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Hacking A Solution To Boston's Opioid Crisis

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MGH and the GE Foundation recently hosted a hackathon at District Hall in Boston's Seaport District. The goal was to come up with novel ideas and technologies to combat the opioid addiction crisis. (Joe Difazio for WBUR)
MGH and the GE Foundation recently hosted a hackathon at District Hall in Boston's Seaport District. The goal was to come up with novel ideas and technologies to combat the opioid addiction crisis. (Joe Difazio for WBUR)

A man in recovery waits in line between a physician and an engineer in a large meeting room with diagrams and flow charts scrolled across washable walls.

"No. 59?" calls the moderator.

Mike Duggan steps onto a small stage and looks at a time keeper. She gives him a nod. Duggan has 60 seconds to describe a concern related to the opioid epidemic that he wants to tackle.

"My problem is finding out or being able to notify when somebody has an accidental overdose in a public restroom," says Duggan, who founded Wicked Sober, a program to help patients get into treatment. Maybe there's a way to alert a store manager if someone lies down on a bathroom floor, Duggan suggests.

Duggan's pitch is one of 68 that launched Boston's first opioid hackathon. Almost 200 counselors, computer coders, architects, doctors and current and former addiction patients gathered over the weekend for a day of stories and speeches and then two days of hacking.

A man from Franklin County says addiction patients in the state's poorest, least populated county need rides to treatment. One physician proposes screening every American for addiction by 2020. A substance use researcher wants a model that would alert patients to physiological and emotional signs of relapse.

Dr. Jonathan Steer says patients need a way to test drugs they buy on the street for traces of fentanyl. Steer, an obstetrician at Boston Medical Center, often orders such tests for a patient who has overdosed.

"But to me that seems too late," Steer says during his 60 seconds on stage. "People should be knowing when or if they’re using fentanyl even before they are overdosing and coming to the hospital."

After the last pitch, these erstwhile strangers break for sandwiches and start networking. They have about 24 hours to form teams with common interests, toss around ideas, tests solutions, and begin building models or mapping plans.

The various teams work on their products and pitches. Five winners will receive $1,000 each from GE, who’s sponsoring the opioid hackathon event. (Joe Difazio for WBUR)
After the initial 68 pitches, the nearly 200 participants broke into teams with common interests to work on their products and pitches. In the end, five winners received $1,000 each from GE, which sponsored the event. (Joe Difazio for WBUR)

Beth Mosher, who teaches industrial design at the Rhode Island School of Design, cuts squares from an old purple T-shirt.

"It's the color of recovery," Mosher explains. The squares may line a wearable pouch Mosher's team is creating. The pouch, something you might clip on a purse or backpack, would contain naloxone, the drug that reverses some opioid overdoses. It might be marked with a first aid style cross, a visible sign that the wearer is an ally ready to help.

"The project is about more than just having the medication there if someone goes into an overdose," Mosher says. "It’s also to help try to counteract the stigma and the shame."

Beth Mosher, who teaches industrial design at the Rhode Island School of Design, works on a prototype of team Ally's naloxone pouch. (Martha Bebinger/WBUR)
Beth Mosher, who teaches industrial design at the Rhode Island School of Design, works on a prototype of team Ally's naloxone pouch. (Martha Bebinger/WBUR)

At a table next to Mosher, other team members are working on a business plan for the project they call "Ally."

"As soon as you start having a metric of cost per life saved, that’s a metric people really want to know," says Dr. Ben Bearnot from Mass General.

"How many Ally cases do you think it would take, in the world, for one of them to get used and save a life?" Bearnot asks, looking around. "Even if only one in 100, the return on investment is $1,500 per life."

"And every one of them will start a conversation about drug use when they see the cross," says Sarah Ahern, with Franklin County's Opioid Task Force.

Teams run through their final presentations as the clock ticks down. They'll have three minutes to illustrate the problem they plan to solve, describe their solution, introduce their team and outline a sustainable business model. Five winners will receive a $1,000 each from GE, who’s sponsoring this event.

Stephen Mandile presents the product his team, Ally, came up with. It is a wearable pouch that contains naloxone, the drug that reverses some opioid overdoses. It might be marked with a first aid style cross, a visible sign that the wearer is an ally ready to help. (Joe Difazio for WBUR)
Stephen Mandile presents the product his team, Ally, came up with. It is a wearable pouch that contains naloxone, the drug that reverses some opioid overdoses. It might be marked with a first aid style cross, a visible sign that the wearer is an ally ready to help. (Joe Difazio for WBUR)

Nineteen teams register for the final round. First up: MATmobile — short for Medical Assisted Treatment. Aubri Esters takes the stage.

"I’ve been sleeping in the doorway of 7-11 for a few months now. This morning I woke up dopesick. Four to six people like me will die of unintentional overdoses in Massachusetts today," Esters says.

To break the cycle, Esters' team proposes a mobile van with would travel to heroin use hot spots around Boston. Staff would hand out clean needles, offer counseling and a two day supply of suboxone to help patients stop using heroin. For some the van would be a place to sit, get out of the rain or cold, and have something to eat.

Team USS SafeSpace comes to the stage flashing a picture of a yacht. The team wants to create a place where heroin users could inject the drug with medical supervision, but Boston police have said they wouldn’t allow that. So the team would operate in international waters while it works to persuade leaders to allow an operation on land.

"Our immediate answer is to go on a boat," says Katrina Ciraldo, a resident at Boston Medical Center. "Twelve nautical miles out, under a Dutch flag, a full medical and behavioral health staff will welcome drug users to a safe space to consume drugs obtained elsewhere and to link them to all the services they need."

The first question from a judge: How would Ciraldo’s team finance the project?

"There are a lot of boats for sale online," Ciraldo says with a laugh, "but we also know that there are a lot of millionaires and billionaires in Massachusetts, so if anyone would donate their boat to us that would be our big plan."

One team presents a Fitbit-style bracelet that would track oxygen levels and automatically inject naloxone if levels drop and stay low. Another wants to place first aid boxes with naloxone and other supplies on streets corners around Boston. The boxes would unlock after a call to 911.

Judges retreat for about an hour and then return with five winners.

The first is a team that would add blinking lights or other alerts to opioid pill bottles once the prescribed time of use is up. The goal is to keep opioids away from teenagers or others who find drugs in a family medicine cabinet.

The other winners are Ally, the naloxone pouch; a SMS texting program that would help users find services; the MATmobile van; and a recovery community center. Dr. David Barash, chief medical officer of the GE Foundation, says these projects will have widespread impact.

"To me this weekend was home run for the people we’re trying to help, for the community we’re trying to help and I think it really did make a statement that GE is committed to the community," Barash said.

Hackathon teams can continue to work with mentors from Mass General’s Center for Global Health and GE, which is offering an additional $10,000 to the team that makes the most progress in the next 90 days.

This segment aired on September 12, 2016.

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Martha Bebinger Reporter
Martha Bebinger covers health care and other general assignments for WBUR.

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