The federal government’s small business innovation research (SBIR) and small business technology transfer (STTR) programs help small businesses create new technologies based on sound scientific research and bring them to market. Over the past few years, NIDA’s Office of Translational Initiatives and Program Innovations (OTIPI) has used these and other funding mechanisms to help biotech startups develop incredibly innovative technologies that translate addiction science into healthcare and consumer products. These tools provide or support psychosocial and medication-based treatment, help individuals sustain their recovery from substance use disorders (SUDs), and even facilitate prevention.
Only 20 percent of the nearly 20 million people with SUDs in the U.S. receive treatment—a “treatment gap” that technology is helping to close. Frustrated by the difficulties of finding beds for patients she was discharging from her ER, Baltimore acute care physician Dr. Nishi Rawat developed a cloud-base referral tool called OpenBeds, and in 2015, NIDA approached her to expand her tool to meet the needs of patients with addiction and other behavioral health problems. OpenBeds now facilitates patient referrals to residential, inpatient, or outpatient addiction treatment facilities and is currently being used by several state governments and hospital systems.
NIDA has also helped small businesses develop tools that put evidence-based psychosocial treatment for SUDs right in the hands of anyone with a smartphone. For example, reSET and reSET-O are apps that were developed by PEAR Therapeutics using research from NIDA’s clinical trials network (CTN). They deliver cognitive behavioral therapy (CBT) and contingency management (i.e., reinforcement) to people with non-opioid SUDs (reSET) and OUD (reSET-O), and are the first mobile medical applications, “digital medicines,” to receive FDA approval for the treatment of addiction. A NIDA SBIR grant is now being used to make these apps more accessible by converting them into a game. And Woebot Labs is a startup founded by research psychologists at Stanford who have developed a smartphone-based mental health chatbot that uses artificial intelligence (AI) and language processing to deliver CBT for people with anxiety and depression. With a NIDA SBIR grant, they are currently studying its effectiveness for people with SUDs.
Smartphone apps can also expand the reach and accessibility of medication treatment for OUD and facilitate medication management. NIDA support helped a group of Johns Hopkins University researchers to further advance the smartphone-based platform they had developed to assist healthcare workers treating HIV patients in Uganda and apply it to OUD treatment. Their tool, emocha Mobile Health, improves buprenorphine compliance by enabling the provider to watch the patient take every dose, keep track of any side effects, and provide support, all via smartphone. And with the help of a NIDA SBIR contract, a startup called WorkIt Health is making medication for OUD more accessible by providing online therapy and both buprenorphine and naltrexone via telehealth. Users in Michigan and California can now visit a physician just a single time for their buprenorphine or naltrexone prescription and thereafter receive medication management remotely via smartphone.
Gentle, random vibrations have been shown to reduce irritability and improve cardiorespiratory function in newborns, so a company called Prapela developed a hospital bassinet pad called Prapela SVS that applies this principle to help babies born dependent on opioids. The company is now using a NIDA grant to win FDA approval. If successful, it will be the first medical device to win FDA approval for the treatment of neonatal abstinence syndrome.
NIDA small business funding is also helping startups develop technologies to prevent overdoses. This past February, a company called Sound Life Sciences was one of the winners of NIDA’s annual “$100,000 for Start a Substance Use Disorders (SUD) Startup” Challenge. They used this award and OTIPI’s entrepreneurial coaching to help strengthen the business case for, and build a startup around, a novel “Batman-esque” app that turns a user’s smartphone into a portable respiratory monitor capable of detecting changes in breathing associated with an overdose. If an overdose is detected, it will sound an alarm, provide instructions, and summon emergency services to the user’s location.
NIDA small business grants and contracts have also helped startups develop technology to help people in recovery. Sober Grid is an app that connects patients with others in recovery and with peer coaches to help them remain drug-free. And We the Village, Inc. uses telehealth and a social support network to deliver a care model based on community reinforcement and family training (CRAFT).
Prevention
Since the roots of the current opioid crisis lay in medical overreliance on addictive opioid pain relievers and the diversion of these powerful drugs for illicit use, technology has a role to play in prevention by reducing the supply as well as demand for opioids. A company called Invistics has used a series of NIDA SBIR grants to apply its inventory-tracking software to the challenge of monitoring controlled substances in hospitals using artificial intelligence to detect theft or diversion of opioids. And a company called S-3 Research, another NIDA “Start a Startup” Challenge winner, used our award and entrepreneurial coaching to develop a tool that uses big data and social surveillance to detect and report illicit online sales of controlled substances.
To reduce the use of opioids, we also need to develop additional effective, safe ways to treat pain. A promising non-drug approach uses virtual reality (VR), which research has shown to be an effective alternative to opioids in pain relief and even to be as effective as anesthesia in some minor surgeries. NIDA funding helped a company called appliedVR create evidence-based content for the commercially available Oculus VR headset that delivers an immersive, distracting environment for patients with acute or chronic pain and those who are anxious about a medical procedure. The company has created the concept of a “virtual pharmacy” and expects its pain content to be the first VR product to gain FDA approval for pain treatment.
There is also a need for better ways to assess pain than the subjective pain rating scales now used in doctor’s offices. With NIDA’s help, a company called PainQx developed an easy-to-use EEG-based tool that uses AI to objectively measure a patient’s level of pain and assist physicians in choosing the right course of pain treatment.
Scientific solutions to addiction require technological innovations that can deliver them effectively in an affordable, personalized, and sustainable fashion. Often, those in a position to create such technologies are not even aware of their potential to help with problems of addiction. This is the value of NIDA’s translational and product development programs. As OTIPI Director Elena Koustova says, “what makes our program so successful is that we know the needs and problems and we match technologies to address them. The point is that we are not only giving them funds, but we expose them to opportunities of our neglected market. Without NIDA—and I do not just mean NIDA money—many of these currently successful companies would not have existed.”
I am very proud that NIDA’s support for pioneering small businesses and startups is making prevention and care for people with addiction more accessible, in some cases by leveraging devices that many people already carry with them and use daily. There seem to be no limits to what ingenuity can achieve in the realm of biomedical products, when sound science partners with biotechnology entrepreneurship in an area of need.
More information on NIDA’s SBIR/STTR programs.