Preventing Opioid Addiction Using Tech
Last weekend, on his show, John Oliver addressed the issue of the nation’s (the United States) epidemic of opioid addiction, i.e. “an increase in the number of people who are dying from overdoses, predominantly after abuse of prescribed opioid analgesics” [1].
For more than a year, the Small Data Lab and The Foundry at Cornell Tech have been involved in a research project (called Limbr) on this very topic.
The Small Data Lab at Cornell Tech has been investigating the use of technology to encourage home physical therapy as a replacement for the long term use of opioids for patients suffering from lower back pain.
The key idea is quite simple: substitute long term dependence on opioids with physical therapy (PT) as a way to manage back pain. The intervention consists of a personalized home PT program based on a set of physical exercises developed by Dr Vijay Vad — at the Hospital for Special Surgery in New York City — and delivered to a patient as short videos using an app developed by NYC-based Force Therapeutics. A coach monitors patients’ activities via mobile technology and helps keep them on track.
The goal of our research project, advised by collaborators at United Health Group, is two fold: measure the effectiveness of the PT treatment and figure out how to encourage the patient to form such a habit leveraging the pervasiveness of mobile phones.
To do so, the Foundry at Cornell Tech developed a suite of tools to (a) assess patient’s day-to-day pain levels by tracking which daily activities they are struggling with and how much they are relying on medications, and (b) to have a coach interact with the patient via chat at times when their pain levels are higher or when their physical activity has declined.
For (a) we leveraged some prior research on visual reporting (a friendlier way for users to report information) and built two mobile apps. For (b) we built a mobile chat app for a coach to interact with each patient. The interaction between the various tools and the various parties is illustrated in the figure below.
Screenshots of some apps we built are presented below.
For more information, visit limbr.cornelltech.io.
Check also some recent scientific publications about addiction-free painkillers [4] and recommendations about prescribing opioids [5].
And to finish on a funny, British and inappropriate note (more aligned with Last Week Tonight), here is another take on drugs.
Acknowledgements
Special thanks to Deborah Estrin (@deborahestrin, http://destrin.smalldata.io), JP Pollak, the Small Data Lab team and the Foundry team for comments on early versions of this post.
References
[1] America’s Addiction to Opioids: Heroin and Prescription Drug Abuse, Testimony to Congress, by Nora D. Volkow, M.D., May 2014.
[2] Need Low Back Pain Treatment? Just Say ‘Om’, August 2012.
[3] Internet Scale Research Studies using SDL-RX, September 2016.
[4] The Painkillers That Could End the Opioid Crisis, MIT Technology Review, August 2016.
[5] CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016
