Navigating an Epidemic: Challenges and Opportunities in Addressing the Opioid Crisis

As an Emergency Physician, I am no stranger to treating people in pain. During each shift in the emergency department, my provider colleagues and I struggle to help patients who are suffering from pain, while also ensuring judicious use of very powerful and potentially dangerous opiates. We must make certain that no one is harmed by our prescribing, that we do not overprescribe, and that prescriptions are not inappropriately used. In some parts of the world, individuals suffer and die from excessive pain because they don't have access to medication. Yet in the U.S., opioid addiction is driving a very real and tragic public health epidemic.

Despite its prevalence, I believe the opioid crisis is a preventable and tangible issue that we can address if we come together to create innovative solutions. This week, the GE Foundation announced a collaborative effort with Massachusetts General Hospital (MGH) and The Consortium for Affordable Medical Technologies (CAMTech) to hold a hack-a-thon specifically focused on the issue of the opioid epidemic. I'd like to offer some perspective on how we can try to tackle this crisis, and perhaps shed some light on why this undertaking is so critical at this point in time.

The unfortunate reality of the opioid crisis.
In recent years, opioid addiction has become dramatically more prevalent in the U.S. Alongside a growing number of opioids being dispensed, the amount of people affected by addiction and related deaths has continued to sky-rocket. According to The New England Journal of Medicine, U.S. retail pharmacies dispensed 245 million prescriptions for opioid pain relievers in 2014. That year, opioid addiction affected 2.5 million adults (The New England Journal of Medicine), and nearly 19,000 overdose deaths were related to prescription pain relievers (Centers for Disease Control). This epidemic is not exclusive to a particular gender, age group, or race. A recent PBS article synthesized this, citing CDC data that shows that, though Whites and Native Americans have experienced the biggest jump in opioid-related deaths in recent years, opioid-related fatalities have increased by 200 percent among African-Americans and by 140 percent among Latinos since 2010. The same article notes that the opioid epidemic affects every age group, with fatal overdoses more likely to occur in middle age. Massachusetts is being hit particularly hard by the opioid crisis, and officials have even said that this "kills more people in Massachusetts than car accidents and guns combined" (The Boston Globe). These statistics are staggering, but they put into perspective how serious this issue has become.

Root causes perpetuating the epidemic.
The opioid epidemic is complex and, like most public health crises of this proportion, there isn't one underlying cause. To effectively address this crisis, we must first reflect on the factors perpetuating it - individual struggles with pain, anthropologic dynamics driving addictive behaviors, and community challenges that instigate opioid and other substance use. Unfortunately, there is a pervasive stigma - including among providers - surrounding substance use. We must also confront factors such as limited availability of Medication Assisted Treatment, gaps in provider knowledge, and a lack of medical school addiction curricula. All of this hinders patients' ability and willingness to seek and access treatment for opioid addiction.

Coming together to arrive at a solution.
To effectively reverse this, we must examine every step on a patient's path to addiction or overdose and mobilize better, more compassionate responses to substance use as a whole. This requires us to be committed, innovative and creative in coming up with potential solutions. Big data and analytics have been used with great success in other health crises, like Ebola. During the peak of this outbreak, mobile phone geo-mapping tracked population movements, preventing spread and pinpointing the best areas for treatment centers. The opioid epidemic is an ideal case for leveraging our massive computing capabilities to identify potential interventions. Across the U.S., cities like Baltimore and states like Massachusetts are already using data to pinpoint populations who are at high-risk of overdose in order to address the opioid epidemic head on. This is just one way leaders are starting to provide solutions to address this crisis.

So, we must continue to innovate to bring the U.S. closer to eradicating the opioid epidemic. That's why I am calling us to action with our 48-hour Opioid Epidemic Hack-a-thon, where we will work with individuals from across the spectrum of substance use - clinicians, patients with substance dependence and their families, anthropologists, computer scientists, police officers, government officials and more - to create innovative, cutting-edge solutions that will revolutionize the face of substance use. I encourage those interested to apply now to this event, which will take place at the iconic District Hall in Boston from September 9 to 11, 2016.

Like in any public health crisis, we must galvanize our collective energy, resources, passion, and innovative DNA to work to tackle this tragic epidemic. The opioid epidemic, in particular, is solvable. If we focus the same energy and attention toward this issue as we have to the Zika virus, smoking cessation, cancer, and other critical public health issues, I believe that we can eradicate the opioid epidemic in next decade.