The opioid crisis has now become the biggest health crisis of our decade, with drug overdose killing more Americans than guns, car crashes and HIV/AIDS ever killed in a single year. The CDC says that about 68% of U.S. drug overdose deaths involve an opioid. Opioids are addictive substances that trigger a euphoric effect in the brain, and when addicts exhaust their supplies, they experience panic attacks, restlessness, and desperation to obtain another fix. Ultimately, opioids suppress an addict’s respiratory system and can cause death.
And the disease isn’t just devastating families across the United States. It’s also destroying their pocketbooks. A report by the Council of Economic Advisors showed that the opioid crisis cost Americans $504 billion or 2.8% of GDP in economic losses in 2015 and is estimated to cost an additional $500 billion by 2020. Economic losses include lost wages, productivity, tax revenue as well as costs associated with healthcare, social services, education, and criminal justice.
Multiple factors have led to this national crisis. In the 1990s, greater numbers of U.S. patients reported experiencing chronic pain, due to an aging population, greater survivorship from injury and cancer, and expectations that pain relief was possible. Big Pharma began more heavily marketing pain medications and downplaying their addictive properties. And physicians began prescribing opioids to patients that didn’t need them. The National Institutes of Health say that these factors – along with U.S. poverty, poor working conditions, degraded social capital, and hopelessness – are believed to have given rise to the alarming rise of opioid abuse and addiction in the U.S. over the past 30 years.
In 2017, society invested significantly fewer public and private resources researching or creating new solutions to Opioid Use Disorder (OUD) than they did HIV/AIDS or cancer. Private equity investors have begun to take notice. For instance, investors provided behavioral health startups with a record amount of funding ($273 million) during the first half of 2018 and have been directing capital toward both preventive (Calm.com, 10% Happier) and treatment (Pear Therapeutics) solutions to mental illness. Digital technologies that use cognitive behavioral methods while also providing virtual or on-demand features have been shown to improve mental health outcomes in cost-effective and scalable ways.
Emerging technologies present significant opportunities for mitigating opioid addiction and death. Prescient Medicine developed a genetic test that uses an algorithm to determine with 87% specificity whether an individual is at an increased risk for opioid dependency. Second Chance is a smartphone app that analyzes a user’s breathing patterns and detects whether an overdose is about to occur. Cognitive behavioral tools like Hayver and Triggr incorporate big data and machine learning to deliver treatment to patients when they need it most. The Hayver app incorporates behavioral health techniques like peer-to-peer accountability to improve patient recovery; this app is designed to prevent drug relapse by requiring that users complete random drug screenings, the results of which are uploaded to the app dashboard and shared with users’ support circles. Triggr Health created an app that virtually connects addicts to recovery coaches and predicts relapse by feeding users’ mobile communications, phone logs, sleep patterns, and location through an AI algorithm.
According to the Food and Drug Administration, another promising area for investment includes non-addictive drugs that target pain. While we should be wary of Big Pharma and their desire to sell more pills (e.g. non-addictive opioids or non-opioid painkillers), small- and medium-sized biotech companies like Cara Therapeutics, Recro Pharma, and Nektar Therapeutics are developing alternative pain medications as well that either avoid or slowly cross the blood-brain barrier, thus minimizing the euphoria that opioids stimulate.
Boundless developed a project to study impact investing solutions to the opioid crisis, and our Project Lead, Dr. Doug Leslie of Penn State University, leads our search for the most effective technologies, business models, and financial vehicles available. Please contact our Health Researcher, Jaishree Singh, at firstname.lastname@example.org for more information.
While the route to an addiction-free America will be gradual, modern science has provided us with the knowledge to be able to identify the most promising technologies which can reduce opioid abuse, addiction, and death. Private investors should scale these technologies so as to aid patient populations with the greatest needs – for health and hope.