Tor, Bitcoin and Silk Road. The dark web, Alibaba and Whatsapp.
All new technologies introduced over the last two decades, and all tools that have been used in the illicit online trade of drugs. It is easier than ever to locate, purchase and obtain almost anything one desires. The digital marketplace has been fueled by a proliferation of technological advancement, creating new anonymous platforms and methods of payments. As people find new ways to use digital tools, such as using cryptocurrency for buying sex and drugs online, public health officials and researchers face increasing pressure to prevent public health problems that can be accelerated by the use of these tools. The answer may be to encourage the public to leverage the digital technology and data causing public health problems, to prevent them.
MDMA, cocaine, and methamphetamine are available for purchase on the dark web, as are opioids heroin, fentanyl, carfentanil (a sedative for elephants,) oxycodone and hydrocodone. The continued availability of these drugs is particularly alarming given that the opioid crisis kills 130-people a day and is estimated to have cost $631-billion in the U.S. alone, according to the Society of Actuaries. It is clear we have an opioid problem, but what is being done to solve it?
The response to the opioid crisis from researchers has been slow-moving for a number of reasons including long delays in the ability to implement strategies found to be feasible or effective. A widely-cited study published in the Journal of the American Medical Association in 2007 found that it took 17 years for new scientific discoveries to enter day-to-day clinical practice. Today, the majority of intervention models that are implemented to help opioid users do not incorporate technology. But digital tools might be part of the answer. They could speed up and scale response efforts and should be incorporated into public health response efforts immediately.
The Helping End Addiction Long-Term (HEAL) initiative is one part of the government’s effort to address this problem of delays in implementation. The National Institutes of Health HEAL Initiative program is releasing 945-million dollars in 2019-2020, aimed at creating quick, implementable, and sustainable solutions to the opioid crisis. UCIPT has been awarded HEAL grants, and we take a unique approach to quickly respond to the opioid crisis. In November, we brought together public health experts and computer scientists for the second annual Opioid Hackathon, at the National Academies of Science, Engineering, and Medicine (NASEM) in Irvine, California.
We divided the 130 participants into groups of 4 or 5 and tasked each team with coming up with a digital solution to one of 5 dimensions of the opioid crisis. Within 24-hours we had more than 30 innovative, multidisciplinary projects that were assessed by two rounds of judging. A winner was chosen in each of the 5 tracks and awarded an initial $1,000 to further the project. UCIPT will continue to mentor the winning groups over the next 12-months at off-site retreats and bring in public health, start-up, technology, and media experts to help shape solutions to the opioid crisis.
The ‘Hackathon’ premise as a means of solving problems has been around a long-time, especially in the Bay area, the U.S. hub of technology, innovation, and idea-generation. It is a relatively new concept in academia and the medical field.
Another example of using crowdsourced information to solve public health problems is mining online search data. Over the last three years, I have worked on a research study with google, analyzing how opioid-related search terms within a geographic area can predict the number of opioid-related visits to emergency rooms. It is these type observations and the immediacy of this data that is critical to making a real-time impact on the opioid epidemic that is currently devastating communities across the country.
Citizen-driven engagement in public health is proving vital to expeditiously address public health challenges. Engaging the public to work on ideas and solutions that impact community health creates a contemporary and innovative model. For example, studies show that citizen-driven engagement in healthcare leads to patients actively participating in their medical care and providing feedback to their health care providers. In our research, engaging public citizens in their own health and behavioral-decision making has shown an increase in the adoption of positive health practices and improved public health.
When citizens are directly involved in finding new approaches to public health problems such as the opioid epidemic, these approaches are more likely to be effectively and efficiently implemented in their communities. Technology has facilitated easy online access to drugs, isn’t it time that we implement technological solutions into the public health system to help curb the excess use of them?