the mobile computing device  120 , and therefore the signal processing device  110  can handle signal processing of the raw sensor data  104  and transmit the processed physiological parameters  118  to the mobile computing device  120 . 
     In the context of pulse oximetry, the signal processing device  110  can use adaptive filter technology to separate an arterial signal, detected by a pulse oximeter sensor  102 , from the non-arterial noise (e.g. venous blood movement during motion). During routine patient motions (shivering, waving, tapping, etc.), the resulting noise can be quite substantial and can easily overwhelm a conventional ratio based oximetry system. This can provide accurate blood oxygenation measurements even during patient motion, low perfusion, intense ambient light, and electrocautery interference. Accordingly, false alarms can be substantially eliminated without sacrificing true alarms. 
     The signal processing device  110  can transmit the physiological parameters  118  wirelessly, using Bluetooth®, near field communication protocols, Wi-Fi, and the like to the mobile computing device  120 , or the signal processing device  110  can transmit the physiological parameters  118  to the mobile computing device  120  through a cable. 
       FIGS. 6A-6J  illustrate various example sensors  102  and signal processing devices  110 .  FIG. 6A  illustrates a mobile physiological monitoring system  610  that includes a fingertip pulse oximeter sensor  102  that is connected to the mobile computing device  120 , which is illustrated as a smartphone, through a cable that includes the signal processing device  110 . 
       FIGS. 6B-6D  illustrate other example mobile physiological sensor assemblies that can be in physical communication with a user to collect the user&#39;s physiological data and send indications of the user&#39;s physiological parameters to the mobile computing device  120 .  FIG. 6B  illustrates a mobile physiological sensor assembly  620  that includes an electroencephalograph (“EEG”) that can be configured to measure electrical activity along the scalp.  FIG. 6C  illustrates a mobile physiological sensor assembly  630  that includes a capnometer or capnograph that can be configured to measure components of expired breath.  FIG. 6D  illustrates a mobile physiological sensor assembly  640  that includes an acoustic respiratory monitor sensor that can be configured to measure respiration rate using an adhesive sensor with an integrated acoustic transducer. 
       FIG. 6E  illustrates the Rad-57® handheld pulse CO-oximeter  650  by Masimo Corporation, Irvine Calif. The oximeter  650  has a fingertip oximeter sensor  102  that communicates the raw data  104  through a cable to the signal processing device  110 , which includes display capabilities. 
       FIG. 6F  illustrates the MIGHTYSAT RX fingertip pulse Oximeter® 660 by Masimo Corporation, Irvine, Calif. The sensor  102  and the signal processing device  110  of the oximeter  660  are integrated into a single package. 
       FIG. 6G  illustrates a physiological parameter assembly  670  comprising a sensor  102  applied to the toe and a signal processing device  110  in an ankle band for discreetly monitoring for opioid overdose conditions. 
       FIG. 6H  illustrates a monitoring hub  680  comprising a ROOT® monitoring hub  326  with a Radical-7® pulse oximeter  200 , both by Masimo Corporation, Irvine, Calif. The medical monitoring hub  680  can expand monitoring capabilities by bringing together signal processing and display for multiple physiological parameters, such as brain function monitoring, regional oximetry, and capnography measurements. 
       FIG. 6I  illustrates a physiological parameter assembly  690  comprising a sensor  102  and a signal processing device  110  that can be worn as a glove. When the glove is placed on the user&#39;s hand, the sensor  102  can be placed on one of the fingertips. The sensor  102  can be a disposable sensor. The sensor  102  can be built inside or outside the fingers of the glove. The sensor  102  can be integrated to the fingers of the glove. The cable of the signal processing device  110  can be integrated to the glove. Advantageously, the glove is easy to wear, stays in place, and can be easily removed when the user is not in need of opioid overdose monitoring. The glove  690  can fasten at the wrist with a strap, hook and loop fastener, and the like. The sensor  110  can be wireless and communicates with the mobile device  120  using wireless technology, such as Bluetooth®, and the like. 
       FIG. 6J  illustrates a physiological parameter assembly  695  comprising a sensor  102  and a cable for connection to a signal processing device. The sensor  102  can be a disposable sensor. The sensor  102  can be placed around a finger. The sensor  102  can communicate sensor data wirelessly. 
     Instrumentation-Mobile Computing Device 
     Any mobile computing device  120  that is compatible with the physiological parameter assembly that includes the sensor  102  and the signal processing device  110  can be used. A compatible mobile computing device can be one of a wide range of mobile devices such as, but not limited to a mobile communications device (such as a smartphone), laptop, tablet computer, netbook, PDA, media player, mobile game console, wristwatch, wearable computing device, or other microprocessor based device configured to interface with the signal processing device  110  and provide notifications based at least in part on the monitored physiological parameters  118 . 
     Referring to  FIG. 2A , the mobile computing device  120  can include a display  122  for display of the physiological parameters, for example in a user interface and/or software application, as discussed in more detail below. The display  122  can include a display screen such as an LED or LCD screen, and can include touch sensitive technologies in combination with the display screen. Mobile computing device  120  can include software configured to display some or all of the output measurement data on the display screen. The data display can include numerical or graphical representations of blood oxygen saturation, heart rate, respiration rate, pleth variability, perfusion index, and/or a respiratory efforts index, and may simultaneously display numerical and graphical data representations. 
     The mobile computing device  120  can include a user interface  126  that can receive user input. The user interface  126  can include buttons, a key pad, the touch sensitive technologies of the display screen  122 , and other user input mechanisms typically found on the various example mobile computing devices  120 . 
     The mobile computing device  120  can also include data storage  124 , which can be configured for storage of the physiological parameters  118  and parameter history data and/or software applications that monitor the physiological parameters for an overdose indication and provide notifications. The storage  124  can be physical storage of the mobile computing device  120 , and the storage  124  can be remote storage, such as on a server or servers of a data hosting service. 
     The mobile computing device  120  can also include a network connectivity feature  128  that provides network connection capabilities such as one or more of a cellular network, satellite network, Bluetooth, ZigBee, wireless network connection such as Wi-Fi or the like, and a wired network connection. The mobile computing device  120  can also include a data transfer port. 
     Application Functionality Overview 
     The mobile computing device  120  can include software such as an application  130  configured to manage the physiological parameters  118  from the physiological parameter monitoring device  110 . The application functionality can include trend analysis, current measurement information, alarms associated with above/below threshold readings, reminders to take measurement data at certain times or cycles, display customization, iconic data such as hearts beating, color coordination, bar graphs, gas bars, charts, graphs, or the like, all usable by a caregiver or application user to provide medical monitoring of specified physiological parameters. The display  122  can display the physiological parameters  118  as numerical values, graphs, charts, dials and the like. 
     The application  130  via the mobile computing device  120  can also alert the user and/or person(s) designated by the user to an abnormal data reading. For example, an abnormally low blood oxygen saturation reading can cause the mobile computing device  120  to buzz, vibrate or otherwise notify the user of an abnormal reading, and to transmit a notification or alert to the user, the designated person(s) or medical personnel to a network via the network connectivity  128 . 
     In addition, the application  130  includes one or more processes to monitor the physiological parameters  118  for the condition of the user, and in particular for signs of an opioid overdose. The application  130  can be set up by the user or a caregiver to notify another of the overdose event. This increases the likelihood that the opioid user, their immediate personal networks, and first responders are able to identify and react to an overdose by administrating medication used to reverse the effects of an opioid overdose, such as naloxone. Naloxone is an overdose-reversal drug. In some states, people who are or who know someone at risk for opioid overdose can go to a pharmacy or community-based program to get trained on naloxone administration and receive naloxone by “standing order,” which means a patient-specific prescription is not required. When administered in time, naloxone can restore an overdose victim&#39;s breathing long enough for trained medical assistance to arrive. In some instances, other overdose reversal drugs can be used, such as buprenorphine, and combination of buprenorphine and naloxone, and the like. 
     The application  130  can include processes and information to monitor and provide care to opioid users, such as, but not limited to an overdose detection process  131  configured to determine the condition of the user and whether medical care is indicated based at least on the physiological parameters  118 , an alert management process  132  configured to manage alerts to the user and others in the user&#39;s network based at least in part on condition of the user, and information for the care/treatment for opioid use, such as a critical care instruction video  133 . 
     Opioid Overdose Monitoring 
       FIG. 2B  illustrates an example process  200  to monitor physiological parameters  118  for opioid use and provide notifications. At block  205 , the sensor  102  collects the raw data  104  from the user. In the case of a pulse oximeter sensor, the sensor  102  passes light, such as red and infrared light through a body part to a photodetector. The raw data  104  from the sensor  102  provides respiration information due to the absorbance of the light in the pulsating arterial blood. 
     At block  210 , the signal processing device  110  receives the raw data  104  from the sensor  102 , processes the raw data  104  to provide one or more parameters  118  to the mobile computing device  120 . In the case of pulse oximetry, the signal processing device  110  generates a blood-volume plethysmograph waveform from which at least the peripheral oxygen saturation of arterial blood (SpO 2 ), respiration, pulse rate, and perfusion index (PI) may be determined. Other physiological parameters that may be determined are, for example, oxygen content (SpOC), blood glucose, total hemoglobin (SbHb), methemoglobin (SbMet), carboxyhemoglobin (SpCO), bulk tissue property measurements, water content, pH, blood pressure, cardiac information, and pleth variability indices (PVI). Sensor data  104  can provide information regarding physiological parameters  118  such as, for example, EEG, ECG, heart beats per minute, acoustic respiration rate (RRa), breaths per minute, end-tidal carbon dioxide (EtCO 2 ), respiratory effort index, and return of spontaneous circulation (ROSC). 
     User Input 
     At block  215 , the application  130  via the mobile computing device  120  can query the user and receive user input. The mobile computing device  120  can present questions on the display  122  and the user can reply using the user interface  126 . For example, the user can be asked for the information on the prescription label, the dosage and/or frequency of the opioid being consumed and any other drugs the user is consuming. The mobile computing device  120  can ask the user to input his weight, age, and other physical attributes that may be factors in the user&#39;s reaction to the opioid and dosages of the medication, such as naloxone and the like, used to reverse the effects of an overdose. The mobile computing device  120  can ask whether the user is OK or in need of assistance. A response from the user can indicate that the user is conscious and not overdosed. The application  130  can ask the user for a response when the analysis of the parameters  118  indicates an overdose event, and if a response is received, indicating the user is conscious and not overdosed, the application  130  can refine the threshold used to determine an overdose event. The mobile computing device  120  can confirm the users name and location. 
     Trends 
     At block  220 , the application  130  can develop trends in the user&#39;s opioid usage using the physiological parameters  118  from past monitoring stored in the storage  124  as well as user input relating to weight, age, dosage, frequency, and additional drugs being consumed. The trends can be based on the parameters  118  and the user input, if any is received. 
     For example, opioid users that are also marijuana users can develop a greater tolerance for opioids. Further, opioids initially cause the perfusion index to increase due to vasodilation, then to decrease due to vasoconstriction. The increase and decrease of the perfusion index creates a perfusion profile. A user with a greater tolerance to opioids can have a different perfusion profile than a user that does not use marijuana in conjunction with opioids. 
