A novel robotic wastewater analysis system to quantify opioid exposure and treatment in residential communities

一种新型机器人废水分析系统，用于量化住宅社区中阿片类药物的暴露和处理

• 批准号: 10381304
• 负责人: Peter R Chai
• 金额: $ 25.08万
• 依托单位: BIOBOT ANALYTICS, INC.
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-15 至 2022-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10381304
• 关键词: 2019-nCoV; Address; Adherence; Affect; Appointment; Area; Biological; Biological Assay; Boston; Buprenorphine; COVID-19; COVID-19 assay; COVID-19 pandemic; COVID-19 testing; Catchment Area; Cities; Clinical; Collaborations; Collection; Communities; Community Outreach; Consumption; Counseling; Data; Data Analyses; Development; Disease; Dose; Emergency medical service; Ensure; Grant; Healthcare Systems; High Pressure Liquid Chromatography; Home; Hospitalization; Incidence; Individual; Infection; Infrastructure; Light; Liquid Chromatography; Maps; Mass Spectrum Analysis; Measures; Medical; Methadone; Methodology; Methods; Modeling; Monitor; Morbidity - disease rate; Neighborhoods; Opioid; Parents; Pattern; Penetrance; Persons; Pharmacologic Substance; Pharmacology; Phase; Plants; Policies; Polymerase Chain Reaction; Population; Prevalence; Procedures; Process; Public Health; Relapse; Reporting; Research; Research Personnel; Robotics; Sampling; Sentinel; Services; Social Distance; Substance Use Disorder; System; Systems Analysis; Taxes; Techniques; Testing; Time; United States; Viral; Visit; Water; Work; base; behavioral health; burden of illness; clinical toxicology; commercialization; dashboard; data de-identification; data visualization; drug of abuse; drug testing; experience; illicit opioid; infection rate; innovation; insight; liquid chromatography mass spectrometry; medication-assisted treatment; member; methadone clinic/center; multimodality; novel; opioid epidemic; opioid exposure; opioid overdose; opioid use; opioid use disorder; opioid user; pandemic disease; parent grant; population migration; prescription opioid; response; sample collection; telehealth; trend; uptake; waiver; wastewater epidemiology; wastewater samples; wastewater testing

ABSTRACT COVID-19 continues to create significant challenges for individuals with opioid use disorder (OUD). During the pandemic, opioid overdose rates increased by more than 50% in 37 of 38 US jurisdictions and emergency medical service calls for opioid related overdose have increased by 50%. This increase in calls has been mirrored by a 70% increase in refusal to transport rates. Opioid related morbidity, especially retention and adherence to medication assisted treatment (MAT) and relapse are increasingly difficult to measure given decreased overall interaction of individuals with OUD with the healthcare system and relaxed rules around buprenorphine and methadone prescribing and waivers of in-person drug testing due to expanded telehealth capabilities. Wastewater-based epidemiology is a feasible, noninvasive method to measure both the extent of COVID-19 and the prevalence of MAT. Analysis of wastewater both upstream in neighborhoods and downstream at wastewater treatment plants has been demonstrated as a feasible method to conduct continuous surveillance of the penetrance of COVID-19 and opioid consumption. By measuring trends in wastewater over time, insights into the effects of the burden of COVID-19 can be mapped in conjunction with drugs of abuse, thereby permitting a longitudinal assessment of the ongoing effects of COVID-19 on OUD. This urgent competitive revision expands our work in the parent grant where we have developed an innovative method to measure and visualize opioids and their key metabolites in wastewater networks. In the first phase of the parent grant, we optimized a wastewater-based opioid assay that can be applied both to wastewater treatment plants as well as community level manholes. We also developed best practices around sample collection methodology to account for population migrations and deliver a commercial opioid analysis product for cities. During the COVID-19 pandemic, we have separately developed a SARS-CoV-2 wastewater assay and modeled the ability of wastewater-based COVID-19 prevalence estimates to foreshadow rises in clinical cases and hospitalizations. This urgent competitive revision will integrate COVID-19 wastewater testing into the Biobot Analytics portfolio of commercial wastewater assay products. By innovatively developing standard operating procedures to measure SARS-CoV-2 as well as opioid use (MAT and illicit opioids) in wastewater networks, we will demonstrate the feasibility of developing maps and dashboards that lend empiric insight into the intersection of OUD, MAT and COVID-19. Our research will enhance public health efforts at monitoring the opioid epidemic and COVID pandemic at the community level by developing sustainable techniques that measure use of MAT in the context of fluctuating COVID-19 disease burden in vulnerable individuals with OUD. OMB No. 0925-0001/0002 (Rev. 03/16 Approved Through 10/31/2018) Page Continuation Format Page

摘要 COVID-19继续为阿片类药物使用障碍（OUD）患者带来重大挑战。期间 在美国38个司法管辖区中的37个，阿片类药物过量率增加了50%以上， 与阿片类药物过量有关的医疗服务电话增加了50%。电话的增加是 反映在拒绝运输率增加了70%。阿片类药物相关的发病率，特别是药物潴留和 药物辅助治疗（MAT）的依从性和复发越来越难以衡量， OUD患者与医疗保健系统的整体互动减少，并放宽了相关规则 丁丙诺啡和美沙酮处方以及因扩大远程保健而免除的现场药物检测 能力的以水为基础的流行病学是一种可行的、非侵入性的方法， COVID-19和MAT的流行。分析上游社区的废水， 下游的污水处理厂已被证明是一种可行的方法， 持续监测COVID-19的发病率和阿片类药物的使用情况。通过衡量 随着时间的推移，对COVID-19负担的影响的见解可以与 药物滥用，从而允许对COVID-19对OUD的持续影响进行纵向评估。这 紧急的竞争性修订扩大了我们在父母补助金方面的工作，我们在那里开发了一种创新的 方法来测量和可视化阿片类药物及其关键代谢物在废水网络。在第一阶段 我们优化了一种基于废水的阿片类药物检测方法， 污水处理厂以及社区一级的沙井。我们还围绕示例开发了最佳实践 收集方法，以说明人口迁移并提供商业阿片类药物分析产品 对于城市来说。在COVID-19大流行期间，我们单独开发了SARS-CoV-2废水检测 并模拟了基于废水的COVID-19患病率估计值预示临床 病例和住院治疗。这项紧急的竞争性修订将把COVID-19废水测试纳入 Biobot Analytics商业废水分析产品组合。通过创新发展标准 测量废水中SARS-CoV-2以及阿片类药物使用（MAT和非法阿片类药物）的操作程序 网络，我们将展示开发地图和仪表板的可行性，这些地图和仪表板可以提供经验性的洞察力， OUD、MAT和COVID-19的交叉点。我们的研究将加强公共卫生工作，监测 通过开发可持续技术， 在COVID-19疾病负担波动的背景下，衡量弱势OUD患者使用MAT的情况。 OMB编号0925-0001/0002（2016年3月修订版，批准至2018年10月31日）