On Sept. 28 and 29, a team of University students, staff and faculty, sponsored by the Weldon Cooper Center for Public Service, participated in the Governor’s Datathon to investigate solutions to the growing opioid addiction epidemic. The datathon focused on using prescription data to battle the growing opioid crisis in Virginia.
Opioid medications are often used clinically to reduce the quantity of pain signals that are sent to the brain. These drugs are used commonly after injuries or surgeries, and they are usually given in small amounts.
However, people can misuse these prescribed opioids, and the brain can change to develop a powerful urge for the drug, causing addiction. Since opioids create artificial endorphins that bind to pain receptors and modulate pain, using too much can cause the brain to rely on those endorphins and stop producing its own. This produces a reliance on the opioid drug to relieve pain stimulation.
This addiction to opioid drugs has local and national consequences. In Virginia itself, opioid overdoses kill an average of three people a day. In the United States, according to the National Institute on Drug Abuse, over 2.5 million people suffer from opioid use disorder, which, in 2014, contributed to over 28,000 deaths.
One of the causes of the opioid crisis in the United States stems from research produced in the 1980s that reported there was a low incidence of addictive behavior in cancer and non-cancer patients who were given opioids like morphine. Although the research did not conduct a long-term study on opioid data and no such data had been collected, the report started a 20 year campaign that perpetuated the long-term use of opioids in non-cancer patients.
The mid-1990s then saw the pharmaceutical industry aggressively marketing to promote opioid use to both patients and doctors. In 1998, the Federation of State Medical Boards stated that physicians should not fear disciplinary action for prescribing opioid substances for medical purposes.
However, the trend towards prescribing opioids liberally reversed when new data came out. According to the CDC, in 2007, drug overdose deaths surpassed motor vehicle collisions as the leading cause of death for Americans. Later, data emerged reporting that four in five new heroin users had formerly misused prescription painkillers.
There is now research focused on providing solutions to opioid addiction. One often-effective treatment is using medications such as methadone and buprenorphine in combination with behavioral counseling. In one study in Baltimore, buprenorphine decreased heroin overdose deaths by 37 percent. The Center for Disease Control has also implemented stricter guidelines on physicians when prescribing opioids.
Even at the University, there is intense research on opioid addiction. Virginia LeBaron, an assistant nursing professor, uses geospatial analysis to map out access to pain relief and indicators of opioid addiction in Southwest Virginia. Her research, in part, seeks to provide a safe way to give opioids to cancer patients while reducing risk and harms associated with the medications.
Although this research has the potential to help fight opioid addiction, like other opioid research, it still requires backing and policy implementation from lawmakers.
“One key aspect, regardless of the specific solution, is that we definitely need the perspectives and insights from multiple stakeholders – policy makers, law enforcement, patients, clinicians, researchers,” LeBaron said in an email interview.
The Governor’s Datathon aimed to propose solutions for this opioid crisis that would translate into policy in Virginia using firsthand health data with the goal of prevention. Fifteen teams, including the University’s, convened at the Library of Virginia for two days. In five-minute pitches, each team presented suggestions on new ways to use prescription data to help battle the opioid crisis in Virginia.
The team was organized by Stephen Holzman, a research and policy analyst at the Weldon Cooper Center for Public Service, and consisted of three undergraduate students, a public health researcher, a demographer and a nursing professor.
Discussions on opioid addiction included ways to deal with the stigma associated with addiction so that the patient can have a support system when prescribed opioid medications. This system would monitor the patient and look for signs of opioid addiction.
In particular, the University’s team proposed building tools that would send automated, personally contextualized emails to patients and their families when opiate prescriptions are given. This Prescription Monitoring Program would allow patients and their advocates to receive emails with information when they fill prescriptions and automated follow-ups.
“So much of what we read and heard was about patients not understanding the risks when they first started taking opiates,” Holzman said in an email to The Cavalier Daily. “We wanted to build a tool to facilitate strong and informed support systems before dependency and addiction develop.”
Other solutions included the use of mobile apps that would provide information about risk factors, opioid statistics and location of resources for patients. Some groups even attempted to produce machine-learning algorithms that might predict where future outbreaks might occur.
“The solutions spanned the gambit collectively targeting policy makers, law enforcement, doctors and opiate users,” said Daniel Donovan, a fourth-year Engineering student who participated in the event.
The reliance on data for prevention of opioid addiction is in the preliminary steps but can serve as an important tool in containing the crisis.
“We’re still in the infancy of the open data movement,” Holzman said. “A lot can be done to improve the speed, quality and accessibility of our data systems to help respond to things like the opioid crisis if the political will is there to fund it.”
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