     The application  130  can use the user input, if available, and stored physiological parameters, such as the perfusion profile, for example, and current physiological parameters to develop trends in the user&#39;s opioid usage and/or tolerance for opioids that can more accurately anticipate an overdose event. The application  130  can use past occurrences of “near misses” to further refine the conditions that may foreshadow an overdose event. A “near miss” is an event that provided indications of an overdose, such as an indication of respiration below a threshold, but did not result in an overdose event. The opioid dosage associated with a near miss can provide an indication of the user&#39;s tolerance to opioids and can be used by the application  130  to refine the determination of an imminent or occurring opioid overdose event. 
     By using the history of the physiological parameters  118  including the near-misses, and the user input, if available, the application  130  can learn which combination of events and parameter values indicate an overdose event may be imminent. Because time is of the essence in administrating medication, such as naloxone and the like, to reverse or reduce the effects of an overdose to an overdose victim, it is desirable to err in over-reporting, but too many false-positives of opioid notifications may desensitize responders. It is important that the application  130  learn the specific triggers for a specific user to increase accuracy in determining an overdose event for the specific user. The application  130  can learn the conditions leading up to an overdose event and refine its algorithm in order to notify others when help is needed and to discriminate against false-positive events. 
     The user&#39;s tolerance, as well as the user&#39;s physical attributes, such as weight and age, can be used by the application  130  to refine the quantity of medication that reverses or reduces the effects of an overdose, such as naloxone and the like, that should be administered to revive the user in an overdose event. The application  130  can monitor doses of the medication and report the dosages to clinicians who can determine whether the dosage is too high or too low. 
     The process  200  uses one or more of the user input, current physiological parameters, stored physiological parameters, “near miss” events, overdose events, to refine the indications of an overdose event so as to be able to more accurately determine the occurrence of an overdose event without notifying others of an overdose event that turns out to be false. Because time is of the essence in responding to an overdose victim, the application  130  may err on the side of over notification, but can learn the triggers for the specific user to avoid “crying wolf”, which may result in others ignoring the notifications. 
     Data Analysis 
     At block  225 , the application  130  determines the condition of the user based on one or more of the physiological parameters, user input, and trends. For example, the application  130  can compare the physiological parameters  118  against a threshold to determine is an overdose event is occurring or will soon occur. For example, opioids depress the user&#39;s breathing. If the one or more of the oxygen saturation, breaths per minute, perfusion index and respiratory effort index indicate respiratory failure but being less that a threshold, the application may determine that an overdose event has occurred. The threshold can be a predetermined threshold that is adjusted as the application  130  learns the overdose triggers associated with the user. As the application  130  develops the trends, the application can refine the thresholds for one or more of the physiological parameters  118 . 
     The application  130  can use the user&#39;s perfusion index to determine the likelihood of an overdose event. For example, opioids initially cause the perfusion index to increase due to vasodilation, then to decrease due to vasoconstriction. This can be an identifiable perfusion profile that anticipates an overdose event. 
     The application  130  can use one or more physiological parameters  118  to determine the condition of the user. The application  130  can use one or more of the perfusion index (PI), respiration, and peripheral oxygen saturation (SpO 2 ) to determine the condition of the user. For example, the application  130  can use, but is not limited to, each of the perfusion index (PI), respiration, and peripheral oxygen saturation (SpO 2 ) alone; a combination of the PI, respiration, and SpO 2  together; a combination of PI and respiration; a combination of PI and SpO 2 ; or a combination of respiration and SpO 2  to determine the condition of the user. The analysis of the physiological parameters  118  may show that the physiological parameters are within normal ranges and the user is not in need of assistance or the analysis may indicate that an overdose event is imminent, is occurring, or has occurred. 
     Other physiological parameters  118  can be analyzed individually or in other combinations can be analyzed to determine whether the physiological parameters  118  of the user are within normal ranges or whether an overdose event is imminent, is occurring, or has occurred. 
     The application  130  can query the user to determine the condition of the user. No response from the user can indicate that the user is unconscious and can trigger an overdose event notification or alarm. As indicated above, a response from the user can indicate that the user is conscious and the information can be used by the application  130  to refine the changes in the user&#39;s physiological parameters  118  that indicate an opioid overdose is occurring or will occur soon. 
     As described above, the mobile computing device  120  can include an accelerometer that can detect user motion. A lack of user motion sensed by the accelerometer can indicate that the user in unconscious and can trigger an overdose event notification or alarm. Motion sensed by the accelerometer can indicate that the user is conscious and the information can be used by the application  130  to refine the changes in the user&#39;s physiological parameters  118  that indicate an opioid overdose is occurring or will occur soon. 
     As described above, the mobile computing device  120  can include an accelerometer that can sense vibrations from the user indicative of the user&#39;s heart rate. A lack of vibrations sensed by the accelerometer can indicate no heart rate and reduced occurrences of vibrations sensed by the accelerometer can indicate cardiac distress, which can trigger an overdose event notification or alarm. Heart rate within normal parameters can indicate that the user is not in need of assistance due to an overdose event. 
     At block  230 , the application  130  can determine whether care is useful based on the condition of the user. If care is indicated, such that the physiological parameters indicate depressed respiration, but not at a life-threatening level, the application moves to block  235 . At block  235 , the application  130  queries the user. If a response is received, the process  200  moves to the END block. A response indicates that the user is conscious and not in need if immediate aid. 
     If, at block  230 , the application  130  determines that care is required because the evaluation of the physiological parameters  118  indicate a life-threatening condition, the process  200  moves to block  240 . In addition, if no response is received from the user query at block  235 , the process  200  moves to block  240 . 
     Notifications 
     At block  240 , the application  130  provides notifications based at least in part of the condition of the user. For example, the application  130  can display on the display  122  the user&#39;s physiological parameters, such as one or more of oxygen saturation, heart beats per minute, breaths-per-minute, pleth variability, perfusion index, and respiratory effort. The physiological parameters  118  can be displayed as charts, graphs, bar charts, numerical values, and the like. The application  130  can display trends in the physiological parameters  118 . 
     The application  130  can provide notifications to selected friends indicating that there are no overdose conditions. The “everything is OK” notifications can be sent periodically or upon request. The “everything is OK” notifications can be sent during known exposure times. For example, the “everything is OK” notifications can be sent every 30 minutes from 6:00 PM when the user typically returns from work, to 11:00 PM when the user typically goes to sleep. 
     The application  130  can also report “near misses” to the caregiver. As described above, a “near miss” is an event that provided indications of an overdose, such as an indication of respiration below a threshold, but did not result in an overdose event. 
     Once the application  130  has determined that an overdose condition is imminent, is occurring, or has occurred, the application  130  can provide notification of the overdose to selected family, friends, caregivers, clinicians, and medical personnel. The notification can be sent to a crowd sourced community of users, friends, and medical personnel that look out for one another. The application  130  can provide the location of the user and/or directions to the user&#39;s location. The notification can include the location of the closest medical care and/or the location of the closest medication that reduces or reverses the effects of an overdose. Examples of such medications are, but not limited to, naloxone, buprenorphine, a combination of naloxone and buprenorphine, Narcan®, Suboxone®, Subutex®, and the like. The application  130  can indicate whether the overdose victim is conscious or unconscious. 
     The notification can include protocol for a first responder to render aid to the user. The application  130  can provide the user data to the medical personnel to aid them in administrating the correct dose of medication that reduces or reverses the effects of an overdose, such as naloxone and the like to the user. For example, if the overdose victim is also a heroin or marijuana user, the overdose victim may need a larger dosage of naloxone to reverse the effects of the opioid overdose than an overdose victim that does not also use heroin or marijuana. Further, the naloxone dosage may also need to be adjusted for the weight and age of the overdose victim. For example, a greater dosage on naloxone may be needed to reverse the depressed respiration effects of opioid overdose for an adult than is needed for a small child. 
     The application can provide trend data to medical personnel or to designated caregivers on a continual basis or may provide the trend data with the overdose notification. The dosage of medication to reduce or reverse the effects of the overdose, such as naloxone and the like, can be adjusted based at least in part on the trend data. 
     The application  130  can notify the user and request an acknowledgement for the user. For example, the application  130  can provide a visual notification on the display  122 , and then cause the mobile computing device  120  to provide an audible notification, such as an audible alarm which can escalate to an increasing louder piercing sound in an attempt to wake up the user. The audible notification can include the name of the user. The application  130  can interact with a home system, such as Alexa®, Amazon Echo®, and the like, to create the alarm. The application  130  can cause the mobile computing device  120  or the home system, for example, to contact a live person who can provide immediate care instructions to the first responder. 
     The application  130  can provide the notifications to others in the user&#39;s community that have downloaded the application  130  on their mobile computing device. The application  130  can cause the mobile computing device  120  to send, for example, but not limited to text messages, emails, and phone calls to selected contacts in the user&#39;s mobile device  120 , who may or may not have downloaded the application  130  to their mobile computing device  120 . The mobile computing device  120  can automatically dial  911  or other emergency response numbers. The application  130  can transmit the location of the user to one or more selected ambulances and paramedics. 
       FIGS. 3A-3E  illustrate various example software applications to provide information, notifications, and alerts to opioid users, first responders, medical personnel, and friends. 
       FIG. 3A  is a screenshot  300  illustrating a request for user input. The illustrated screenshot  300  displays a question “ARE YOU OK? DO YOU NEED MEDICAL ASSISTANCE?” and selections for the user&#39;s response. If no response is received, the user may be assumed to be unconscious. If a response is received, the application  130  can use the physiological parameters  118  associated with the response to refine the algorithm to determine an overdose event for the specific user. The refinements can include refinements to the overdose threshold for the physiological parameters  118  or can include refinements to the parameter trends associated with an overdose event. 
       FIG. 3B  is a screenshot  310  illustrating a periodic status alert that can be send via text message or email to friends or family that have set up periodic well checks for the user in the user&#39;s application  130 . The illustrated screenshot  310  also indicates when the next well check will occur. 
       FIG. 3C  is a screenshot  320  illustrating a status alert that can be send via text message or email to friends or family that have set up periodic well checks for the user in the user&#39;s application  130 . The illustrated screenshot  320  indicates current values for monitored physiological parameters and provides a section SEE TRENDS to view the trend data for the physiological parameters. The illustrated screenshot  320  also indicates the date and time of the most recent overdose event. 
       FIG. 3D  is a screenshot  330  illustrating first responder protocols. The illustrated screenshot  330  displays resuscitation information for the person(s) responding to the overdose notification. 
       FIG. 3E  a screenshot  340  illustrating the nearest location to the user that has available naloxone. The illustrated screenshot  340  displays an address and a map of the location. 
     Notify a Friend 
       FIG. 4  illustrates an example process  400  to monitor for opioid overdose using the mobile physiological parameter monitoring system  100  including the sensor  102  and the signal processing device  110 , and the mobile computing device  120 . The user or the caregiver downloads the application  130  into the mobile computing device  120 . The user or caregiver can select a person or persons to be notified by the mobile computing device  120  when the application  130  determines an opioid overdose event is occurring. The mobile computing device  120  can comprise a mobile communication device, such as a smartphone. The user attaches the sensor  102  to a body part, such as clipping the sensor  102  onto a finger, a toe, the forehead, for example, and connects either wirelessly or via a cable to the mobile computing device  120  that includes the application  130 . 
     At block  405 , the mobile physiological parameter monitoring system  100  collects raw data  104  from the sensor  102 . At block  410 , signal processing device  110  processes the raw data and provides the mobile computing device  120  with physiological parameters  118 . 
