SXSW in Austin Texas
Austin's South by Southwest Conference & Festivals continues through March 17. Credit: JJ Velasquez / San Antonio Report

AUSTIN – Blockchain can be key to tackling the opioid crisis, said speakers Saturday at a South by Southwest Conference & Festivals panel, because of its ability to track actions, such as when an opioid user opens a bottle to take a pill, while also maintaining patient privacy.

Bexar County holds the dubious distinction of having almost a third of the state’s cases of neonatal abstinence syndrome, in which babies are born with opioid withdrawal because of their mothers’ opioid use during pregnancy.

Local attorney and activist T.J. Mayes sat on Saturday’s panel to discuss some of the work the Joint Opioid Task Force he chairs has done to tackle the opioid crisis locally. Mayes, who recently stepped down from his chief of staff post in County Judge Nelson Wolff’s office, has since been hired as a junior partner at the law firm Phipps Deacon Purnell but continues his work fighting the pharmaceutical companies perpetuating the opioid epidemic.

The law firm is representing Bexar County in a suit against opioid drug manufacturers and distributors, whom the suit accuses of “causing and contributing” to a nationwide addiction problem.

The county has the third-highest rate of opioid-related drug overdose deaths per capita in the state of Texas, according to a presentation by the City of San Antonio’s Metropolitan Health District last year.

It ranks first for rates of neonatal abstinence syndrome, according to the presentation.

Exacerbating the problem, less than half of Bexar County physicians are registered to use Prescription Drug Monitoring Programs, which states use to intervene when patients are improperly prescribed opioids. Less than a quarter of the county’s dentists are registered for the program.

“They’re giving pushback about having to use it,” Mayes said of local physicians. “But if we make it easier on them and if we can make it more effective, then physicians are able to provide better care to the patients, and patients are able to get the prescriptions they need when they need them.”

T.J. Mayes, Bexar County Judge Nelson Wolff's chief of staff, discusses the evolving Howard W. Peak Greenway System. Photo by Kathryn Boyd-Batstone.
San Antonio attorney T.J. Mayes, who chairs the  Joint Opioid Task Force, participated in the panel discussion.

That’s where the technology comes in.

“Evolving technologies could help us address not only the opioid epidemic and not only the substance abuse and mental health crises, but also the broader health care system and what we can do in our community to help move that along,” he said.

Developing a holistic and widely adopted software system, such as blockchain technology, to record instances of opioid drug use and other patient health records related to the addiction crisis will be a “long journey,” Mayes said. But he’s hopeful integrating PDMP systems with electronic health records can be a powerful first step in the near term.

Vanila Singh, chief medical officer in the U.S. Department of Health and Human Services, said she is excited by the improvement in care options and patient outcomes since she received her medical training. The innovations in care and technology, however, will have to be carefully balanced with attention to privacy issues and ethics.

Data is a powerful resource that enables health care providers to make good patient decisions, panelists said, but a framework must be in place to the data both accessible and tightly secured. Victoria Adams, government practice lead at the D.C. tech firm Consensys, said data storage must be decentralized and must flow seamlessly, but patients should own their own data to maximize trust in the health care system.

Adams, whose own daughter struggles with opioid addiction, has direct experience with the failures of the health care system in tackling the opioid crisis. Blockchain, she said, can incentivize better patient outcomes to address gaps in an often-siloed health care system.

“It’s not that blockchain is the solution to everything,” she said. “No technology is, but it can help in terms of keeping record of that data, tracking what is going on, and retaining people’s privacy – not stigmatizing them as that junkie, as the person that lacks the moral fiber to do this.”

JJ Velasquez was a columnist, former editor and reporter at the San Antonio Report.