
Sewage Is Helping Cities Flush Out the Opioid Crisis - dustfinger
https://www.scientificamerican.com/article/sewage-is-helping-cities-flush-out-the-opioid-crisis/
======
joshe
Biobot Analytics (YC W18) is possibly the "Massachusetts Institute of
Technology–affiliated company" mentioned in the article. They will "scour the
waste pipes with robots that suck up sewage, measure drug amounts and remotely
report the data". [http://www.biobot.io/](http://www.biobot.io/)

The Techcrunch write up: [https://techcrunch.com/2018/03/20/these-are-
the-64-startups-...](https://techcrunch.com/2018/03/20/these-are-
the-64-startups-unveiled-at-y-combinator-w18-demo-day-2/) mentions "they hope
to also measure pharmaceuticals, infectious disease and food consumption".

Infectious disease finding could be really cool. Imagine easily mapping where
a zika outbreak was happening an hour after an infected person uses the
restroom. That same day you could do mosquito abatement and post flyers to
come to the hospital for treatment.

~~~
alexpotato
I was reading a book[1] on bacteria phages aka viruses that attack bacteria
and they mentioned that in countries that used phages (e.g. Soviet Russia due
to a lack of antibiotics), the sewage plant is the first place they would go
to look for phages to combat intestinal diseases. There were large amounts of
the offending bacteria so it was a prime place to find viruses that had
evolved to fight them.

[1] Viruses vs Superbugs [https://amzn.to/2IZXZiJ](https://amzn.to/2IZXZiJ)

------
mirimir
If prescription opioids were available legally to addicts, there would be much
less of an overdose problem.

[https://www.rollingstone.com/culture/news/treating-heroin-
ad...](https://www.rollingstone.com/culture/news/treating-heroin-addiction-
with-heroin-what-you-need-to-know-w494829)

[https://www.nytimes.com/2017/09/22/opinion/sunday/portugal-d...](https://www.nytimes.com/2017/09/22/opinion/sunday/portugal-
drug-decriminalization.html)

[https://www.springboardrecovery.com/switzerlands-approach-
he...](https://www.springboardrecovery.com/switzerlands-approach-heroin-
epidemic/)

~~~
himom
Yup. Portugal and Prohibition also proved it yet again. Drugs, gambling and
prostitution oughta be decriminalized in order to drive out the criminal
element from the supply side and drive down the risks on provider & consumer
sides.

For-profit prisons, desperate small towns towns and greedy politicians
benefiting, plus the revelations of Ehrlichman of the Nixon administration’s
intent (WoD targeted the admin’s enemies: hippies and blacks), make it and
outlawing of other vices perversely-corrupt in the extreme. Let’s not forget
the 13th amendment loophole expressly endorses slavery of prisoners.

[https://www.cnn.com/2016/03/23/politics/john-ehrlichman-
rich...](https://www.cnn.com/2016/03/23/politics/john-ehrlichman-richard-
nixon-drug-war-blacks-hippie/index.html)

[http://www.browardpalmbeach.com/news/geo-group-earns-
over-60...](http://www.browardpalmbeach.com/news/geo-group-earns-
over-600-000-a-year-from-prisoners-phone-calls-644357)

[http://www.miaminewtimes.com/news/five-reasons-boca-
private-...](http://www.miaminewtimes.com/news/five-reasons-boca-private-
prison-company-geo-group-is-evil-9967258)

~~~
jernfrost
But a solution that works isn’t worth it, if the abusers don’t get punished
and humiliated for their moral failings. /s

~~~
senorjazz
also got to keep them prisons full

------
joe_the_user
Some have claimed the opioid epidemic is merely part of the "epidemic of
despair" [1]. I am inclined to agree.

This may sound harsh but I am inclined to say, _instead of sifting shit,
cities might consider ways to find to decent jobs, housing and recreation for
their citizens_.

What else can be said? All this a product of the redistribution of wealth
upward in an ostensibly wealthy society? What could possibly go wrong?

[1]
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5607670/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5607670/)

~~~
keypress
Some people just enjoy taking opioids.

But the problem with opioids is that they are slightly moreish.

~~~
empath75
[https://en.wikipedia.org/wiki/Rat_Park](https://en.wikipedia.org/wiki/Rat_Park)

Rats that live in interesting, healthy environments don't get addicted to
opiates.

~~~
JBReefer
Rat Park has serious replication problems:

[https://news.ycombinator.com/item?id=7743089](https://news.ycombinator.com/item?id=7743089)

------
everyone
Sewage is “the information superhighway under your feet,”

Life imitates art?

[https://youtu.be/DJklHwoYgBQ](https://youtu.be/DJklHwoYgBQ)

~~~
RankingMember
I was thinking the exact same thing when I read that haha. Part of the genius
of that bit is that it's such a believable product in this day and age.

------
flashman
Australia recently proposed (and later shelved) drug-testing welfare
recipients in certain localities. These areas were to be chosen partially due
to the level of illicit drugs and metabolites in their waste water.

