Combating the Opioid Crisis, One Flush at a Time

Startup Biobot Analytics monitors wastewater to identify at-risk neighborhoods

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THE INSTITUTEMost people don’t spend time thinking about what’s in the waste they flush down the toilet. But health officials do. The urine in sewer water is a surprisingly rich source of information about the health of communities. Epidemiologists can analyze wastewater to check for viruses, chemicals, and both illegal and prescription drugs.

Armed with that information, public health officials can stock up on vaccines, equip ambulances with life-saving medications, and run awareness campaigns.

But testing wastewater samples can be an expensive, time-consuming job. Biobot Analytics, a startup in Somerville, Mass., that was spun out of MIT in 2017, is working to improve the process with its collection, measurement, and analysis service.

Biobot uses portable devices to collect wastewater samples, which it analyzes in the laboratory. The company uses the resulting data to create spatial maps and charts that can illustrate which neighborhoods have high concentrations of a particular substance.

Biobot’s approach can be used to look at lots of different compounds. But so far the company is focusing on one target: opioid metabolites from prescription pain relievers and synthetic opioids such as fentanyl.

Metabolites are byproducts of the body metabolizing a drug. They are reliable indicators of whether a person has ingested or injected an opioid.

“Right now our focus is just analyzing for opioids, because opioid addiction is a major public health crisis,” says IEEE Member Irene Hu, a hardware electronics engineer at Biobot.

Around 68 percent of the more than 70,200 U.S. drug-overdose deaths in 2017 involved an opioid, according to the federal Centers for Disease Control and Prevention.

Biobot has partnered with Cary, N.C., to help town officials assess the scope of its opioid epidemic, allocate resources, and then gauge the effectiveness of their efforts over time.

Hu talked about the project at the IoT–Smart Networks and Social Innovations panel, held in May during the IEEE Vision, Innovation, and Challenges Summit in San Diego. You can watch the session on IEEE.tv.

PUBLIC HEALTH OBSERVATORY

Biobot last year began a pilot with Cary, North Carolina’s seventh-largest municipality, with about 162,000 citizens. Last year 11 people in Cary died and about 60 others overdosed on opioids—a 70 percent increase from the previous year.

Biobot works with the town to identify which catchment basins and associated manholes they want to survey. At the chosen manholes, a sampling bot is suspended by a rope so it sits just above the water. The bot houses filters, a pump, sensors, and other hardware. Sewage is pumped through a series of filters—which bind the compounds of interest—and then out again during a 24-hour period.

A city worker collects the filters, which are sent back to the company. Back in the Biobot lab, analysts use mass spectrometry and other techniques to scan the filters for 16 different opioid metabolites.

In Cary, samples were extracted from 200,000 gallons of wastewater that flowed through 10 sample areas—gathering information from neighborhoods of about roughly 5,000 homes each. The results helped researchers determine a baseline level of opioid consumption.

The reports that Biobot provides to Cary officials include, for example, comparisons of reported overdoses—which the city already collects from first responders—and the levels of opioids that were found in the sewers. Presented as spatial maps of the city with blocks corresponding to the sampled catchment areas, the comparisons allow the city to visualize and identify “hidden” areas of consumption that are not captured by the officially reported overdoses, Hu says. For example, preliminary results showed that opioids were found all throughout Cary, not just in areas with reported overdoses.

In addition, Biobot found that prescription opioids were driving much of the consumption. The town used the information to tailor outreach programs around prescription opioids, resulting in a threefold increase in people using drop-off points to dispose of their leftover prescribed opioid medication.

Biobot also measures levels of naloxone (Narcan), a medication that can rapidly reverse opioid overdose. Preliminary results showed that Narcan usage correlates with reported overdoses in Cary, but the levels found in the sewers were much higher than expected, implying many unreported overdoses. The city is now digging into potential barriers that might exist to reporting overdoses, Hu reports. And the town is conducting awareness campaigns about opioid use.

Hu says first responders have expressed interest in data about trends on emerging drugs, such as marijuana and cocaine, so Biobot is now measuring for those as well.

FULFILLING CAREER

After graduating from Princeton with a degree in electrical engineering, Hu spent a few years working for a financial consulting company. She decided to pursue a graduate degree in environmental engineering. “I wanted to do something that helped the world,” she says, “and pursue a cause I believed in.”

She earned a Ph.D. in environmental engineering from MIT. Her research thesis involved building sensors to measure naturally occurring chemicals in water.

Hu joined IEEE as a grad student because of the discounted rates members receive on conferences. She remains a member, she says, because she finds that “IEEE isn’t just for electrical engineers; it’s very interdisciplinary. There’s a conference for everyone, and it’s nice to have this professional community.

“Being on the IoT–Smart Networks and Social Innovations panel was one of my first forays into branching out in IEEE and talking about my work to a broader audience,” she says.

A friend who works at Biobot persuaded her to join the startup. The company, which was founded by two MIT graduate students, has almost a dozen employees. “It was a really good fit for me,” Hu says.

Biobot, which plans to expand its client base to more cities, counties, and states, has raised nearly US $2.5 million in seed funding from 22 investors.

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