     At block  415 , the mobile computing device  120  receives the physiological parameters  118  from the physiological parameter monitoring device  110 . 
     At block  420 , the application  130  displays on the display  122  of the mobile computing device  120  the physiological parameters  118 . The mobile computing device  120  can display numerical indications, graphs, pie charts, dials, and the like. The displays can include acceptable and unacceptable ranges for the physiological parameters  118 . The display can be color coded. For example, acceptable ranges can be colored green and unacceptable ranges can be colored red. The application  130  can display on the mobile computing device  120  the physiological parameters  118  as the physiological parameters  118  are received (in real time) or at approximately the same time (near real time) as the physiological parameters  118  are received. 
     At block  425 , the application  130  can monitor the physiological parameters  118  for indications of an opioid overdose. The monitored physiological parameters  118  can include the physiological parameters that are most likely affected by an overdose condition. The physiological parameters  118  can be one or more of the oxygen saturation, heart rate, respiration rate, pleth variability, perfusion index, and the like of the user. 
     The application  130  can determine whether the physiological parameters  118  indicate that the user needs on-site care. A blood oxygen saturation level below a threshold can indicate an opioid overdose condition. For example, the application  130  can monitor the oxygen saturation of the user and trigger an alarm when the oxygen saturation falls below a threshold. The application  130  can compare the user&#39;s current oxygen saturation level with a threshold that can indicate a minimum acceptable blood oxygen saturation level. An oxygen saturation level below the minimum acceptable blood oxygen saturation level can be an indication of an overdose event. For example, an oxygen saturation level below approximately 88 can indicate respiratory distress. 
     The application  130  can compare each of the monitored physiological parameters  118  with a threshold that indicates a minimum or maximum acceptable level for the physiological parameter  118 . For example, the application  130  can compare the user&#39;s heart rate in beats per minute with the acceptable range of approximately 50 beats per minute to approximately 195 beats per minute. The application  130  can compare the user&#39;s respiration rate in breaths per minute with the acceptable range of approximately 6 breaths per minute to approximately 30 breaths per minute. The application  130  can compare the user&#39;s pleth the acceptable range of approximately 5 to approximately 40 and the user&#39;s perfusion index to a minimum acceptable perfusion index of approximately 0.3. 
     One or more physiological parameters  118  can be weighted and when the combination of weighted parameters falls below a threshold, the application  130  can trigger the notification of an opioid overdose event. One or more physiological parameters  118  can be weighted based on trends in the user&#39;s physiological parameters during opioid use and when the combination of weighted parameters falls below a threshold, the application  130  can trigger the notification of an opioid overdose event. 
     When the measured physiological parameters  118  are within acceptable ranges, the process  400  can return to block  415  and the mobile computing device  120  can continue to receive the physiological parameters  118  from the sensor  102  via the physiological parameter monitoring device  110 . The application  130  can compare one, more than one, or all of the measured physiological parameters  118  to determine an overdose event. 
     When an overdose is indicated as imminent or occurring, the process  400  moves to block  430 . For example, when the user&#39;s blood oxygen saturation level is at or below the threshold, the application  130  triggers an alarm at block  430 . When at least one of the monitored parameters  118  is below an acceptable threshold, the process  400  can trigger an alarm. The alarm can be an audible alarm that increases in loudness, frequency, or pitch. The alarm can be the user&#39;s name, a vibration, or a combination of audible sound, vibration, and name. 
     The mobile computing device  120  can vibrate, audibly alarm, display a warning, visibly flash, and the like to notify the user or someone at the same physical location as the mobile computing device  120  to the overdose event. The alarm can be an audible alarm that increases in loudness, frequency, or pitch. The alarm can be the user&#39;s name, a vibration, or a combination of audible sound, vibration, and name. 
     The mobile computing device  120  can display the location of and/or direction to naloxone or other medication to reverse or reduce the effects of an overdose closest to the user. The mobile computing device  120  can display the phone number of the person associated with the closest medication to reverse or reduce the effects of an overdose, such as naloxone. The mobile computing device  120  can display resuscitation instructions to the first responder. The mobile computing device  120  can request an acknowledgement from the first responder. The mobile computing device  120  can display the resuscitation instructions to the first responder, call medical personnel, and facilitate questions and answers between the first responder and the medical personnel. 
     If the user is alone, this may not be enough to avoid a life-threatening overdose condition. At block  435 , the application  130  can send a notification to the user&#39;s network, such as the person(s), emergency personnel, friends, family, caregivers, doctors, hospitals selected to be notified. The notification can be sent in conjunction with the network connectivity  128  of the user&#39;s mobile computing device  120 . The notification informs the selected person(s) of the user&#39;s opioid overdose. For example, the selected person(s) can receive a notification on their mobile computing device. The selected person(s) can be a friend, a group of friends, first responders, medical personnel, and the like. The mobile computing device  120  can automatically dial  911  or other emergency response numbers. 
     The notification can be sent to a crowd sourced community of opioid users that look out for one another, such as a community of individuals and/or organizations associated with one or more opioid users. The community functions to provide help to opioid users and can includes not only other opioid users, but friends, family, sponsors, first responders, medics, clinicians, and anyone with access to medication to reverse or reduce the effects of an overdose, such as naloxone. 
     The notification can be one or more of text message, an automatically dialed phone call, an email, or the like. The notification can include one or more of a graphical representation, a numerical value or the like of the user&#39;s unacceptable or out-of-acceptable-range physiological parameter  118 , the time of the overdose, the location of the user, directions to the location, and the phone number of the user&#39;s mobile computing device  120 . The notification can also provide the location of and/or direction to medication to reverse or reduce the effects of an overdose, such as naloxone, closest to the user, as well as the phone number of the person associated with the closest medication to reverse or reduce the effects of an overdose, such as naloxone. 
       FIGS. 5A-5F  illustrate various example software applications to trigger an alarm and notify a friend when an opioid overdoes is indicated. 
       FIG. 5A  is an example screenshot  510  illustrating active monitoring of physiological parameters  118 . The illustrated monitoring screenshot  510  displays the user&#39;s oxygen saturation, heart rate as beats per minute, respiration rate as breaths per minute, pleth variability and perfusion index. The physiological parameters  118  are represented as dials. The dials indicate a normal range and unacceptable ranges that can be above, below or both above and below the normal range. A needle within the dial points to the current value of the physiological parameter and a numerical indication of the current value is displayed in the center of the dial. 
       FIG. 5B  is an example screenshot  520  illustrating a home screen with the main menu. The illustrated home screen  520  includes a selection LIVE to display physiological parameters being monitored in real time or near real time, such as shown on the monitoring screenshot  510 . The home screen  520  further includes a selection for HISTORY, HEART RATE RECOVERY, and NOTIFY A FRIEND. 
     Selecting HISTORY can display the past physiological parameters stored in storage  124  as one or more of graphs, charts, bar graphs, and the like. The application  130  can use the HISTORY to develop trends for the specific opioid user to more accurately determine when an opioid overdose event is imminent. 
     Heart rate is the speed of the heartbeat measured by the number of contractions of the heart per minute (bpm). The heart rate can vary according to the body&#39;s physical needs, including the need to absorb oxygen and excrete carbon dioxide. Selecting HEART RATE RECOVERY can display the recovery heart rate of the user after a near opioid overdose or overdose event. 
     Selecting NOTIFY A FRIEND allows the user or a caregiver to select a contact from the mobile computing device  120  to be notified in the event that the user&#39;s physiological parameters  118  indicate that the user is experiencing or will soon experience an overdose event. 
     The home screen  530  further includes a setup section that includes DEVICE, SOUND, DATA, MEASUREMENT SETTINGS, APP INTEGRATION, ABOUT, AND SUPPORT. The user can receive information, such as device data, for example, or select setting, such as what measurements are displayed, change alarm volume, and the like. 
       FIG. 5C  is an example screenshot  530  illustrating the NOTIFY A FRIEND screen. The illustrated NOTIFY A FRIEND screen  530  allows the user or caregiver to select a person from the contacts stored on the mobile computing device  120  to be contacted when an overdose event occurs. In the illustrated NOTIFY A FRIEND screen  530 , the second person on the contact list has been selected. 
       FIG. 5D  is an example screenshot  540  illustrating live or active monitoring of the user having an alarm condition. The illustrated parameter monitoring screen  540  shows that the user&#39;s oxygen saturation level has dropped below an acceptable threshold of 88 to a value of 73. This indicates an overdose event may be occurring. The user&#39;s heart rate, respiration rate, pleth variability and perfusion index have not changed from the values displayed on the live monitoring screen  510 . 
       FIG. 5D  also includes a RESPIRATORY EFFORT INDEX, which provide an indication of whether breathing is occurring or is suppressed. 
       FIG. 5E  is an example screenshot  550  illustrating a notification screen sent to the friend/selected contact to notify the friend of the user&#39;s overdose event. Once the alarm is triggered on the user&#39;s mobile computing device  120 , the selected person is notified of the alarm status. The notification screen  550  can display the user&#39;s name and the alarm condition. The illustrated notification screen  550  informs the friend that Ellie Taylor has low oxygen saturation of 73. Selecting or touching the VIEW selection provides additional information. 
       FIG. 5F  is an example screenshot  560  illustrating the friend alert including additional information provided to the selected person. The friend alert screen  560  can include the trend and current value of the alarming parameter. For example, the illustrated friend alert screen  560  displays the graph and current value of the user&#39;s oxygen saturation. The friend alert screen  560  can also display the user&#39;s location on a map, display the time of the initial alarm event, provide access to directions to the user from the friend&#39;s current location in one touch, and provide access to call the user in one touch. The friend has the knowledge that the user is overdosing and the information to provide help. 
     Assistance for Responders and Caregivers 
     It is critical to administer an opioid receptor antagonist, such as Naloxone, to victims of opioid overdoses as soon as possible. Often it can be a matter of life or death for the overdose victim. As described herein, self-administrating delivery devices can administer the opioid receptor antagonist without user or responder action. Opioid overdose victims without a self-administrating delivery device rely on the responders, friends, or caregivers that are first on the scene to administer the opioid receptor antagonist. Assistance that can be provided to the first responders can be useful and the assistance can take many forms. The assistance can be visual or auditory indicators and/or instructions. The user can wear a band, such as a wrist band, for example, that changes color to indicate an opioid overdose event. A display, such as a display on a mobile device, can change color, or flash to draw attention when an opioid overdose event is detected. The mobile or other device can transmit a notification or transmit the flashing display to other devices within range to notify others of the opioid overdose event. The display can display instructions that explain how to administer the opioid receptor antagonist, such as Naloxone. The display can display instructions to wake the overdose victim using smelling salts, shaking, escalation of painful stimulation, loud noises, or any combination of these. The responder can be instructed to incrementally increase aggressive actions to wake the overdose victim. An example of incrementally increasing aggressive action can be loud sound, followed by a small amount of painful stimulation, followed by administration of a small amount of Naloxone or other opioid receptor antagonist, followed by an increased amount of painful stimulation. The first responder can be instructed to induce pain using acupuncture. The mobile or other device can speak the instructions to get the attention of others that are nearby. The mobile or other device can speak “Please inject Naloxone” to indicate urgency. The mobile or other device can beep to attract attention. The mobile or other device can buzz and/or provide voice directions to help in directionally finding the overdose victim. 
