How dashboards, analytics and e-prescribing battle opioid addiction

This information provided by Smart Cities Council Compassionate Cities.
Mon, 2016-05-02 15:00 -- Liz Enbysk

When a drug addict finally decides to seek help, what if help isn't available at that moment in time? Or what if there is a treatment option available but a caseworker doesn't know about it?

Those scenarios have concerned public health officials in Baltimore for years now, but city Health Commissioner Dr. Leana Wen tells NPR they are still nowhere close to the notion of treatment-on-demand.

But that doesn't mean Wen and her team aren't making progress in what Fox News calls "one of the nation’s opioid addiction hotspots." Wen sees progress in society's perception of addiction, underscored by President Obama's announcement of new federal efforts to battle prescription drug and heroin abuse. No longer is it viewed as a law enforcement issue, but rather as a chronic medical condition.

Even so, there's plenty of debate in the public health arena about the best way to battle drug addiction – such as whether medication-assisted treatments like methadone and buprenorphine simply replace one addiction for another -- to the notion of setting up heroin injection "safe sites" as cities from Seattle to Ithaca, NY are contemplating.

The reality is, as President Obama pointed out, today more people in the U.S. die from opioid overdoses than traffic accidents. Oxycodone and Percocet are common opioids prescribed by doctors to kill pain – but they are highly addictive and are also killing people.

And as heroin use has increased in the last decade, so have heroin overdoses, says the Centers for Disease Control and Prevention (CDC). It reports that from 2002 through 2013, the rate of heroin-related overdose deaths nearly quadrupled. And 45% of people who use heroin were also addicted to prescription opioid painkillers, the CDC says.

So it seems the war on drug addiction will take place on several fronts – and technology is one of them.

A role for technology
A dashboard that emergency room doctors and others can monitor in real time to locate available treatment space for addicts is on Wen's radar in Baltimore, where they've already introduced a 24/7 hotline for addicts that receives more than 1,000 calls a week. The state of Vermont has a dashboard system that monitors treatment center capacity and sends alerts when more resources are needed.

Baltimore is also reaching out online to prevent overdose deaths. Its "Get Naloxone – Save a Life" campaign encourages friends and family members to get naloxone (Narcan), a prescription medicine that can reverse an opioid overdose. Health Commissioner Wen basically wrote a prescription for naloxone for every Baltimore resident and the website dontdie.org features videos with Wen explaining what naloxone is and demonstrates how to use it.

E-prescriptions reduce forgeries
New York recently became the second state in the nation to mandate electronic prescribing -- also an attempt to reduce opioid drug deaths. According to a MarketWatch report, New York's new e-prescription law replacing paper prescriptions with digital versions aims to reduce forgeries. It also supports the state's drug prescription monitoring system designed to prevent patients from getting multiple prescriptions by "doctor shopping."

Electronic prescriptions have been the law in Minnesota since 2011, according to the NCADD, and under consideration in Massachusetts and Maine.

Other states have voluntary e-prescriptions but the numbers aren't great, according to Surescripts LLC, an e-prescription network. It reports that only 1.4% of providers in the U.S. were equipped to e-prescribe controlled substances in 2014.  With controlled substances involved, requirements for electronic software and doctor authentication are high, making e-prescription implementation more extensive and expensive a prospect, doctors say.

"E-prescribing in the right circumstances is fast, efficient and liked by patients and pharmacists and physicians. But there are many circumstances where there are challenges,” said Dr. Steven Stack, president of the American Medical Association. He suggested the software can be a challenge for small doctors' offices and that there are still kinks to work out in doctor-pharmacy coordination.

Predicting overdoses
Still, as e-prescribing becomes more common, there's more opportunity to monitor prescription drug activity.

Todd Newcombe writes at Governing.com that Massachusetts public health officials are using analytics to spot patterns in data and develop a sort of early-warning system to pinpoint hotspots where opioid overdoses and deaths might occur.

Given that drug addiction can tear families apart, lead to joblessness, homelessness, even violence,  there's an urgency to combine compassion, innovation and smart technologies to develop solutions.


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This article is from the Council's Compassionate Cities initiative which highlights how city leaders and other stakeholders can leverage smart technologies to end suffering in their communities and give all citizens a route out of poverty. Click the Compassionate Cities box on our registration page to receive our weekly newsletter.

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