So, welfare recipients may find themselves drug tested not because they use
drugs, but because the people around them do. It stinks of collective
punishment.

~~~
duxup
To what end?

So they can go from a desperate drug user to a very desperate drug user?

~~~
denverkarma
Kind of a circle jerk of poor summaries of the conservative positions on
welfare.

Generally the conservative argument is that welfare money should be earned in
some way, essentially by doing socially constructive things (ie staying off
drugs, applying for jobs, not committing crime). The goal is to direct
resources to people who can be helped and are actually putting in effort to
take care of themselves, on the assumption that those people can take some
assistance and really benefit from it, whereas the addict who is sleeping on
the street will just use tax money to buy more drugs.

A common liberal argument (not the only one but a common one), is that it’s
more important to help “those in need,” no strings attached, that you can’t
expect them to get out of the gutter until their basic needs are met and even
if giving them money just enables their habit you have to “do something” and
giving them clean needles and cash is better than “doing nothing.”

One of the problems that manifests all over the world in varying degrees is
the tension between doing “something” which can easily harm more than it helps
(the conservatives tend to point to this), and doing ENOUGH to actually help
someone (or robust social services to rehabilitate people). In the US it used
to be common for people to be institutionalized, they’d have all their needs
met and in most cases get some semblance of help, albeit at a cost to their
freedom. Well, nobody really liked that system since it was very expensive and
was prone to human rights problems (if someone is too mentally ill to consent
and you try and experimental treatment on them, are you helping or using them
as a lab rat?). So now those people are on the street.

At the end of the day it’s a very difficult set of economic and moral problems
to solve, and demonizing the political party you dislike and labeling them as
heartless villains accomplishes exactly nothing.

What arguably would help is sane housing and public health policies so people
could afford a roof over their heads and get medical treatment when needed
without having to have an upper class job to pay for it.

~~~
jernfrost
I can respect that we have different views on how to reach the same goal,
however I take issue with the conservative propensity to judge people. All too
frequently conservatives rate people with some sort of failing as lesser
people. There is a propensity to believe more in punishment and threats than
positive re-enforcements.

I believe in effective solutions. Often it seems conservatives will refuse to
use an effective and proven solution if they deem it had somebody getting
something for nothing.

It seems as if conservatives will stay wide awake at night angry about
somebody getting something they didn’t deserve.

As a liberal I don’t care as much about what people deserve as I care about
what works as well as human dignity.

~~~
denverkarma
There may be some of that but I think you’re misunderstanding the predominant
conservative view, which has two crucial parts:

1\. Most conservatives believe that the government forcibly taking your money
via taxes and using it for purposes you do not approve of is undemocratic and
immoral. This is the root of the small government argument - that the
government should only do the things that are broadly supported by the
population and since the population is fragmented the set of things that enjoy
near universal support are very small.

2\. Most conservatives believe very deeply that human dignity is found in
freedom, independence, and meaningful work. Some might say “meaningful life”
instead but for many conservatives they believe very literally that _doing
something that matters_ is the reason for living and if you aren’t doing
anything that matters then you will be miserable and have no dignity. It isn’t
even about making money - though that can help make the work meaningful. For
many they would say that what matters is being able to contribute to your
community and take care of your friends and family, and if you do a job that
sucks but it’s what you’ve got and it gives you the money to contribute and
take care of the people who rely on you, then THAT is what is meaningful.

So, suppose the proposal is “shall we give this homeless drug addict a home
and food and money so their needs are met and put them in additction
counseling and treatment and then hope they recover from their addiction,
etc.”

Perhaps the liberal argument is “yes that should work for getting most people
on their feet, and if it enables some people to just live more comfortably in
a drugged stupor then that’s okay because overall everyone will be better
off.”

The conservative argument would generally be, (1) it’s immoral to take money
from people who work hard and take care of themselves to give it to someone
who doesn’t work so they can live comfortably on drugs, and (2) by just giving
them everything you are actually taking away the satisfaction and dignity that
comes from taking care of yourself and knowing that you are independent and
free.

Note also that the conservatives tend to worry a lot about the moral hazard:
they fear that any kind of “bailout” whether it’s for homeless people or for
Wall Street etc. takes away the consequences of an individuals actions and
therefore incentivizes risky, dangerous, or antisocial activity.

Another way to distill it down is to say that liberals tend toward viewing
individuals as inherently good and not responsible for bad things that happen
to them, and conservatives tend to view people as inherently bad and mostly
responsible for both the good and bad that happens to them.

Conservatives tend to see civilization and civil, productive behavior as
something very hard earned and fragile, and worry about how social changes
like universal social programs and such may undermine civilization - think
Brave New World.

What I find most interesting is the economic libertarian argument about such
things which is just to do whatever costs the least :)

Anyway, this stuff is all interesting but to boil it all down what I’ve
learned over time is that there isn’t really an us or them or right or wrong
politically, rather there are mostly rational people who have reasonable
justifications for how they think about these problems, and significantly
different life experiences that result in significantly different beliefs
about what works and what doesn’t, and therefore what politics they subscribe
to.

