Wearable sensor system for continuous monitoring of alcohol withdrawal syndrome

The National Institute on Alcohol Abuse and Alcoholism awarded Creare LLC $314,357 on September 1, 2026, under the Alcohol Research Programs (CFDA 93.273) to develop a wearable sensor system for continuous monitoring of alcohol withdrawal syndrome.

The project delivers a real-time bracelet-based device integrating tremor detection, heart rate variability, sleep tracking, and sweat ethanol sensing with a machine learning algorithm that synthesizes multiple physiological inputs into a continuous alcohol withdrawal syndrome severity score aligned with Clinical Institute Withdrawal Assessment for Alcohol thresholds. The system enables objective assessment in place of subjective episodic evaluations, supports early clinical intervention, and integrates with the Ria Health telehealth platform for remote clinical oversight and enhanced treatment adherence in outpatient settings. Phase I uses off-the-shelf wearable sensors to collect human study data from participants enrolled in an alcohol use disorder treatment program to develop a prototype algorithm. Phase II will develop an integrated device and validate it in a multi-site human study. The primary commercialization pathway targets telehealth-based alcohol use disorder platforms.

The award period runs from September 1, 2026, through February 28, 2027, with place of performance in Hanover, New Hampshire. The assistance type is a Project Grant, classified as SBIR Phase I funding for a domestic small business.

Abstract

Alcohol withdrawal syndrome (AWS) is a life-threatening complication of alcohol use disorder (AUD), affecting up to 50% of heavy drinkers and resulting in seizures, delirium tremens, and mortality rates as high as 25% in severe cases. Early detection and intervention reduce complications, hospitalizations, and costs, yet AWS remains underdiagnosed, particularly in outpatient settings. Current assessments, such as the clinical institute withdrawal assessment for alcohol (ciwa-AR), are subjective, episodic, and reliant on patient participation, limiting their utility for continuous monitoring. This project aims to develop a real-time, wearable sensor system for objective AWS severity monitoring. The system integrates tremor detection, heart rate, heart rate variability, sleep tracking, and sweat ethanol sensing into a comfortable bracelet that continuously collects physiological data. A machine learning algorithm synthesizes the multiple inputs into a continuous AWS severity score aligned with ciwa-AR thresholds, enabling early clinical intervention and reducing reliance on subjective assessments. Seamless integration with the RIA health telehealth platform provides remote clinical oversight and enhances treatment adherence in real-world outpatient settings. Our innovation fills a critical GAP in outpatient AWS management by enabling passive, real-time monitoring to guide treatment adjustments and prevent severe withdrawal complications. In phase i, we will use off-the-shelf wearable sensors to collect data in a human study with participants enrolled in an AUD treatment program to develop a prototype algorithm. In phase II, we will develop an integrated device and validate the prototype in a multi-site human study. The primary commercialization pathway targets integration with telehealth-based AUD platforms, such as RIA health, to enhance treatment adherence, safety, and outcomes. This project aligns with niaaa's mission to improve diagnosis, treatment, and prevention of alcohol-related problems. By enabling continuous AWS monitoring, IT has the potential to transform outpatient withdrawal management and significantly reduce alcohol-related morbidity and mortality.