The Delaware Division of Public Health (DPH) hosted a media call on October 3, 2019, to provide an update on its participation in a multi-state investigation into an outbreak of severe pulmonary disease reported across the country. As of September 27, 2019, 46 states, including Delaware, have reported 805 cases of lung injury associated with use of e-cigarette products (e.g., devices, liquids, refill pods, and cartridges).
The CDC launched its investigation into the lung illnesses on August 1, 2019, and has worked closely since then with the Food and Drug Administration, states and other public health partners, and clinicians to determine the cause. No evidence of infectious diseases has been identified in these patients, therefore lung illnesses are likely associated with a chemical exposure. The investigation has not yet identified any specific substance or e-cigarette product that is linked to all cases. Many patients report using e-cigarette products with liquids that contain cannabinoid products, such as tetrahydrocannabinol (THC).
DPH recently issued a health alert to Delaware medical providers advising them of the CDC outbreak investigation and providing guidance for reporting possible cases. Clinicians should report cases of significant respiratory illness of unclear etiology and a history of vaping to the Delaware Division of Public Health, Bureau of Epidemiology (24/7) at 1-888-295-5156.
Congratulations to Cape Henlopen High School, Thomas McKean High School, and Polytech High School for participating in the Youth Risk Behavior Surveys (YRBS) and winning one of the incentives! These surveys provide accurate and timely biennial estimates of student substance perceptions, and contributing risk and protective factors for purposes of surveillance and program evaluation.
A multidisciplinary team from UD has worked with industry partners to develop a free, interactive app to help address Delaware’s opioid crisis.
A new smartphone app puts a network of information and support about opioid and other substance use disorders into the hands of users, their loved ones and health care providers.
The app, Help Near and Now (or HeNN), was developed by a multidisciplinary team at the University of Delaware, along with industry partners Greenline Business Group and CompassRed.
It offers novel features designed to address Delaware’s opioid crisis. According to the Centers for Disease Control, the state was ranked in the top 10 in the nation for highest 2018 overdose rates, with 400 fatal overdoses.
“Like many other states across the country, overdose deaths in Delaware continue to escalate and are expanding to other types of opioids and other drugs, both legal and illegal in origin,” said Tammy L. Anderson, leader of the team that developed HeNN.
A professor of sociology and criminal justice and associate director of the University’s Center for Drug and Health Studies, Anderson has been studying drugs and crime since the crack cocaine epidemic of the 1980s. She said HeNN provides a location-based, interactive platform to connect those with opioid and other substance use disorders and their families to resources and services.
The app is free, is available for download on all Android and Apple devices and offers immediate help, including information about where services are located and the best ways to reach them.
“The uniqueness of the HeNN app lies in providing users with a one-stop source of high-quality information related to substance use and abuse,” said fellow team leader Hui Fang. “HeNN can efficiently connect users with the services that they need and can trust, and it aims to provide more customized proactive information support in the future.”
Anderson noted that, because HeNN’s development features partnerships with many public and private agencies, stakeholders and care providers, it offers access to a broad range of services. For example, a doctor looking for addiction treatment for a patient could use HeNN to learn about all such services in the state, not just those affiliated with the hospital where he or she works.
In addition to the wide access, another important feature is that the app creates a peer network where people can rate and comment on services.
“Just like a customer buying a TV on Amazon can see what other customers say about it, those seeking treatment services can hear from their peers on this app,” Anderson said. Health care providers can also use the feedback, she said, to help patients find the kinds of services most appropriate to their individual situation.
Cathy Wu, also a HeNN team leader, said work will continue on ways to further enhance the app.
“We will conduct data analytics to improve utilization and user experience of the HeNN app, to increase community engagement and network building and to identify gaps in services to inform care and treatment providers and policy-makers,” Wu said.
Gabriel Humphreys, director of technology and operations at Green Line Business Group, said the company was enthusiastic about the project from the start.
“On hearing HeNN’s mission and proposed goals, we knew immediately they aligned with Green Line’s values,” he said. “So we decided to contribute our expertise in crafting location-based mobile apps in order to provide the help HeNN’s users need.”
The app lists available resources, using location-based services to map where each is located, and provides driving directions and information on available public transportation to the nearest services. It also includes an “events” section that can be continually updated with information about support group meetings, adolescent counseling sessions or similar one-time or recurring services.
Anderson said that HeNN offers help in four distinct categories of services and events:
Prevention. Before someone develops a substance use disorder, the app can help individuals and families find information about risk factors and preventive actions.
Treatment. Its directory of providers and agencies gives detailed information about the types of services offered and their location.
Post-treatment. The app also provides a listing of support resources for those who have completed treatment and are rebuilding their lives.
Harm reduction. HeNN features information about topics including where to safely dispose of unused medications and where to get training on providing emergency overdose treatment (administering naloxone).
The app has won praise from those working to combat the opioid crisis. Lt. Gov. Bethany Hall-Long, who leads the state’s Behavioral Health Consortium and is also a UD nursing professor, said access to treatment is a continuing concern.