------
shams93
Spending money on trying to find out who is addicted to opiates is a massive
waste compared to offering treatment on demand everywhere. It's a very safe
bet to assume that opiate addiction is in every community across the board.

~~~
totalZero
Phrase this as a positive rather than pejorative statement, and it seems far
less compelling.

"Offering treatment on demand everywhere is massively cheaper than trying to
find out who is addicted to opiates."

1\. Why can't you do both?

2\. Treatment on demand can be marketed and tailored based on information
about users.

3\. I'm not sure it's a safe bet that opiate addiction is in every community.
Seems like a false assumption. To my knowledge there are geographic
differences, economic differences, and medical access differences between
cohorts that use and those that don't.

The danger of disparaging an idea before it reaches maturity is that criticism
may actually be incorrect, and discourage/dissuade positive developments. You
can get the same criticism across without being counterproductive.

~~~
secabeen
>3\. I'm not sure it's a safe bet that opiate addiction is in every community.
Seems like a false assumption. To my knowledge there are geographic
differences, economic differences, and medical access differences between
cohorts that use and those that don't.

The data is pretty staggering. 1 in 3 Americans have an opiate prescription
each year, 1 in 20 had misused or obtained opiates, and 1 in 100 self-reported
as an addict:

[https://www.cbsnews.com/news/more-than-one-third-
americans-p...](https://www.cbsnews.com/news/more-than-one-third-americans-
prescribed-opioids-in-2015/)

~~~
mirimir
> Nearly 92 million U.S. adults, or about 38 percent of the population, took a
> legitimately prescribed opioid like OxyContin or Percocet in 2015, according
> to results from the National Survey on Drug Use and Health.

That is mind boggling! I had no idea that opioid prescriptions were that
common.

So is this a Baby Boomer effect?

------
dumbneurologist
> Flush Out the Opioid Crisis

"Clever" titles are annoying to me, and more so when they degrade the clarity
of the message.

What does "flushing out" even mean, in the context of the opioid crisis?

Fixing it?

Measuring the crisis?

Identifying hot spots?

Focusing resources?

Identifying specific types of narcotics?

The author has decided that "I am clever" is a more important message than
whatever the point of the article is.

If you exert editorial control over anything, fight the temptation to be
clever; especially when it obscures the real message.

------
Nasrudith
Opiods use ttacking seem like one of the potentially less reliable uses for it
given legitimate users and high tolerances. It brings to mind a squeaky clean
high school in the same pipe as retirement homes and veteran's centers where
there are plenty of chronic pain patients and concluding the school must have
a drug problem. I am aware that there are statistical levels of usage beyond
what would be remotely probable without the area literally being designated
for chronic pain patients.

Meanwhile you can't go wrong with looking for disease tracking.

~~~
dontchooseanick
W.w.w.whaat ?

------
test6554
Sewage is “the information superhighway under your feet,” says Rolf Halden.

Download has a whole new meaning.

------
aae42
are there privacy concerns here?

~~~
tomjen3
Good question. Well if you mix an entire suburb or city block? Probably not,
but I imagine that there could be some issues when those robots become cheap
enough that you can get it down to house level. Even if you cannot monitor all
houses everywhere you could sample houses.

And you wouldn't want that, because then your sample data becomes useless and
people start to shit in their back yards, or in public parks.

That said I am still looking for the toilet that does urin analyses ala The
Island, I just only want it to tell me, and let me choose to inform my doctor.

~~~
dustfinger
> I just only want it to tell me, and let me choose to inform my doctor.

I totally agree. It would be wonderful if there was an inexpensive device (it
doesn't need to be a toilet) that could perform thorough health analysis, but
inform only the user and not any third party. i.e. no Dr or pharmaceutical
companies, the producer or manufacturer, the user's insurance broker, ad /
marketing companies etc. Absolutely nobody but the user.

I want to trust technology like this because it could perform a profound
public good, but untrustworthy companies keep being identified that have
ulterior motives (for all sorts of technology, not this specifically).

~~~
xori
It's going to have to contact a 3rd party to download the latest health
diagnostics/flu of the week/software updates.

And speaking of "public good" it would be extremely beneficial to scientists
and doctors if that information was made available to them. And beneficial to
you, because that device could be improved to give you a better, more informed
diagnosis.

The question is what do you care more about, your health? Or your insurance
premium?

EDIT: Of course you would want to anonymize it, but you could only go so far
while making it still useful. If you unfocused it to a neighbourhood,
insurance premiums would go up for bad areas, and the housing market would
fluctuate with the health of it's residence.

On the upside, cities and landowners would be incentivized to now care about
the health of their residents. So ¯\\_(ツ)_/¯

~~~
dustfinger
Thank you for your input. You brought up some important points.

> On the upside, cities and landowners would be incentivized to now care about
> the health of their residents. So ¯\\_(ツ)_/¯

That would be an interesting consequence.

