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Harnessing Innovation in the Opioid Fight

Civic hackathons are one way to build new tools that can augment existing efforts to combat the epidemic.

There is perhaps no issue more pressing for local governments than the opioid epidemic. In 2017, of the 70,237 drug-overdose deaths in the United States, 67.8 percent involved an opioid. While municipal leaders have devoted significant resources to combating the epidemic, they are too often drawn into a costly game of Whac-A-Mole.

Nowhere has that arcade-game frustration been felt more keenly than in New York City. Staten Island, once the epicenter of the opioid epidemic in the state, saw overdose deaths fall by 15 percent in 2017, while the Bronx experienced a 12 percent increase. It was therefore completely rational for Mayor Bill de Blasio to announce, as he did last November, a plan to implement in the Bronx the same approaches attributed to Staten Island's success. Then, several weeks later, preliminary data for 2018 indicated that overdose deaths on Staten Island had likely increased.

Clearly governments need to find new ways to decrease those numbers. In addition to pressing ahead with traditional public-health and law-enforcement resources, they should incorporate open calls for innovation into any new investment aimed at addressing this pressing public health crisis. There's even a place for civic hackathons.

In recent years, municipalities have embraced these events as valuable, relatively low-cost opportunities to improve core services, typically offering modest cash "challenge" awards. The goal of New York City's inaugural hackathon, for example, was to improve its public website. Various cities also have convened coders, statisticians and academics to sift through the treasure trove of government data for insights.

It was in that spirit of organized innovation-seeking that the Empire State Opioid Epidemic Innovation Challenge, a novel public-private partnership, came to be. Since a two-day event launched the challenge last September, 12 teams have been co-creating solutions with the potential to save lives and curb the local and national opioid epidemic.

The Opioid Epidemic Innovation Challenge, which is funded by New York state and Northwell Health in partnership with Columbia University's public health and engineering schools, created value on its first day simply by convening government officials, substance use treatment providers, health care professionals and the private sector in the same room to exchange lessons learned and information about their respective initiatives. Perhaps even more importantly, the experts heard directly from individuals and family members who shared their personal experiences with opioid addiction.

During the next 48 hours, the 12 cross-disciplinary teams, with the guidance of 23 mentors, crafted pitches to address the most pressing challenges as identified by those fighting the epidemic on the front lines. The top four, as selected by an expert panel of judges, received seed funding and three months of acceleration support for a network to remake the culture in emergency departments; a search-engine-driven peer-support "widget"; an intranasal patch that automatically releases naloxone; and a kit that consolidates existing prevention, treatment and recovery tools. In a final round of the competition on Jan. 31, the team that developed the intranasal patch was awarded $10,000 and six months of acceleration support, and the team that developed the online-search widget received six months of acceleration support.

When the Staten Island Borough president's staff first conceived this idea, they were quite aware of the criticisms sometimes leveled at civic hackathons, especially that these competitions were nothing more than marketing gimmicks -- superficial attempts at innovation without tangible outcomes. Therefore, they sought a capable organizer that had demonstrated the positive impact of hackathons.

They turned to the Consortium for Affordable Medical Technologies (CAMTech), whose prior public health hackathons had resulted in more than 40 patents filed and 35 companies formed. CAMTech reported that 30 projects originating in its hackathons had moved toward piloting. Some products and services that originated at CAMTech's inaugural hackathon have found their places in the health care marketplace: Last year, for example, Philips Healthcare licensed the Augmented Infant Resuscitator, which aims to help prevent the deaths of newborns with breathing problems. And Amazon acquired PillPack, a pharmacy that provides medications pre-sorted by day and dosage.

Of course, no single innovative product or service can by itself turn the opioid crisis around. It is critical for governments to set reasonable expectations. There are no substitutes for naloxone distribution, medication-assisted treatment, law enforcement diversion programs and other evidence-based strategies that save lives. However, given the grim continuing overdose death data, it does not seem that existing strategies are enough.

It's never too late to seek help. Local governments nationwide must find ways to tap into the talents of their constituencies in an effort to change the trajectory of the opioid epidemic. Ignoring such resources would be a grave disservice to their communities.

This column has been updated to include the results of the Jan. 31 round of the competition.

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