This App Maps Opioid Overdoses in Real Time

Opioid overdoses proliferate, like a disease. A new app lets health and law-enforcement officials anticipate their spread.
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The backend of ODMAP, visualizes real-time data of overdoses across the US. (This screenshot is of test data; real data is inaccessible to the public.)ODMAP- Baltimore/Washington D.C. HIDTA

The opioid epidemic is ripping through America like a fire untamed. Blame big pharma, if you want. Blame cheap pain pills and cheaper heroin. Blame the mesolimbic reward system. Just don't wallow in it—the blame. Wallowing takes time, and with opioid abuse killing close to 100 Americans a day, time is in exceedingly short supply. “The number one question is, how do we get a better sense of what's going on in our communities in real-time," says Jeff Beeson, deputy director of the Washington/Baltimore High Intensity Drug Trafficking Area. Not a year from now. Not a month from now. Today.

So last year, the Washington/Baltimore HIDTA set out to create a tool that would give law enforcement and health officials the data they need to respond to the public health crisis as swiftly as possible. The result was a web app called ODMAP that combines street-level data with tools from Esri, the digital mapping company, to help public health officials, police departments, and first responders track and respond to overdoses in real time.

ODMAP's national scope distinguishes it from similar opioid-tracking apps. States across the US are racing to develop tools for managing the country's opioid crisis, and Indiana in particular has successfully tracked trends, collecting data from local agencies to build a statewide database of things like drug arrests, seizures, and administrations of the overdose-reversing drug naloxone. ODMAP takes a similar approach, but focuses on mapping overdoses, specifically—whether they're happening locally, two towns over, or several states away.

That's the kind of geospatial data that can help communities brace for overdoses before they happen. "You've seen those epidemiology maps where a disease spreads outward from an initial set of dots? We're seeing similar patterns on a daily basis with ODMAP," says Beeson. If ODMAP registers a spike in overdoses in Anne Arundel County, Maryland, the app immediately notifies public health officials in Berkeley County, West Virginia, 120 miles away. Why? Because in 8 to 10 hours, West Virginia's eastern panhandle is going to start seeing overdoses, too.

"A lot of these geographic correlations, we didn't know they existed until we started tracking overdoses with the app," Beeson says. By anticipating a ripple effect of overdoses, regional officials can warn their communities, notify hospitals, and ensure first responders have the naloxone they need to administer to overdose victims.

Meanwhile, the same data helps law enforcement officials double-check theories about the way drugs travel into and out of their jurisdictions. Take the relationship between Berkeley and Anne Arundel. Washington/Baltimore HIDTA had suspected a link for years, Beeson says, based on arrest data. "But if we pick someone up for trafficking in Baltimore, it's not like we know where that person's drugs are going. Now, we're basically tracking the drug. We're able to see it in black and white, as it spreads throughout a region." And the more data ODMAP collects, the more regional relationships health and law enforcement officials can confirm. "We've never had overdose data like this before—and we've never shared it with each other," Beeson says.

ODMAP- Baltimore/Washington D.C. HIDTA

Health and law enforcement officials I spoke with about the tool say they like it because it's simple, powerful, and free. First responders at the scene of an overdose (Beeson says there are currently close to 1,000 registered nationwide) log in to ODMAP via a password-protected web portal. The interface lets these so-called Level I users specify whether the overdose was fatal, whether they administered naloxone, and, if they did, how much. That information, along with the time and location of the overdose, goes to ODMAP's central database. For first responders, that's all there is to it; the process takes seconds to complete and requires no personal information about the victim.

Police have additional, password-protected access to a form that lets them enter information like the victim's date of birth and overdose history; witness information; whether the victim overdosed on fentanyl, oxycodone, or some other narcotic; whether any drugs were found at the scene; even a photograph of the drugs' packaging. That information is stored on a separate database, to keep everything HIPAA compliant. If any of the data matches a previous overdose report, ODMAP will connect the reporting officers so they can coordinate.

Things get more interesting on ODMAP's backend, which is accessible to Level II user like sheriffs and public health chiefs. It requires a separate username and password and provides a bird's-eye view of overdose incidents at the national level. Every overdose appears on the map in the form of a color-coded blip. Accessing data for a state, county, or neighborhood is as simple as panning and zooming.

"It's like having real-time traffic data on Google Maps," says Aaron Kustermann, chief of intelligence for Illinois State Police, one of several organizations in the state that recently began using ODMAP. "Being able to monitor trends and see what's happening and compare with other areas? That's where the power is." Understanding where and how people are overdosing can take local health and law enforcement months to suss out. "With this tool, we can react in real time to a spike in fentanyl-related deaths, or purity-related deaths."

Adoption will make or break this tool. "From a surveillance perspective, the more data you have on a given health issue the better," says Harvard University's John Brownstein, a computational epidemiologist who uses digital tools to map disease and drug abuse across populations. "Having direct data on overdoses is super exciting, but it's a crowdsourcing tool, so you want as much engagement as possible."

From the looks of it, ODMAP is spreading quickly. It launched on January 18th in just two West Virginia counties. Today, 70 counties across 19 states are actively contributing data to the system. Last week there were 16 states on board, and in the past few days, the number of health and law enforcement agencies using the program jumped from 168 to 186. The opioid crisis might be sweeping the country, but so, too, are the tools that could curb its spread.

“Ask any health or law enforcement agency in the country: We don’t have the time, and we don’t have the resources to sufficiently deal with the opioid crisis,” Beeson says. “We can’t throw money at it, and we can’t arrest our way out of it. But what we can do is use data and technology as a tool, to maximize what limited resources we have.”