     The mobile or other device can provide codes to emergency personnel within proximity. The mobile or other device can send a signal to emergency personnel or police indicating that the Naloxone needs to be delivered as soon as possible. 
     The first responder can also administer medication to induce vomiting once the overdose victim is awake and upright. The user may regurgitate any opioid substances, such as pills, for example, that are still in the user&#39;s stomach. 
     Network Environment 
       FIG. 7A  illustrates an example network environment  700  in which a plurality of opioid user systems  706 , shown as opioid user systems  706 A . . .  706 N, communicate with a cloud environment  702  via network  704 . The components of the opioid user systems  706  are described in greater detail with respect to  FIG. 7C . 
     The network  704  may be any wired network, wireless network, or combination thereof. In addition, the network  704  may be a personal area network, local area network, wide area network, over-the-air broadcast network (e.g., for radio or television), cable network, satellite network, cellular telephone network, or combination thereof. For example, the network  704  may be a publicly accessible network of linked networks such as the Internet. Protocols and components for communicating via the Internet or any of the other aforementioned types of communication networks are well known to those skilled in the art and, thus, are not described in more detail herein. 
     For example, the opioid user systems  706 A . . .  706 N and the cloud environment  702  may each be implemented on one or more wired and/or wireless private networks, and the network  704  may be a public network (e.g., the Internet) via which the opioid user systems  706 A . . .  706 N and the cloud environment  702  communicate with each other. The cloud environment  702  may be a cloud-based platform configured to communicate with multiple opioid user systems  706 A . . .  706 N. The cloud environment  702  may include a collection of services, which are delivered via the network  704  as web services. The components of the cloud environment  702  are described in greater detail below with reference to  FIG. 7B . 
       FIG. 7B  illustrates an example of an architecture of an illustrative server for opioid user monitoring. The general architecture of the cloud environment  702  depicted in  FIG. 7B  includes an arrangement of computer hardware and software components that may be used to implement examples of the present disclosure. As illustrated the cloud environment  702  includes one or more hardware processors  708 , a remote application manager  710 , a registration manager  712 , a map server manager  714 , a distress notification manager  716 , a non-distress manager  718 , and an opioid user database  720 , all of which may communicate with one another by way of a communication bus. Components of the cloud environment  702  may be physical hardware components or implemented in a virtualized environment. The remote application manager  710 , the registration manager  712 , the map server manager  714 , the distress notification manager  716 , and the non-distress  718  manager may include computer instructions that the one or more hardware processors execute in order to implement one or more example processes. The cloud environment  702  may include more or fewer components than those shown in  FIG. 7B . 
     The remote application manager  710  may oversee the monitoring and notifications of associated with the plurality of opioid user systems  706 A . . .  706 N. The remote application manager  710  is remote in the sense that it is located in a centralized environment as opposed to each opioid user&#39;s local environment. The remote application manager  710  may oversee the registration manager  712 , the map server manager  714 , the distress notification manager  716 , and the non-distress notification manager  718 . The remote application manager  710  may perform one or more of the steps of  FIGS. 2B, 4 . 
     The registration manager  712  may manage the information associated with each opioid user registrant and the contact information supplied by each opioid user registrant during registration for the opioid overdose monitoring system. The contact information may include the names, phone number, email addresses, etc. of individuals and/or organizations to contact on behalf of the opioid user when an overdose event is predicted or detected, or for status check information, as well as the name, address, phone number, email address, etc. of the opioid user registrant. Examples of individuals and organizations are illustrated in  FIG. 1B . The opioid user information and the contact information associated with each opioid user registrant may be stored in database  720 .  FIGS. 5B, 5C  illustrate examples of interface screens that may be used during registration. 
     The map server manager  714  may locate maps and directions, such as those illustrated in  FIGS. 3E and 5F  to display on devices associated with first responders, friend and family, and other individuals from the opioid user&#39;s contact information to display maps or directions to the opioid user, to the location of the closest naloxone or other such medication to the opioid user, and the like, in the event of an overdose.  FIGS. 5E, 5F  illustrate examples of distress notifications. The map server manager  714  may interface with third party map sites via the network  704  to provide the maps and directions. 
     The distress notification manager may receive an alert from the opioid user&#39;s mobile device that an overdose event may soon occur or has occurred. For example, the mobile device  120  or the monitoring device  110  may process the sensor data from the sensors  102  and determine that an overdose event is occurring. The mobile device  120  may communication the occurrence of overdose event with the distress notification manager  716 . The distress notification manager  716  may retrieve contact information from the database  720  and provide notification of the overdose event or a soon to occur overdose event to the individuals and organizations indicated by the opioid user during registration so that assistance can be provided to the opioid user.  FIG. 5F  illustrates an example of a distress notification. 
     The non-distress notification manager  714  may receive the status of the opioid user as monitored by the mobile device  120  and/or the monitoring device  110 . The non-distress notification manager  718  may receive the status periodically. After determining that the status of the opioid user indicates that the opioid user is not in distress, the non-distress notification manager may access the database  720  to retrieve the contact information for the individual and organizations that are to be notified of the well-being of the opioid user.  FIGS. 3B, 3C, 5D  illustrate examples of non-distress notifications. 
       FIG. 7C  illustrates an example opioid user system  706 , which includes the monitoring device  740  and the mobile communication device  722 . The monitoring device can include the sensor(s)  120  that are sensing physiological state of the opioid user and the signal processing device  110  that is processing the raw sensor data from the sensor(s)  110  to provide the mobile communication device  722  with the physiological parameters  118 . The raw sensor data  104  from the sensor(s)  102  can be input into the mobile communication device  722 , which processes the raw sensor data  104  to provide the physiological parameters  118  of the opioid user. 
     The illustrated mobile communication device  722  includes a display  724 , similar to display  122 , described herein, a network interface  726  that is configured to communication at least with the cloud environment  702  via the network  704 , a local application  728 , a monitoring application  730 , a distress application  732 , a non-distress application  734 , a query opioid user application  736 , and a local alarm application  738 . The local application  728 , the monitoring application  730 , the distress application  732 , the non-distress application  734 , the query opioid user application  736 , and the local alarm application  738  may be software instructions stored in memory within the mobile communication device  722  that are executed by the computing devices within the mobile communication device  722 . The applications  728 - 738  can be downloaded onto the mobile communication device  722  from a third party or from the cloud environment  702 . The mobile communication device  722  may include more or fewer components than those illustrated in  FIG. 7C . 
     The local application  728  may oversee the communication with the remote monitoring manager of the cloud environment and may oversee the monitoring application  730 , the distress application  732 , the non-distress application  734 , the query opioid user application  736 , and the local alarm application  738 . The local application  728  is local in the sense that it as well as its associated applications  730 - 738 , are located on the mobile communication device  722  associated with the opioid user, devices associated with organizations to assist opioid users, and devices associated with individuals that are associated with the opioid user. 
     The monitoring application  730  may receive the physiological parameters  118  and process the physiological parameters according to one or more of the steps of  FIGS. 2B, 4 . The monitoring application  730  may cause the display of the physiological parameters  118  on the display  724  mobile communication device  722 .  FIGS. 5A, 5D  illustrate examples of displays of the physiological parameters. 
     The distress application  732  may be called when the monitoring application  730  determines that the opioid user is experiencing an overdose event or an overdose event is imminent. The distress application  732  may perform one or more steps of  FIGS. 2B, 4 , such as send out distress notifications. Further, the distress application  732  may communicate with the distress notification manager  716  in the cloud environment  702  to cause the distress notification manager to provide distress notifications as described above. 
     The non-distress application  734  may be called when the monitoring application  730  determines that the opioid user is not experiencing an overdose event or an overdose event is not imminent. The non-distress application  734  may perform one or more steps of  FIGS. 2B, 4 , such as send status notifications. Further, the non-distress application  734  may communicate with the non-distress notification manager  718  in the cloud environment  702  to cause the non-distress notification manager to provide status notifications as described above. 
     The query opioid user application  736  may be called when the monitoring application  730  determines that care is indicated. The query opioid user application  736  queries the user to determine whether the user is conscious in order to reduce false alarms. The query opioid user application  736  may perform step  235  of  FIG. 2B .  FIG. 3A  illustrates a display to query the user that may be caused by the query opioid user application  736 . 
     The local alarm application  738  may be called when the monitoring application  730  determines that on-site care of the opioid user is required. The local alarm application  738  may perform step  430  of  FIG. 4 . The local alarm application  738  may cause the mobile communication device  722  to display first responder instruction, a map or directions to the nearest facility with medication to reverse or reduce the effects of an overdose, such as naloxone, and the like. The local alarm application  738  may cause the mobile communication device  722  to audibly alarm and/or visually alarm to alert anyone near the mobile communication device  722  of the overdose event.  FIG. 3D  illustrates an example of a first responder instructions and  FIG. 3E  illustrates an example of a display displaying the location of naloxone. 
       FIG. 8  is a flowchart of an example process  800  to notify an opioid user&#39;s notification network of the status of the opioid user. The process  800  can be performed by the cloud environment  702 . At block  802 , the cloud environment  702  receives a user identification and user status from the opioid monitoring system  706 . For example, the remote application manager  710  retrieves the user information from the database  720  based on the user identification. 
     At block  802 , the cloud environment  702  may determine, based on the status of the user, whether care is indicated. The status information may comprise the physiological parameters  118  from the monitoring application  730 . The status may be an indication of whether care is indicated or not indicated. Remote application manager  710  may analyze the physiological parameters  118  to determine whether care is indicated. 
     If care is indicated at block  804 , the process  800  moves to block  806 . At block  806 , the distress notification manager  716  may retrieve the contact information stored in the database and associated with the user identification. 
     At block  808 , the distress notification manager  716  may notify the individuals and organizations of the contact information of the need for care. 
     If care is not indicated at block  804 , the process  800  moves to block  810 . At block  810 , the non-distress notification manager  718  may retrieve the contact information stored in the database and associated with the user identification. 
     At block  812 , the non-distress notification manager  718  may notify the individuals and organizations of the contact information of the status of the opioid user. The non-distress notification manager  718  can send an “Everything OK” message. 
     Communication Between Opioid Overdose Monitoring Application and Transportation/Ride Sharing Services 
     A mobile device or other computing device executing the opioid monitoring application can communicate with one or more transportation services such as, a ride sharing service, such as Lyft® or Uber®, for example, a taxi service, or any commercial transportation service, when an overdose event is occurring or imminent. This is illustrated in  FIG. 1B  as “Rideshare network” that is within the representation of the location of naloxone message. The opioid monitoring application may communicate, via the mobile computing device, with servers associated with the ridesharing services over a network such as the Internet. The communication can be entered into the transportation service system the same as a person would normally call for a taxi, Lyft, or Uber, for example. 
     The transportation service can receive a notification from the mobile device or other computing device that is deploying the opioid overdose monitoring application. The notification can be an alert. The alert may be for an ongoing or an imminent opioid overdose event. The notification may include the address of the opioid user, the address of the nearest facility with medication to reverse or reduce the effects of an overdose, such as naloxone, buprenorphine, combination of buprenorphine and naloxone, and the like, and the address of the nearest caregiver, emergency service, treatment center, and other organizations or individuals that can provide life-saving care to for the opioid user. 
     The transportation service can transport the opioid user to receive care, transport the opioid user to a location having the medication, transport the medication to the opioid user, to pick up the medication and transport the medication to the opioid user, and the like. 
