Tackling the opioid epidemic with connectivity and cannabis
Silver bullets are in short supply for the opioid crisis. It’s time to propose radical ways to tackle the entrenched epidemic.
Editor's Note: The following is a guest post from Ying Tam, managing director of Health Venture Services at Toronto-based MaRS Discovery District.
An average of 115 Americans die each day from opioid-related overdoses — more than a year after the Trump administration declared the opioid crisis a public health emergency.
The epidemic is now so widespread that the Centers for Disease Control and Prevention (CDC) cited it as a contributor to the recent drop in U.S. life expectancy. A new report from the National Safety Council found that people are more likely to succumb to opioid overdoses than die in vehicle accidents. In response, Washington has expanded access to treatment programs and stepped up enforcement against illicit drugs and over-prescribing.
Meanwhile, global social media companies like Facebook have started blocking searches for drug-related terms and redirecting users to treatment options. While these are steps in the right direction, solving the growing crisis will take action on all fronts — and some creative thinking.
It’s time to propose radical ways to tackle the entrenched epidemic. Here are three to consider:
1. Use big data and artificial intelligence to find clues about the path to addiction
Doctors still write around 200 million prescriptions for opioids each year, and each time they roll the dice with addiction. Around one in 10 patients prescribed opioids for pain relief will go on to become dependent, but there’s still scant evidence to indicate who is most at risk. The uneven distribution of the opioid epidemic — hitting rural and struggling communities hardest — indicates a complex network of personal traits and socio-economic conditions is at work.
In other fields, big data techniques that integrate information from a wide range of sources and algorithms that rapidly hunt for hidden links have proven adept at pulling together these kinds of disparate threads. It’s possible they could shed new light on the opioid problem. The aim would be to create systems that use real-time information from sources like prescribing databases to flag at-risk patients and inform doctors’ choices. There are already some promising pilot projects. In Michigan, for instance, public health officials have used a similar approach to create predictive models that generate overdose risk scores using historical data.
2. Crowdsource ideas from the tech community
Silver bullets are in short supply for the opioid crisis. It’s too complex and too widespread for any single intervention to control. So public health agencies need to assemble a coalition of innovations that can make incremental changes. There’s no shortage of ideas: The FDA recently received more than 200 applications for an expedited approval program for medical devices that help diagnose, treat or avoid opioid addiction.
However, there are many more areas where technology could play a role. One being explored in Canada is using innovations to track the full extent of the crisis, because public health surveillance systems can’t detect illicit drug use where first responders aren’t called. We need more efforts like the Opioid Data Challenge, a partnership between MaRS and the Public Health Agency of Canada, that crowdsource for ideas to unlock vital insights or warning signs that could be hiding in the enormous quantities of citizen data amassed by tech companies and governments. Initiatives should focus on insights from social media posts, spikes in particular online searches or shifts in interactions with police and other government agencies.
3. Fight fire with fire: Consider medicinal cannabis as an opioid substitute
After the legalization of cannabis in Canada and several U.S. states, there’s renewed interest in the medical potential of cannabis for pain relief. Until recently, cannabis prescribing — where it’s legal — had been something of a wild west with few evidence-based guidelines. Companies like Canopy Health and Reformulary Group are now trying to create rigorous evidence bases around use of different strain types, dosages, delivery mechanisms and other research-backed methods that could open the way to more effective clinical use of cannabis.
Reformulary Group, for instance, is creating Cannabis Standard, a system where medicinal users can log their level of symptom control using clinically-validated questionnaires. This will allow researchers to mine the data for insights into the most effective combinations for various conditions, including chronic pain relief. The worthwhile idea of using medicinal cannabis as an opioid alternative is admittedly a longer play, while researchers work on the science and while regulatory hurdles remain high in countries like the U.S.
Opioid addiction does not discriminate based on race, age, occupation or class. People living in wealthy, poor and middle-class neighborhoods all share a risk of becoming addicted, already are or know someone in the throes of it. Everyone has a stake in finding a pathway to awareness, action and prevention.
Looking to AI, the technology community and medicinal cannabis might provide some of the answers people are so desperately looking for in order to help people today and end the opioid epidemic in the future.