“The development of HeNN … enables individuals, treatment professionals and significant others the ability to connect with needed resources and services in near real time,” she said. “The peer network facilitates meaningful feedback relative to access, which will promote improvement where it is needed the most.”
Dr. Karyl Rattay, director of Delaware’s Division of Public Health and chair of the state’s Addiction Action Committee, said the “events” section will be particularly helpful.
“No matter whether you are in recovery and need to identify the nearest support meeting, or you are a family or community member who wants to get training on how to administer naloxone so that you are prepared to respond in the event of an overdose, the events section will provide you with updated information on where to go for what you need,” she said.
“The HeNN app also connects users to HelpIsHereDE, the state’s one-stop online source of information on prevention, treatment, recovery and harm reduction.”
Elizabeth Romero, director of Delaware’s Division of Substance Abuse and Mental Health, said HeNN complements the state’s comprehensive online behavioral health referral system for health care providers.
That network, the Delaware Treatment and Referral Network (DTRN), allows patients to be transitioned through electronic referrals to behavioral health providers in the state that match the level of care needed.
“Technology is advancing when it comes to connectivity to treatment services,” Romero said. “So many individuals and families in our state can benefit from well-designed tools that support their journey to recovery.”
About the development of HeNN
The project’s leaders, in addition to Anderson, are UD’s Hui Fang and Cathy Wu.
Fang is associate professor of electrical and computer engineering, David L. and Beverly J.C. Mills Chair, and JPMC Interim Fellow. She is also affiliated with the Department of Computer and Information Sciences, the Institute for Financial Services Analytics and the Center for Bioinformatics and Computational Biology. Fang’s group leads app wire-framing and programming.
Wu is the Unidel Edward G. Jefferson Chair in Engineering and Computer Science, professor of computer and information sciences and director of the Center for Bioinformatics and Computational Biology and the Data Science Institute. Her group assists with the underlying database development with an automated workflow to streamline data integration and update.
Other members of the development team were Haibi Hu from Computer Science and Engineering; Sachin Gavali and Julie Cowart, from the Center for Bioinformatics and Computational Biology; Joshua Stout and Logan Neitzke-Spruill, both of the Center for Drug and Health Studies; Gabe Humphreys, Andrew Braune and John Hedberg, all of Green Line Business Group, a technology company; and Patrick Callahan of CompassRed, a data and analytics company.
HeNN was funded by a Center for Advanced Technology grant from the Delaware Biotechnology Institute. The team is exploring other sources of support to continue expanding HeNN’s functionality and services offered.
What’s next for HeNN?
In the future, the HeNN team hopes to incorporate services from surrounding areas, including Philadelphia and northern Maryland, and to expand resources and services that address mental health and general health.
“The app has been designed in a way that can be easily scaled to more services with minimum manual effort,” Fang said.
Article by Ann Manser; photo illustration by Jeffrey Chase
Dr. Anderson, the Associate Director of The Center for Drug and Health Studies and Dr. Rapp, an Associate Scientist of The Center for Drug and Health Studies were interviewed by the University of Delaware’s Magazine for their research on opioid addiction crisis. They highlighted the complexity of opioid addiction victims’ experiences as well as the stigma that came with the addiction. They suggested that sufficient social support from family and friends was a critical component for victims’ rehabilitation and the prevention of stigmatization.
The Interactive Map of the Latest Data about Youth Substance Use
The interactive maps visually represent the rates of different types of substance use among Delaware youth as well as the geographic distribution of after school programs. The latest data of youth substance are reflected in the maps. Users can compare the rate of a certain type of substance use across the years from 2014 to 2018 to investigate the longitudinal trend as welll as examine the disparity of using rate across different types of substances.
Dr. Tammy Anderson, the Associate Director of The Center for Drug and Health Studies, and researchers Jim Highberger, Jascha Wagner, Logan Neitzke-Spruill, and Joshua Stout recently launched the DOMIP Mapping App. This app contains five years of overdose death data in the state of Delaware and allows users to see how their communities have been impacted, as well as the available resources in their areas.
Dr. Anderson, the Associate Director of The Center for Drug and Health Studies who specializes in opioid study, was interviewed by Time magazine for a story on Demi Lovato’s overdose. Read the article
The interactive maps are designed to highlight substance use rates among teenagers in Delaware. Using the Delaware School Survey data, past month rates of alcohol use, marijuana use, and past year rates of prescription pain killer use are displayed by zip codes. In addition to substance use rates, a map illustrating after school programs and substance use rates is available. Organizations can use these maps to help identify areas that have higher concentration of substance use and to identify gaps in services. For parents, these maps highlight resources and programs to benefit their families. Click here to view all of the heat maps.
Lin Liu, a graduate researcher in the Center of Drug and Health Studies and a doctoral student in the Department of Sociology and Criminal Justice,won the first place of the 2018 Alpha Kappa Delta graduate paper competition. Marcia Marx, a professor of sociology from California State University who served as the Chair of the AKD graduate paper awards committee, presented the First Place Award to Lindy in the AKD Distinguished Lecture and Awards Ceremony.