     The transportation service or ride sharing service can bill for the transportation that occurs after receiving an alert or notification generated by the opioid overdose monitoring application as a special billing or a charitable billing. The transportation service or ride sharing service can bill for the transportation in the same manner that its transportation services are billed for a typical customer. 
     The transportation service or ride sharing service can participate in a community outreach program to provide transportation responsive to receiving an alert or notification generated by the opioid monitoring application. 
     Physiological Monitoring and Medication Administration System 
     Including Activation Circuitry 
       FIG. 9A  is a block diagram of an example physiological monitoring and medication administration system  900 . The illustrated physiological monitoring and medication administration system  900  is like the physiological monitoring system  100  of  FIG. 2A  except that an applicator  904  having medication to reverse or reduce the effects of an opioid overdose, such as an opioid receptor antagonist, and at least signal  902  from the mobile communication device  120  to actuate the applicator  904  are included in the physiological monitoring and medication administration system  900 . 
     The applicator  904  can be worn by the user in a manner that facilitates the application of the medication. For example, the applicator  904  can be strapped to the user&#39;s wrist, as illustrated in  FIG. 13 , and the medication can be applied through the skin, intramuscularly, or intravenously. The applicator can be configured as a watch band, a bracelet, a vest-like garment worn next to the user&#39;s skin, or the like. The applicator can be configured to apply the medication intranasally, sublingually, or other methods of application. 
       FIGS. 9B and 9C  are schematic diagrams  940 ,  950  of example self-administrating medication applicators.  FIG. 9B  illustrates an applicator  944  configured to apply topical medication to reverse or reduce the effects of an opioid overdose. The applicator  944  includes an actuator  946  and medication in gel form  946 . The gel  946  may be contained in a pouch or container with frangible seals, for example. The actuator  946  can receive the actuation signal  902  from the mobile device  120  to initiate the actuation process. In the illustrated applicator, the actuation signal  902  is received via an antenna. The actuation signal  902  can be in electrical communication with the applicator  944  via one or more wires. Once the applicator  944  receives the actuation signal  902 , the actuator can actuate to dispense the gel  948  onto the skin or tissue of the user. For example, the actuator can include a gas squib, that when activated, creates a pressurized gas or fluid that is in fluid contact with the gel  948 , via one or more conduits, for example. The pressurized fluid forces the gel  948  to break frangible seals next to the tissue, causing the gel  948  to be applied to the surface of the tissue. 
       FIG. 9C  illustrates an applicator  954  configured to inject medication to reverse or reduce the effects of an opioid overdose into the tissue of the user. The applicator  954  includes a vial or container of injectable medication, an actuator, and a needle  960 . The needle  960  can be a microneedle. The actuator can receive the actuation signal from the mobile communication device  120  to initiate the actuation process. In the illustrated applicator, the actuation signal  902  is received via an antenna. The actuation signal  902  can be in electrical communication with the applicator  944  via one or more wires. Once the applicator  944  receives the actuation signal  902 , the actuator  958  can actuate to force, by using pressure as described above, for example, the injectable medication  956  through the needle  960 . The needle  960  can be configured to inject the medication  956  into the tissue under the pressure generated by the actuator  958 . 
       FIG. 10  is a flow diagram of an example process  1000  to monitor for opioid overdose and to apply medication to reverse the effects of an overdose. The process  1000  is like the process  400  of  FIG. 4  except that the process  1000  includes steps activate an applicator worn on the body of the user, such applicator  904 ,  944 ,  954 , and the like, to apply the medication to revere or reduce the effects of an opioid overdose. Once the need for on-site care is determined at block  425 , the process  1000  moves to block  430  to trigger an alarm and also to block  1002 . At block  1002 , the applicator  904 ,  944 ,  954  receives an actuation signal  902 , which actuates the applicator  904 ,  944 ,  954 . At block  1004 , the medication is dispensed from the application  904 ,  944 ,  954 , and applied to the user. The medication can be applied topically, through intramuscular injection, through intravenous injection, and the like, to the user to reverse or reduce the effects of the opioid overdose. 
       FIGS. 11A-11C  are schematic diagrams of an example needle-free injection, multi-dose, self-administrating medication applicator  1100 . The applicator  1100  can be configured to inject, without a hypodermic needle, one or more doses of medication to reverse or reduce the effects of an opioid overdose into the tissue of the user.  FIG. 11A  illustrates a side view of the needle-free injection, multi-dose, self-administrating medication applicator  1100  comprising an adhesive layer  1102  configured to adhere the applicator  1100  to the skin and a protective or safety layer  1104  configured to inhibit inadvertent dispensing of the medication. Other safety mechanism, such as a latch or safety catch can be used to prevent inadvertent dispensing of the medication. To prepare the applicator  1100  for use, the user or caregiver removes the safety layer  1104  and adheres the applicator  1100  to the opioid user&#39;s skin. 
       FIG. 11B  illustrates a cut-away side view of the applicator  1100  further comprising one or more activation circuitry  1106 , antenna  1114 , plunger or other dispensing mechanism  1108 , reservoir  1110 , and drug delivery channel  1112 . The activation circuitry  1106  is configured receive an activation signal via the antenna  1114  and activate a delivery mechanism  1108  to dispense medication in the reservoir  1110  through the drug delivery channel  1112  through the skin, intramuscularly or intravenously. The medication can be naloxone, an opioid receptor antagonist, or the like to reduce the effects of an opioid overdose event. The delivery mechanism  1108  can be a plunger propelled forward by a propellant such as a CO2 cartridge, gas squib, compressed air, and N2 gas cartridge, a pump motor, spring, and the like. The drug delivery channel  1112  can be a small bore tube that forces the medication through the adhesive  1102  and the skin as a high pressure spray like a jet spray. The applicator  1100  deposits the medication in the tissue under the administration site. 
       FIG. 11C  illustrates a top cut away view of an example of the needle-free injection multi-dose self-administrating medication applicator  1100 . The applicator  1100  further comprises multiple doses of the medication. In the illustrated example, the applicator comprises 1 to N applications, where each application is administered by activation circuitry activating a plunger or other dispensing mechanism to dispense the medication in the reservoir through the drug delivery channel as described above in  FIG. 9B . Each activation circuitry  1106  can receive an activation signal via the antenna  1114 , where each antenna  1114 ( 1 ) to  1114 (N) can be tuned to receive a unique activation signal such that only one activation circuit activates. More than one of antenna  1114 ( 1 ) to  1114 (N) can be tuned to activate with the same signal to dispense medication from more than one reservoir upon receipt of the activation signal. 
       FIGS. 12A-12B  are schematic diagrams of an example injection, multi-dose, self-administrating medication applicator  1200 . The applicator  1200  is configured to inject, using a hypodermic needle, one or more doses of medication to reverse or reduce the effects of an opioid overdose into the tissue of the user.  FIG. 12A  illustrates a cut-away side view of the injection multi-dose self-administrating medication applicator  1200  comprising an adhesive layer  1202  configured to adhere the applicator  1200  to the skin, one or more activation circuitry  1206 , antenna  1214 , plunger or other dispensing mechanism  1208 , reservoir  1210 , and needle  1212 , which is shown in the retracted state. In the illustrated example, a safety layer configured to inhibit inadvertent dispensing of the medication has been peeled away and the applicator  1200  is adhered to the skin of the user at the dispensing site. Other safety mechanisms, such as a latch, safety catch, or cap over the needle  1212  can be used to prevent inadvertent dispensing of the medication. To prepare the applicator  1200  for use, the user or caregiver removes the safety layer and adheres the applicator  1200  to the opioid user&#39;s skin. The needle  1212  can be a microneedle. 
     The activation circuitry  1206  is configured receive an activation signal via the antenna  1214  and activate a delivery mechanism  1208  to dispense medication in the reservoir  1210  through the needle  1212  through the skin, intramuscularly or intravenously. The medication can be naloxone, an opioid receptor antagonist, or the like to reduce the effects of an opioid overdose event. The delivery mechanism  1208  can be a plunger propelled forward by a propellant such as a CO2 cartridge, gas squib, compressed air, and N2 gas cartridge, a pump motor, spring, and the like. The pressure from the delivery mechanism  1208  pushes the medication through the needle and causes the needle  1212  to move forward through the adhesive layer  1202  and into the skin, muscle, vein or the like at the deliver site. The needle  1212  can be a hypodermic needle or any sharp configured to inject substances into the body. The applicator  1200  deposits the medication in the tissue under the administration site. 
       FIG. 12B  illustrates a top cut away view of an example of the injection multi-dose self-administrating medication applicator  1200 . The applicator  1200  further comprises multiple doses of the medication. In the illustrated example, the applicator  1200  comprises 1 to N applications, where each application is administered by activation circuitry activating a plunger or other dispensing mechanism to dispense the medication in the reservoir through the needle as described above in  FIG. 9B . Each activation circuitry  1206  can receive an activation signal via the antenna  1214 , where each antenna  1214 ( 1 ) to  1214 (N) can be tuned to receive a unique activation signal such that only one activation circuit activates. More than one of antenna  1214 ( 1 ) to  1214 (N) can be tuned to activate with the same signal to dispense medication from more than one reservoir upon receipt of the activation signal. 
       FIG. 14  is a block diagram of example activation circuitry  1400  for multi-dose, self-administrating medication applicators, such as applicators  1100  and  1200 . The illustrated activation circuitry  1400  comprises one or more antenna  1414 , processing circuitry  1402 , and a plurality of delivery circuitry and mechanisms  1410 . A battery  1412  can be used to power the activation circuitry  1400 . 
     The applicator  1100  can further comprise an opioid overdose detection sensor  1406 , which can be considered a local opioid overdose detection sensor because it is local to the user. The local opioid overdose detection sensor  1406  can receive sensor data from the opioid user. Local opioid overdose detection sensor  1406  sends the sensor data to the processing circuitry  1402 . The processing circuitry  1402  receives the sensor data from the local opioid overdose detection sensor  1406 , processes the sensor data, and determines whether an opioid overdose event is occurring or will soon be occurring. The local opioid overdose detection sensor  1406  can send the sensor data to the transceiver  1404 . The transceiver  1404  sends the sensor data via the one or more antenna  1414  to at least one of the mobile device  120 , the server, and the hub for processing. Once the data is processed, the transceiver  1404  can receive via one or more antenna  1414  a signal indicating that the opioid overdose event is occurring or soon will be occurring. The transceiver  1404  sends the processing circuitry  1402  an indication that the opioid overdose event is occurring or soon will be occurring. 
     The applicator  1100 ,  1200  may not include an opioid overdose detection sensor  1408 , such that the opioid overdose detection sensor  1408  can be considered remote from the applicator  1100 ,  1200 . The remote opioid detection sensor  1408  can send the sensor data to at least one of the mobile device  120 , the server, and the hub and when the processed sensor data indicates that an opioid overdose event is occurring, the transceiver  1404  receives via one or more antenna  1414  a signal indicating that an opioid overdose event is occurring or soon will be occurring. The transceiver  1404  sends the processing circuitry  1402  an indication that the opioid overdose event is occurring or soon will be occurring. The remote opioid detection sensor  1408  can send sensor data wirelessly or through a wired connection to the processing circuitry  1402 . 
