Opiate overdoses can have devastating consequences if they are not stopped in time. But help could be on the way thanks to an innovative new concept that emerged from recent opioid hackathon event.
What makes opiates so dangerous to the human body? For one thing, they can literally take your breath away.
When opiates enter the bloodstream, they bind to and suppress opioid receptors in the brain and spinal cord that perform a variety of critical functions, including the regulation of breathing.
In the case of an overdose, these receptors are suppressed to the point where the body no longer takes in enough oxygen to support brain functioning. This puts the brain into a critical oxygen-deprived state called hypoxia, and the consequences can change lives forever.
In many cases, the person dies. There were 1,531 confirmed deaths attributed to opioid overdoses in Massachusetts in 2015, according to statistics recently released by the state.
For those who survive, the long-term effects can include loss of speech, vision, coordination and learning ability, just to name a few. Permanent brain damage can set in after just three minutes of hypoxia.
With the introduction of powerful new synthetic opioids such as fentanyl and carfentanil, the problem could get even worse. These drugs, which are difficult to distinguish from heroin if mixed with other agents, are 10 to 100 times more powerful than heroin respectively.
It’s a grim scenario, but help could be on the way thanks to an innovative new concept that emerged from a recent hackathon put on by the Center for Affordable Medical Technologies (CAMTech) and Global Medicine at the Massachusetts General Hospital and sponsored by the GE Foundation.
The Allies Concept
The three-day hackathon provided an opportunity for three Mass General specialists—Kristian Olson, MD, the Medical Director of CAMTech and a core educator in the Department of Medicine, Benjamin Bearnot, MD, a primary care physician and Innovation Fellow at MGH Charlestown, and Jessica Moreno, PharmD, a clinical pharmacist at Mass General—to devise a plan for reversing overdoses before they do lasting damage.
Olson, Bearnot and Moreno were part of a nine-person team that also featured an industrial designer, an engineer, an industry pharmacologist, and importantly, people in recovery.
Their plan, titled We Are Allies, calls for equipping everyday citizen volunteers with an easy to administer spray version of anti-overdose drug naloxone, commonly known by the brand name Narcan®.
Naloxone reverses the effects of an overdose by releasing the hold that opiates have on the brain and spinal cord receptors. It does not have an adverse affect on someone who is not having an opioid overdose, which makes it safe to administer if an overdose is suspected but not confirmed.
The team believes that getting naloxone into the hands of more people will increase the odds that someone will be nearby to help when an overdose occurs. Naloxone is relatively easy to get and safe to use, but many people—even doctors—don’t carry it with them on a regular basis.
Another key component of the team’s plan is to have the Allies carry their naloxone in a bright purple pouch that can be attached to their handbag or workbag. This distinctive design will let others know that the person is carrying naloxone and is ready to help if needed.
"Not enough people have easy access to this life-saving medication, especially in situations where it is needed most," says Moreno. "On top of that, those who do need it may be afraid or ashamed to seek it out due to the stigma they face every day. We hope to address both of these issues head-on by encouraging Allies to essentially wear the naloxone on their sleeves in our carrying cases."
Olson has seen the devastating effects of overdoses firsthand in his clinical work at Mass General, and knows how important a quick response is to both saving lives and preserving quality of life.
“I recently saw four people under the age of 30 with anoxic brain injury on the same floor at the same time. I think that if somebody—as a good deed—saw these individuals down and administered naloxone, they might have saved their brains.”
The team hopes the high visibility purple pouches and indicator pins will also raise the public profile of the Allies in the community, which may help to foster new conversations about opioid use disorder and reduce the stigma and sense of isolation that many who suffer from the disorder experience.
“We thought that ‘ally’ was such a great term,” explained Olson. “We rallied around it because it changed the notion of isolation. We wanted to say; ‘We’re all allies in fighting opioid use disorder.’”
The Researcher Mentality
Hackathons are multi-day events designed to bring together experts from different backgrounds to brainstorm new solutions to challenges in science and medicine.
While a hackathon may not fit the mold of traditional bench-based medical research, Bearnot says the team employed a researcher mindset in developing the concept during the event.
“I think a lot of us are researchers in some part of our lives, and we all enjoy that rigorous kind of thinking,” he said. “So when there is an opportunity to borrow from that skill set—the critical thinking, the creativity, the detail-orientedness, putting it in a framework where you are innovating and implementing—it’s different and it’s really empowering."
We Are Allies Inc. has received a planning grant from the GE Foundation to move ahead. Eight other teams will compete for an additional $10,000 post-hackathon award on Tuesday, January 24th from 3 to 5 in the O’Keefe Auditorium at Mass General.
In addition to incorporating as We Are Allies, Inc. as a non-profit at the state and federal level, the team has started to develop and test the purple carrying cases.
The positive feedback the team has received thus far has fueled their drive to turn the concept into a reality, Olson said.
“Everyone we talk to is so enthusiastic and [our thought process] goes from ‘Do we take this from touching a hundred people’s lives to a thousand people’s lives to a million people’s lives?' We know the idea has legs, but we also need to put on our research, design, technical and business people hats and take it one step at a time.”
Read more articles from the 01/13/17 Hotline issue.