Blunders and Wonders: The Opioid Epidemic's Tech Problem & Digitization of Health Records

Nick van Terheyden, MD
SEPTEMBER 26, 2018
Hello! I'm Dr. Nick, the Incrementalist, and I'm here today to talk about Blunders & Wonders. 

Digital Health Blunder: Opioid Crisis & Treatment 

This week's blunder involves the opioid crisis and its treatment. 

The statistics are staggering. This crisis has been killing us steadily over the last several years. Here in the US, over 100 people a day die of an opioid-related overdose, and 2.1 million have some form of opioid misuse disorder. 



Currently we're struggling to find ways of easing this addiction. One of the tools available is with a medication assistance program, using a combination of naloxone and buprenorphine, whose history of development dates back to the 1960s, when the researchers tried to synthesize a drug that was as effective as morphine, but shared some of the undesirable effects of dependence and addiction. 

They were ultimately successful and the new drug was released and has been in use since the late 1970s. 

>>> READ: Rise of the Anti-Opioid Algorithm

The patent has long since expired and generics are available, which is great news given the desperate need for ways and means to treat and manage the burgeoning demand of opioid-dependent people. 

But it was the news that Richard Sackler, a member of the family that founded the Purdue Pharmaceuticals company, the one accused of fueling the opioid crisis, has filed, and was issued a patent for a new formulation of this drug. With this in place, they get to benefit from a formulation of a drug designed to treat addiction, that they're accused by more than 1,000 jurisdictions of fueling. 

There are other potential methods for treating opioid addiction, such as those being developed and tested by Pear Therapeutics as an adjunct therapy, and clearly interesting enough for the FDA to launch an innovation challenge seeking developers of medical devices and digital health technologies that can provide a novel solution to detecting, treating and preventing opioid abuse. 

This is an exciting area to watch!

Digitial Health Wonder: The Digitization of Science & Healthcare

This week's wonder: The digitization of science and healthcare.

You may have missed the news of the tragic fire that burnt Brazil's natural history museum at the beginning of the month, but it was hard to miss the commentary from so many people expressing the sadness and the loss of so many irreplaceable holotypes. 

The totals aren't in, but the risk is to some 20 million specimens, and as one commentator aptly put it, this was a lobotomy of the Brazilian memory. 

>>>READ: Interoperability During disasters: Lessons from Tragedy

Which brings me to the digitization in healthcare. Through the tragedy of hurricane Katrina and the displacement of so many and the destruction of medical records, a new age of digitization and health exchanges was accelerated. With the latest hurricane event, many patients are finding their access to their latest records and treatments is improved thanks to the resilience of this process and the backups. 

There are some limitations to this digitization that's dependent on what exactly you digitize. DNA of the lost fossils cannot be recreated from the scans, but the bones and the mechanical features can. What's interesting about this effort and its potential, is the crowdsourcing aspect. The internet is already trying to help, putting out a call for any images to put into a database and use a 3D modeling platform - Sketchfab - to compile the images and recreate what they can. 

You have to love the community effort and the spirit, which reminds me a lot of the patient-engagement community, and the projects that share knowledge and insights, and collectively hack health for the better of everyone. Case in point: the Four Thieves Vinegar group, who hacked the EpiPen and created an affordable EpiPencil version using all the tools available in our technology-packed world. 

As for DNA, given the ongoing decline of the genome sequencing cost, that, at its current rate, will allow for not just the sequencing of the individual, but the sequencing of all our biomes, and may be done on a regular basis, we might be well on our way to full digitization. 

As is often the case, want to get a sense of where this might go? You can turn to Hollywood. For some historical perspective on sequencing, check out the dystopian "Gattaca," and for the future storage of humans, "Transendence" gives you a peek into the digitization of the brain. 

Until next time, I'm Dr. Nick, the Incrementalist. Don't let perfection stand in the way of progress.

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Related:

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