     The processing circuitry  1402  can determine that the opioid overdose event is occurring or will soon occur by processing the sensor data from the local opioid overdose detector sensor  1406  or can receive an indication from the transceiver  1404  that the opioid overdose event is occurring or will soon occur. The processor  1402  can generate one or more activate signals ACTIVATE(1) to ACTIVATE(N) to the delivery systems DELIVERY(1) to DELIVERY(N), respectively, to dispense one or up to N doses of the medication. For example, if the physiology of the user is such that a single dose of medication is insufficient, the processing circuitry  1402  may be programmed to deliver multiple doses at approximately the same time. 
     The processing circuitry  1402  can generate more than one activate signal at approximately the same time to deliver more than one dose of the medication to the user at approximately the same time. The processing circuit  1402  can generate successive activate signals in response to successive indications of an overdose event. For example, if the application of a first dose of medication does not reverse the effects of an opioid overdose, the processing circuitry  1402  can generate a second activation signal to provide a second dose of medication to the user. The activation circuitry  1400  can count the number of doses dispensed and provides an alert when the applicators  1100 ,  1200  are empty. 
       FIG. 15  is a flow diagram of an example process  1500  to administer medication from a self-administrating medication applicator  1100 ,  1200 . At step  1415 , the activation circuitry  1400  receives an indication that an opioid overdose event is occurring or soon will be occurring. At step  1420 , the processing circuitry  1402  transmits at least one activate signal to the at least one delivery circuit DELIVERY(1) to DELIVERY(N) to dispense at least one dose of the medication. 
       FIGS. 16A and 16B  are flow diagrams of example processes  1500 ,  1550  to administer multiple doses of medication from a self-administrating medication applicator. Processes  1500 ,  1550  utilize a bi-directional communication link between the activation circuitry  1400  and at least one of the mobile device  120 , the server, and the medical monitoring hub. 
     Referring to  FIG. 16A , at the start of process  1500  a counter m can be initialized to zero. At step  1505 , the activation circuitry  1400  receives an alarm signal indicting an overdose event. At step  1505 , the counter is incremented. At step  1515 , the processing circuitry  1402  transmits activation signal to the delivery circuitry to deliver the medication to the user. At step  1520 , the processing circuitry  1402  determines whether all of the doses in the multi-dose self-administrating medication applicators  1100 ,  1200  have been activated. The count m can be compared to the number of doses N in the applicator  1100 ,  1200 . When there are doses remaining in the applicator  1100 ,  1200  (m&lt;N), the process  1500  returns to step  1505 . When there are no more doses of the medication in the applicator  1100 ,  1200 , (m=N), then the process  1500  moves to step  1525 . At step  1525 , the processing circuitry  1402  transmits, via the transceiver  1404  and one or more antenna  1414 , a notification that the applicator  1100 ,  1200  is empty. 
     Referring to  FIG. 16B , at process  1550 , the activation circuitry  1400  receives an alarm signal that an opioid event is occurring or will soon occur. At step  1560 , the processing circuitry  1402  transmits the activate signal to one or more of the delivery circuitry  1410  to deliver the medication to the user. At step  1465 , the activation circuitry  1400  transmits, via the transceiver  1404  and the one or more antenna  1414 , an indication of the number of remaining doses in the applicator  1100 ,  1200 . 
     Patch with Pressurized Reservoir 
       FIG. 17  a schematic diagram of an example wearable self-administrating medication applicator  1700  that includes an antenna, a reservoir  1710 , a needle  1712 , a processor  1714 , a sensor  1716 , a battery  1718 , a fabric layer  1720 , and an adhesive layer  1722 . The self-administrating medication application can be configured as a patch  1700  that is adhered to the user&#39;s skin by the adhesive layer  1722 . The patch  1700  can provide opioid overdose monitoring and administration of an opioid receptor antagonist. The patch  1700  can be a single use, preloaded, disposable device. 
     The reservoir  1710  can include an opioid receptor antagonist, such as Naloxone which is dispensed via the needle  1712  into the user. The needle  1712  can be a microneedle. Sensor  1716  can be internal to the patch  1700  and monitors the user&#39;s physiological parameters. Instead of the patch  1700  including an internal sensor  1716 , an external sensor  1717  can monitor the user&#39;s physiological parameters and can wirelessly communicate with the patch  1700  via the antennas. The external sensor  1717  can be wired to the patch  1700  and provide the sensor data via wires. External sensor  1717  can be a finger sensor that wraps around or over a finger or a toe a Sensor  1716  or sensor  1718  can include pulse oximeters, respiratory monitors, and other sensor devices disclosed herein that monitor the user&#39;s physiological parameters. The processor  1714  can process the sensor data to detect an overdose event. The patch  1700  can transmit the sensor data to an external processing device, such as a mobile device or a hub device for detection of an opioid overdose event. 
     The needle  1712  can be spring-loaded (e.g., in a switch-blade like manner). Fabric layer  1720  can hold the spring-loaded needle  1712  in a compressed state without the spring-loaded needle puncturing the fabric layer  1720 . When an opioid overdose event is detected, the battery  1718  can release a charge that passes through at least a portion of the fabric layer  1720 . The fabric layer  1720  receives the electrical charge from the battery  1718 , which can cause the fabric layer  1720  to burn or shrink and the spring-loaded needle to be no longer restrained. The needle  1712  releases and can inject the user with the opioid receptor antagonist, such as Naloxone, stored in the reservoir. The reservoir  1710  can be pressurized to assist in the injection of the opioid receptor antagonist when the needle is released. An external pump can pressurize the reservoir  1710 . The patch  1700  can have no mechanical triggers. The battery  1718  can be sized to provide operating power for approximately one week. The battery  1718  can be sized to provide operating power for more than one week, more than two weeks, more than one month, or greater periods of time. 
     Hub Based Opioid Monitoring System 
       FIG. 18A  is a block diagram of an example opioid use monitoring system  1800  that includes a sensor  1802 , a delivery device  1804 , a medical monitoring hub device  1806 , and a network  1812 , such as the Internet hosting a cloud server, which can be considered a remote server because it is remote form the user. Sensor  1802  is configured to monitor the user&#39;s physiological parameters and deliver device  1804  is configured to deliver a dose of an opioid receptor antagonist, such as Naloxone or the like, when an opioid overdose event is detected. Sensor  1802  can be an oximetry device, respiration monitor, devices described herein to obtain the user&#39;s physiological parameters, and the like. The sensor  1802  can be an acoustic sensor, a capnography sensor or an impedance sensor to monitor the user&#39;s respiration rate. The sensor  1802  can includes the signal processing device  110  to process the raw sensor data. 
     Delivery device  1804  can be a self-administrating device, such as devices  940 ,  950 ,  1100 ,  1200 ,  1700 . The delivery device can be a device that is user or responder activated. The sensor  1802  can be internal to the delivery device  1804 . The sensor  1802  can be external to the delivery device  1804 . 
     The hub device  1806  can be configured to collect data and transmit the data to a cloud server for evaluation. The hub device  1806  can comprise communications circuitry and protocols  1810  to communication with one or more of the delivery device  1804 , the sensor  1802 , network  1812 , mobile communication device  1818 , such as a smart phone and the like, and other devices with monitoring capabilities  1816 . Communications can be Bluetooth or Wi-Fi, for example. The hub device  1806  can further comprise memory for data storage  1807 , memory for application software  1808 , and a processor  1809 . The application software can include a reminder to put on the patch before sleeping. The hub device  1806  is powered by AC household current and includes battery backup circuitry  1818  for operation when the power is out. The hub device  1806  can be powered through a USB port, using a charger connected to an AC outlet or connected to an automobiles USB charging port. The hub device  1806  can annunciate a battery-low condition. 
     The hub device  1806  can be a Radius-7® by Masimo, Irvine, Calif. The hub  1806  can comprise at least the memory for data storage  1807  and the battery backup circuitry  1818  can physically interface and communicate with the Radius-7®. The hub device  1806  can interface with the phone cradle of the Radius-7®. 
     The sensor  1802  can monitor the user&#39;s physiological parameters and transmit the raw sensor data to the delivery device  1804 , via wired or wireless communication. Optionally, the sensor  1802  can transmit the raw sensor data to the hub device  1806 , via wired or wireless communication. The delivery device  1804  can process the raw sensor data to determine when an opioid overdose event occurs. The hub device  1806  can process the raw sensor data to determine when an opioid overdose event occur. The hub device  1806  can transmit the raw sensor data to a cloud server for processing to determine when an opioid overdose event occurs. When an opioid overdose event is imminent or occurring, the cloud server can transmit to the delivery device  1804  via the hub device  1806  instructions to activate and deliver the opioid receptor antagonist, such as Naloxone. The cloud server can further transmit messages to contacts  1814 , such as friends, family emergency personnel, caregivers, police, ambulance services, other addicts, hospitals and the like. The hub device  1806  can send the delivery device  1804  instructions to activate. 
     It is important to avoid false-positive indications of an overdose event. Users may not wear the self-administrating delivery device  1804  if the user experiences delivery of the opioid receptor antagonist when an overdose event is not occurring or imminently going to occur. To avoid false-positive indications, the wearable delivery device  1804  can induce pain before administrating the opioid receptor antagonist when an overdose event is detected to inform the user that the antagonist will be administered. The wearable delivery device  1804  can provide electric shocks to the user to induce pain. The induced pain can escalate until a threshold is reached. The user can employ a manual override to indicate that the user is conscious and not in need of the opioid receptor antagonist. The override can be a button, switch, or other user input on the delivery device  1804 , the mobile communication device  722  and/or the hub device  1806 . The delivery device  1804 , the mobile communication device  722  and/or the hub device  1806  can wait for the user input for a period of time before triggering the release of the opioid receptor antagonist to avoid false-positive indications. The period of time can be less than 1 minute, less than 5 minutes, less than 10 minutes, between 1 minute and 5 minutes, between 1 minute and 10 minutes, and the like. 
     The memory for data storage  1807  can store the raw sensor data. The memory for data storage can act as a “black box” to record data from a plurality of sources. It is critical to administer the opioid receptor antagonist to a user as soon as an opioid overdose event is detected. The opioid overdose event can be cessation of respiration or an indication that respiration will soon cease. The administration can be by a responder, such as a friend or emergency personnel, by a self-administrating device worn by the user, or by the user. To avoid missing any signs that lead to an opioid overdose event, the hub device  1806  can receive data from any devices with a monitoring capability. For example, many homes have household cameras which provide a video feed. Cell phones can provide text messages and also include microphones to record voice. The cell phone or smart phone can be configured to listen to breathing and transmit the breathing data. Intelligent personal assistants, such as Amazon&#39;s Alexa® controlled Echo speaker, Google&#39;s Google Assistant®, Apple&#39;s Siri®, and the like, for example, also include microphones and have the ability to interface with the Internet. Many household appliances, such as refrigerators, washing machines, coffee makers, and the like, include Internet of Things technology and are also able to interface with the Internet. Medical monitoring devices that are being used by the opioid user for medical conditions, such as ECG&#39;s may also provide additional data. Data from one or more of these devices can be stored in the memory  1807  and used by the hub device  1806  or sent to the cloud server and used by the cloud server to detect an opioid overdose event. The hub device  1806  can determine what monitoring and Internet-connected devices are available and connect wirelessly to the available monitoring and Internet connected devices to receive data. 
     The hub device  1806  can interface with an internet filter, such as a Circle® internet filter that connects to a home network to monitor content. The hub device  1806  can determine which network data is directed to the user&#39;s well-being and store the well-being data. 
