The opioid crisis is still getting worse. In 2017, there were an estimated 72,000 overdose deaths in the United States from opioids, a 10 percent rise from the previous year.
Yet even as the crisis continues to grow, federal, state and local efforts to contain it have fallen woefully short. Governments at all levels should be using the best technology available to consolidate data from doctors, pharmacies and distributors that can be used to identify communities at risk and enable predictive analysis to find solutions that can help in solving the crisis.
In just a single state, Ohio, a study last year found that opioid abuse had cost the state economy up to $8.8 billion, but the state only had the capacity to treat 20 to 40 percent of those addicted to opioids. So far, states have scrambled to put in place new programs to track and combat opioid abuse, but the most visible sign of action has been a series of lawsuits.
At the state, county and city level, government attorneys and private lawyers working on contingency contracts are joining a massive federal lawsuit called a multidistrict litigation assigned to the Northern District of Ohio that is charged with resolving more than 400 federal lawsuits in one mega-settlement. In a crisis that is killing over 100 people a day, sitting on the sidelines and waiting for a cut of the settlement money paid out by the makers of the prescription painkillers, companies that distribute them and pharmacy chains that sell them is not good enough.
While opioid addiction and abuse are not new problems, the scale of the problem, along with the tools and data available to the government agencies tasked with addressing the issue, is new. The federal government uses an automated, comprehensive drug reporting system called “Automation of Reports and Consolidated Orders System,” which manufacturers and distributors must submit to the Drug Enforcement Agency. The system monitors the flow of controlled substances from their point of manufacture through commercial distribution channels to the point of sale or distribution at the dispensing/retail level — hospitals, retail pharmacies, practitioners, mid-level practitioners and teaching institutions.
The DEA is finally trying to add tools to its ARCOS online reporting system that gives access to competitor information for a prospective customer for the past six months. This follows years of manufacturers and distributors asking for DEA assistance in fulfilling their reporting and dispensing obligations.
Nearly every state has prescription monitoring programs, but the agencies they report to, the software used in collection, and who has access to the data varies widely from state to state. Only recently have many of these states started monitoring the dispensation of prescription drugs, and even now state systems don’t communicate with one another.
The good news is that giving pharmacies and law enforcement agencies access to the tools they need to fight the crisis works: For example, since New York updated its monitoring program and adopted its e-prescribing mandate in 2016, “the state has reduced doctor shopping incidents by more than 98 percent.” To see these types of results brought to scale, state and local governments need to be able to work with the federal government and private sector, to share information and then incorporate machine learning tools to make sure that the most important information for preventing abuse and overdoses can be flagged.
Health care is a field that is rich with data, but it is only recently that we have the tools to build effective predictive models to recognize dangerous conditions and solve them before a patient becomes an addiction statistic. Machine learning is a technology that sifts through historical data to predict a likely outcome.
It’s particularly good at detecting patterns in data that may go unnoticed by humans, which may include seemingly unrelated environmental factors. For opioid addiction, machine learning could flag over-prescribing doctors, “pill mill” pharmacies and doctor-shopping patients.
States should treat companies in the drug supply chain as potential partners in ending the crisis and start working collaboratively to gather and interpret all of the data available and ensure it is getting to the agencies and treatment centers that can use it to save lives. Of course, there are bad actors — aggressive drugmaker marketing campaigns that played down the risks of addiction, doctors who were willing to take handouts from pharmaceutical companies while pushing their patients into dangerous long-term opioid treatments, and pharmacies that should have done more to stop pill mills on their own — and those bad actors deserve to be punished.
The lawsuits can run their course, but the primary focus needs to be on giving enforcement agencies and treatment facilities the tools and technology they need to stop the crisis.
Erin Hawley is the vice president of public sector at DataRobot.
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