     The data can comprise text messages, voice recordings, video, and the like. Because of privacy concerns, the hub device  1806  can determine which small portions of data are helpful to determining the user&#39;s physical condition and store only those portion of data. 
     Because devices can fail to connect to the Internet, it is important to have redundant systems to report the sensor data for overdose detection. In the event that the hub device  1806  fails to connect to the Internet  1812 , the mobile device or other internet-connected devices found in the home can provide an internet connection. For example, the hub device  1806  can transmit the sensor data to the mobile device  1818  and the mobile device  1818  can transmit the sensor data to the cloud server for processing. The sensor  1802  or delivery device  1804  can communicate with the mobile device  1818  when the hub device to Internet connection fails. Intelligent personal assistants and IoT devices can also provide redundant (backup) internet communication. The hub device  1806  can annunciate when its internet connection fails. 
     The mobile device  1818  can monitor respiration rate, SPO2, or ECG in parallel with the sensor  1802  and hub device  1806  monitoring of the user&#39;s physiological parameters to increase the likelihood that an imminent overdose will be detected. The sensor  1802  can monitor the concentration of an opioid in the user&#39;s bloodstream. The measured concentration can be a factor in determining an opioid overdose event to reduce instances of false positives. 
     A home security monitoring system can include the hub device  1806  and a home security company can monitor the user&#39;s health via the hub device  1806  and sensor  1802 . 
     The opioid overdose monitoring application can be integrated into intelligent personal assistants, such as Amazon&#39;s Alexa®, for example. 
     The delivery device  1804  can include medication to induce vomiting. The opioid user can ingest the vomit-inducing medication, if desired, to regurgitate any opioid substance remaining in the user&#39;s stomach. The delivery device  1804  can include reservoirs containing the vomit-inducing medication and a position-sensing sensor. The vomit-inducing medication can be automatically dispensed after receiving sensor input indicating that the user is in an upright position. 
     The position-sensing sensor can monitor the user&#39;s movements to determine that the user is upright. The delivery device  1804  can include one or more sensors configured to obtain position, orientation, and motion information from the user. The one or more sensors can include an accelerometer, a gyroscope, and a magnetometer, which are configured to determine the user&#39;s position and orientation in three-dimensional space. The delivery device  1804  or the hub device  1806  can be configured to process the received information to determine the position of the user. 
       FIG. 19  illustrates an example hub device  1900  of the opioid overdose monitoring system of  FIG. 18A .  FIG. 18B  is a flow diagram of a process  1850  to administer the opioid receptor antagonist using the system of  FIG. 18A . At block  1852 , the sensor  1802  can collect raw sensor data that comprises physiological data. The sensor  1802  can transmit the raw sensor data to the delivery device  1804  and the delivery device  1804  can transmit the raw sensor data to the hub device  1806 . Alternately, the sensor  1802  can transmit the raw sensor data to the hub device  1806 . 
     At block  1854 , the hub device  1806  can store the raw sensor data. At block  1856 , the hub device  1806  can collect and store data associated with the user&#39;s well-being from other devices local to the user. For example, the hub device can receive data from one or more home cameras, data from microphones and cameras of intelligent home assistants, such as Alexa®, for example, internet data from a home internet filter, and the like. 
     At block  1858 , the hub device  1806  can transmit via the network  1812 , the stored data to a cloud server for processing. The cloud server can process the data to determine whether an opioid overdose event is occurring or will be imminent. At block  1860 , the hub device  1806  can receive from the cloud server an indication that an opioid overdose event is occurring or imminent. The hub device  1806  can transmit the indication to the delivery device  1804 . 
     At block  1862 , the delivery device  1804  can provide the user with escalating actions to prompt the user to activate a manual override to indicate that the opioid overdose event is not occurring. For example, the delivery device can provide increasing electric shocks to the user, up to a threshold. 
     At block  1864 , the delivery device  1804  can determine whether an override from the user has been received. When an override is indicated, such as from a user activated button or switch on the delivery device  1804 , the process  1850  returns to block  1852  to continue collecting physiological parameters. When an override is not indicated, the process  1850  moves to block  1866 . At block  1866 , the delivery device  1804  administers the medication, such as Naloxone or other opioid receptor antagonist and returns to block  1852  to continue monitoring the physiological parameters. 
     FIGS.  18 A 1 - 18 A 25  illustrate various example software applications to trigger an alarm and notify a friend when an opioid overdose is indicated. The software application can be downloaded onto the user&#39;s smart mobile device  1818 . 
     FIG.  18 A 1  is an example screenshot illustrating a welcome message to a new user of the opioid overdose monitoring application. The illustrated screenshot of FIG.  18 A 1  displays an illustration of a hand wearing an example sensor and signal processing device  1802 . The user can create an account for the overdose monitoring application. Once account registration is successful, the example application  1808  can instruct the user to set up the communications between the mobile device  1818 , the sensor and signal processing device  1802 , the medical monitoring hub device  1806 , and the home Wi-Fi network. 
     FIG.  18 A 2  is an example screenshot illustrating instructions to the user to power the medical monitoring hub device  1806  to wireless connect to the mobile device  1818 . For example, the medical monitoring hub device  1806  can be Bluetooth enabled. FIG.  18 A 3  is an example screenshot illustrating that the medical monitoring hub device  1806  is successfully connected. 
     FIGS.  18 A 4 - 18 A 6  are example screenshots illustrating instructions to power the sensor and signal processing device  1802  in order to wirelessly connect to the medical monitoring hub device  1806 . The illustrated screenshot of FIG.  18 A 4  displays an illustration of the signal processing portion of the sensor and signal processing device  1802  in an open state to receive an integrated circuit (“chip”). The illustrated screenshot of FIG.  18 A 5  displays an illustration of the signal processing portion of the sensor and signal processing device  1802  in a closed state. The illustrated screenshot of FIG.  18 A 6  displays an illustration of the sensor portion of the sensor and signal processing device  1802  in a powered state. 
     FIG.  18 A 7 - 18 A 8  is are example screenshots illustrating instructions to pair the powered sensor and signal processing device  1802  with the medical monitoring hub device  1806 . For example, the sensor and signal processing device  1802  can be Bluetooth enabled. 
     The user can allow the software application to access Wi-Fi settings for a router on a local network, such as a home network. The user can access the Wi-Fi hub setup and choose a network from a list of available networks local to the user. The illustrated screenshot of FIG.  18 A 9  is an example screenshot displaying an indication that the medical monitoring hub device  1806  is connecting to the local network. 
     FIG.  18 A 10  is an example screenshot asking the user to allow the software application to access location information. When the software application has access to the user&#39;s location information such as the location information found on the user&#39;s mobile device  1818 , the software application can provide the user&#39;s location to emergency personnel, caregivers, friends, and family, etc. when they are notified of an overdose event. 
     FIG.  18 A 11  is an example screenshot displaying an indication that the medical monitoring hub device  1806  is connecting to the cloud server  1812  via the local network. After the setup is complete, the medical monitoring hub device  1806  can communicate with the sensor and signal processing device  1802 , the mobile device  1818  running the software application, and the could server  1812 . 
     FIG.  18 A 12  is an example screenshot displaying a prompt to the user to add contact information for the respondents to be notified of an opioid overdose event that is occurring or will soon occur. the user can select, for example, from the list of contacts found in the mobile device  1818 . 
     FIG.  18 A 13  is an example screenshot illustrating a selected respondent to be notified in the event of an opioid overdose event, where the opioid overdose event can be an overdose that is presently occurring or, based on the user&#39;s physiological parameters sensed by the sensor and signal processing device  1802 , will soon occur. The selected respondent can also be notified of situations that may cause the opioid monitoring system to fail if not corrected, such as when the user is not wearing the sensor or the sensor battery is low. The illustrated screenshot of FIG.  18 A 13  displays the selected respondent&#39;s name and phone number and provides a selection of alerts that the user can choose the respondent to receive. The example selections include a parameter alert, a sensor off alert, and a battery low alert. The parameter alert can be sent when the monitored physiological parameter falls outside a range of acceptable values. The sensor off alert can be sent when the user is not wearing the sensor and signal processing device  1802 . The batter low alert can be sent when the battery voltage in the sensor and signal processing device  1802  fall below a threshold value. 
     FIG.  18 A 19  is an example screenshot illustrating a selection of parameter notifications to be sent to the selected respondent. In the illustrated screenshot of  FIG. A19 , the user can select to send the respondent any combination of a red alarm, an orange alarm, and a yellow alarm. For example, for the oxygen saturation parameter, a red alarm can be sent when the user&#39;s oxygen saturation falls within the range of 0-88; an orange alarm can be sent when the user&#39;s oxygen saturation falls within the range of 89-90, and a yellow alarm can be sent when the user&#39;s oxygen saturation falls within the range of 91-95 to provide an indication of the severity of the overdose event to the respondent. 
     FIGS.  18 A 14 - 18 A 15  are example screenshots illustrating the real time monitoring of the user&#39;s physiological parameters. The illustrated screenshots of FIGS.  18 A 14 - 18 A 15  display representation of dials indicating the monitored oxygen saturation, heart rate in beats per minute, and perfusion index. The illustrated screenshot of FIG.  18 A 14  indicates that the monitored oxygen saturation ( 96 ), heart rate  102 ), and perfusion index (8.5) are acceptable values. The illustrated screenshot of FIG.  18 A 15  indicates that the monitored oxygen saturation ( 86 ) is no longer within an acceptable range. 
     FIG.  18 A 16  is an example screenshot displaying a warning message to the user that the sensor is disconnected. 
     FIG.  18 A 17  is an example screenshot illustrating historical averages of the user&#39;s monitored physiological parameters. The illustrated screenshot of FIG.  18 A 17  displays the average oxygen saturation, heart rate, and perfusion index for the period of time the sensor and signal processing device  1802  collected data for two dates, March 11, and March 12. 
     FIG.  18 A 18  is an example screenshot illustrating session data for oxygen saturation, heart rate, and perfusion index on March 7. The displayed information in the illustrated example includes the minimum, maximum and average of the monitored physiological parameter. 
     FIG.  18 A 20  is an example screenshot illustrating sound options available for the software application. In the illustrated screenshot of FIG.  18 A 20 , the software application can cause the mobile device  1818  to play a sound, such as a beep, that coincides with the user&#39;s pulse, play a sound, such as a beep, when a measurement value breaches its threshold range, and play a beep sound even when the software application is running in the background. 
     FIG.  18 A 21  is an example screenshot illustrating customizable alarm values. Some users may have a higher tolerance for opioids and an opioid event may not be occurring when the user&#39;s physiological parameters fall within a range that typically signals an opioid overdose event. It is desirable to avoid false alarms that may desensitize respondents to notifications. In the illustrated screenshot of FIG.  18 A 21 , the ranges for a red, orange, and yellow alarms for oxygen saturation can be customized for the user by, for example, sliding the indicators along the green-yellow-orange-red bar until the desired values are displayed. Selecting beats/minute and pleth variability permits the user to customize the alarm ranges for heart rate and perfusion index, respectively. 
     FIG.  18 A 22  is an example screenshot illustrating that the user&#39;s physiological parameter data can be shared with other health monitoring applications, such as Apple Health. 
     FIG.  18 A 23  is an example screenshot illustrating a reminder to put on the sensor and signal processing device  1802  before going to bed. The software application may provide other reminders, such as time to replace the sensor battery, turn on notifications, and the like. 
     FIGS.  18 A 24 - 18 A 25  are example screenshots illustrating a request for user input when the user&#39;s physiological parameters indicate an opioid overdose event is occurring or will soon occur. To avoid sending false alarms, the software application requests user input to confirm that the user is not unconscious or otherwise does not want alarm notifications to be send to respondents. In the illustrated screenshot of FIG.  18 A 24 , the user is asked to swipe the screen to confirm safety. In the illustrated screenshot of FIG.  18 A 25 , the user is asked to enter an illustrated pattern on the screen to confirm safety. Different user inputs can be used to confirm different cognitive abilities of the user. For example, it is more difficult to enter the illustrated pattern of FIG.  18 A 25  than to swipe the bottom of the screen in FIG.  18 A 24 . 
     Opioid Monitoring Kits 
       FIGS. 20A and 20B  are schematic diagrams of example prescription and non-prescription opioid overdose monitoring kits  2000  and  2050 .  FIG. 20A  is an example of the opioid overdose monitoring kit  2000  that may be available by prescription only, per the applicable state or country law. Kit  2000  can comprise a hub device  1806 , a sensor  102 ,  610 - 640 ,  1802 , and a delivery device  940 ,  950 ,  1100 ,  1200 ,  1702  that includes one or more doses of an opioid receptor antagonist, such as Naloxone.  FIG. 20B  is an example of the opioid overdose monitoring kit  2050  that may be available without a prescription. Kit  2050  can comprise the hub device  1806  and a sensor  102 ,  610 - 640 ,  1802 . Kits  2000 ,  2050  may include additional components to assist in opioid overdose monitoring. 
       FIG. 20C  is an example of an opioid overdose monitoring kit. The kit can include more or less items than the example illustrated in  FIG. 20C . The kit can include a base station or hub device as described herein, and charger plug and cord. The kit can also include a sensor assembly having a sensor dongle and at least one sensor  102 . In one embodiment, the kit includes more than one sensor  102 . In the illustrated kit, the base station includes one or more carve outs or depressed areas in the housing that functions as a tray to hold one or more of the base station or hub device, the charger plug and cord, the sensor and the sensor dongle. In an aspect, the sensor  102  is an air sensor. In another aspect, the sensor  102  is sensor that is worn on a fingertip of the user, such as, for example, the sensor  102  illustrated in  FIG. 6I . In further aspects, the sensor  102  can be, but not limited to, any of the sensors  102  described herein that sense a physiological parameter, such as a physiological parameter used to monitor a user for an opioid overdose condition or event, and transmit the sensed data to a monitoring device, such as the base station or hub device, to detect an opioid overdose event of the user wearing the sensor  102 . 
       FIG. 21  is an example tray or kit housing for use in an opioid overdose monitoring kit. The tray can be fabricated from sustainable molded pulp or molded fiber. The molded pulp tray can be slush molded, transfer molded, or formed using cure-in-the mold processes. The molded pulp tray may also undergo one or more secondary processes, such as coating, printing, hot-pressing, die-cutting, trimming, manufactured using colors or special slurry additives, and the like. In other examples, the tray can be fabricated from expanded polystyrene (EPS), vacuumed formed PET and PVC, corrugation, and/or foams. The example tray illustrated in  FIG. 21  comprises a top or lid that folds over the lower half of the tray to enclose the opioid overdose monitoring kit. The example tray illustrated in  FIG. 21  further comprises one or more compartments or molded depressions to hold one or more of the base station or hub device, the charger plug and cord, the sensor and the sensor dongle. 
       FIGS. 22A-22G  illustrate various view of an example tray or kit housing.  FIG. 22A  illustrates a top, front, and right side perspective view of a tray or kit housing embodying a new design.  FIG. 22B  illustrates a front view of the tray or kit housing of  FIG. 22A .  FIG. 22C  illustrates a back view of the tray or kit housing of  FIG. 22A .  FIG. 22D  illustrates a left side view of the tray or kit housing of  FIG. 22A .  FIG. 22E  illustrates a right side view of the tray or kit housing of  FIG. 22A .  FIG. 22F  illustrates a top view of the tray or kit housing of  FIG. 22A .  FIG. 22G  illustrates a bottom view of the tray or kit housing of  FIG. 22A . 
     Locating a Locally Stored Opioid Receptor Antagonist 
     A user may locally store one or more doses of an opioid receptor antagonist, such as Naloxone, for use at the user&#39;s residence, for example. A first responder may respond to the indication of opioid overdose and find the user unresponsive or unable to communicate the location within the user&#39;s residence of the opioid receptor antagonist, such as Naloxone or the like, to the first responder. The problem of finding the opioid receptor antagonist stored proximate to the user when the user cannot communicate its location can be solved by storing the one or more doses of the opioid receptor antagonist in a container, such as a vile, carton, box, tamper proof container, and the like, that is able to communicate with the application on the first responder&#39;s mobile device via the hub device. The container including the opioid receptor antagonist can further include one or more of an RFID, an antenna, an alarm or vibratory device, processing circuitry, and the like to communicate with the hub device and/or the first responder&#39;s mobile device. For example, the first responder can indicate on the application running on the first responder&#39;s mobile device that the first responder is searching for the opioid receptor antagonist stored in the user&#39;s residence. The mobile device can communicate this to the hub device. The hub device can send a command via Bluetooth, for example, to the container of opioid receptor antagonist. Upon reception of the command, the alarm circuitry within the container can alarm by performing one or more of sending an audible alarm, vibrating, flashing a light to draw attention to its location. The container may also send a message with written directions to its location when the location is stored in a memory included in the container. 
     Other Delivery Methods/Mechanisms 
     As discussed herein, opioid receptor antagonists can be delivered by intravenous injection, intramuscular injection, and intranasal application, where a liquid form of the medication is sprayed into the user&#39;s nostrils. Administration of the medication can also occur via an endotracheal tube, sublingually, where a gel or tablet of the medication is applied under the tongue, and transdermally, where the medication can be a gel applied directly to the skin or within a transdermal patch applied to the skin. 
     Other methods of administrating the opioid receptor antagonist can be via rectal capsule or suppository. The capsule can also monitor respiration rate and/or pulse rate and rupture the capsule when an opioid overdose event is imminent or occurring. A Bluetooth® signal can activate the capsule. 
     The opioid receptor antagonist can be included in an inhaler, by first injecting the user with an antiseptic and then with the opioid receptor antagonist, or in administered in an ear or other body orifice. The opioid receptor antagonist can be delivered through a cannula for a ventilator or breathing machine, for example. 
     The opioid receptor antagonist can be stored in a dental retainer that is crushed to release the stored drug. 
     An implantable delivery device can deliver the opioid receptor antagonist for chronic opioid users. The device can be implanted in a similar location as a pacemaker. The device can monitor one or more of respiration rate, pulse rate, ECG and SPO2 and release a dose of opioid receptor antagonist when an opioid overdose event is detected. The implantable device can comprise multiple doses and/or can be refillable by injecting the opioid receptor antagonist into the implantable delivery device. Such as delivery device can be implanted for one or more months. Another example of an implantable delivery device comprises a capsule containing the opioid receptor antagonist and an external device, such as a strap over the capsule that transmits a resonant frequency. The resonant frequency causes the capsule to rupture and the released opioid receptor antagonist is absorbed by the body. 
     The opioid receptor antagonist is contained in a pill that is activated when needed. The opioid receptor antagonist can be encased in a gel pack that is ingested or worn on the skin. An ultrasonic device, worn as a wrist strap, for example, can rupture the gel pack, adhered to the skin, for example, when an opioid overdose event is detected. The body can absorb the opioid receptor antagonist from the ruptured gel pack. 
     TERMINOLOGY 
     The embodiments disclosed herein are presented by way of examples only and not to limit the scope of the claims that follow. One of ordinary skill in the art will appreciate from the disclosure herein that many variations and modifications can be realized without departing from the scope of the present disclosure. 
     The term “and/or” herein has its broadest least limiting meaning which is the disclosure includes A alone, B alone, both A and B together, or A or B alternatively, but does not require both A and B or require one of A or one of B. As used herein, the phrase “at least one of “A, B, “and” C should be construed to mean a logical A or B or C, using a non-exclusive logical or. 
     The description herein is merely illustrative in nature and is in no way intended to limit the disclosure, its application, or uses. For purposes of clarity, the same reference numbers will be used in the drawings to identify similar elements. It should be understood that steps within a method may be executed in different order without altering the principles of the present disclosure. 
     As used herein, the term module may refer to, be part of, or include an Application Specific Integrated Circuit (ASIC); an electronic circuit; a combinational logic circuit; a field programmable gate array (FPGA); a processor (shared, dedicated, or group) that executes code; other suitable components that provide the described functionality; or a combination of some or all of the above, such as in a system-on-chip. The term module may include memory (shared, dedicated, or group) that stores code executed by the processor. 
     The term code, as used above, may include software, firmware, and/or microcode, and may refer to programs, routines, functions, classes, and/or objects. The term shared, as used above, means that some or all code from multiple modules may be executed using a single (shared) processor. In addition, some or all code from multiple modules may be stored by a single (shared) memory. The term group, as used above, means that some or all code from a single module may be executed using a group of processors. In addition, some or all code from a single module may be stored using a group of memories. 
     The apparatuses and methods described herein may be implemented by one or more computer programs executed by one or more processors. The computer programs include processor-executable instructions that are stored on a non-transitory tangible computer readable medium. The computer programs may also include stored data. Non-limiting examples of the non-transitory tangible computer readable medium are nonvolatile memory, magnetic storage, and optical storage. Although the foregoing invention has been described in terms of certain preferred embodiments, other embodiments will be apparent to those of ordinary skill in the art from the disclosure herein. Additionally, other combinations, omissions, substitutions and modifications will be apparent to the skilled artisan in view of the disclosure herein. Accordingly, the present invention is not intended to be limited by the reaction of the preferred embodiments, but is to be defined by reference to claims. 
     Conditional language used herein, such as, among others, “can,” “might,” “may,” “e.g.,” and the like, unless specifically stated otherwise, or otherwise understood within the context as used, is generally intended to convey that certain embodiments include, while other embodiments do not include, certain features, elements and/or states. Thus, such conditional language is not generally intended to imply that features, elements and/or states are in any way required for one or more embodiments or that one or more embodiments necessarily include logic for deciding, with or without author input or prompting, whether these features, elements and/or states are included or are to be performed in any particular embodiment. The terms “comprising,” “including,” “having,” and the like are synonymous and are used inclusively, in an open-ended fashion, and do not exclude additional elements, features, acts, operations, and so forth. Also, the term “or” is used in its inclusive sense (and not in its exclusive sense) so that when used, for example, to connect a list of elements, the term “or” means one, some, or all of the elements in the list. Further, the term “each,” as used herein, in addition to having its ordinary meaning, can mean any subset of a set of elements to which the term “each” is applied. 
     While the above detailed description has shown, described, and pointed out novel features as applied to various embodiments, it will be understood that various omissions, substitutions, and changes in the form and details of the devices or algorithms illustrated can be made without departing from the spirit of the disclosure. As will be recognized, certain embodiments of the inventions described herein can be embodied within a form that does not provide all of the features and benefits set forth herein, as some features can be used or practiced separately from others. 
     Additionally, all publications, patents, and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication, patent, or patent application was specifically and individually indicated to be incorporated by reference.