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Nicholas Reville1
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Hi-- I just posted a paid part-time research position for this project, in case you know anyone!

https://docs.google.com/document/d/1STK_E23WneUAT416cKSruCWNVm4SNVI-yP58oSQOdIo/edit?pli=1

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by Nicholas Reville
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Global health & developmentForecastingOpportunities to take actionPolicyUnited StatesRequests (open)Vaccines
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UPDATES:  

  1. We just launched a new substack, called Curing Addiction. 
  2. And here's a new EA forum post with the latest on what we're doing.

 

Hi

I'm working on a research, policy, and advocacy project that's looking at breakthrough treatments for opiates, cocaine, and alcohol addictions and overdoses.  There are radical new treatments in development, including several in Phase I, such as:

• Vaccines for fentanyl, heroin, cocaine, and oxycodone 

• More effective non-opiate painkillers

• Drugs that reduce addictiveness and craving 

My growing belief is that (1) negative impact of the addiction crisis in the US and around the world is underestimated, (2) breakthrough medical treatments are the only realistic way to actually solve the problem, and (3) research and development of these treatments is radically and irrationally underfunded (see the NIH HEAL Initiative for some funding that is happening). At this stage, I'm working to put together strong evidence for all three points.

And I'm looking for help! The goal is to build a powerful argument that this space lacks funding and political urgency relative to its potential and then advance that case to the public and policy makers.  I've been doing some writing that may become a public substack and have done a lot of research already on the state of the field and the key players.  I don't think this information has been brought together anywhere publicly before.

My background is in public policy and tech-- I went to Brown for public policy, started and ran award-winning open-source and tech rights advocacy non-profit organizations, and then had a successful run in for-profit tech, which has given me the ability to choose my next project without worrying about income.  I also have a science background so I'm able to read and understand the literature on these emerging treatments to a moderate level of granularity.

I'm making good progress myself but could use help in a few areas and I think having a small team of folks who are volunteering together could work really well and would be pretty fun.

Skills I'm looking for:

• It would be great to have someone looking at the numbers and building the analytic case for investment.  For example, I believe that in the US overdoses are the 3rd largest cause of years of life lost behind only heart disease and cancer, but I need a little help locking down the numbers on that since the overdose stats are buried within 'accidents' mortality reporting.  Similarly, I want to quantify some costs of the drug war on global development, impact of drug related crime in the US and globally, etc etc.

• A biology PhD would be great to have on this ragtag squad.

• Anyone with professional expertise in health policy would be super helpful.

• Anyone with professional experience in bringing drugs to market would be very helpful for evaluating timelines and likelihood of approval for various treatments, as part of building the case for increased investment.

• Someone who is good at turning numbers into clean charts and graphics would be very helpful for making strong presentation materials.

If you're interested or have questions or suggestions or know of resources that have addressed this topic that I may have missed, please message me on the forum!  I'm new here, so I apologize if I'm not familiar with forum practices and etiquette.

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Stan Pinsent13
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I think you could build a very compelling case for this. Even if official data sources do underestimate key numbers like overdose deaths, they are still a stirring call to action.

  1. Drug problems have got considerably worse in the past decade. This CDC source implies that overdose rates have more than doubled since 2015. Much of the increase came during the pandemic, which could add a little narrative spice to your argument.

2. Other "similar" problems are not getting worse. Other "despair" indicators like suicide and depression appear to be stable. Road accidents and violence have fallen. On one hand it's a bit sneaky to pick and choose comparisons like this, but it could be argued that they are all societal problems that often cause (very) early death. They're tragic.

3. Vaccines/ other pharma interventions may offer an unusually tractable and scalable solution. Addiction and all of the other problems in the chart above are very difficult problems to fight. At best, interventions usually take a chunk out of the burden but offer no hope of big change. Drug interventions can be controversial, with effects of uncertain sign. If you can show that your ideas are significantly better, you are doing well.

I expect that a major difficulty is that your solutions involve developing new vaccines/drugs, which is of course an expensive, unknown and long process. Will pharma companies see potential for a profit? Is there scientific grounding for optimism on these new drugs being possible?

Unfortunately I don't have the spare capacity to volunteer much time. I'd be interested in giving feedback on any future work. Good luck!

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Nicholas Reville2
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Thanks Stan, I really appreciate it!  I have several short articles that I'm writing covering various aspects of this and will reach out to get your feedback when I'm closer.  

On question 3-- yes, I think there is reason for optimism that the new treatments under development can work, including vaccines, non-opiate painkillers, addiction reducers, etc.  Il'l be writing about this very soon and also looking for experienced pharma folks for thoughts on pipeline to market timing and obstacles.  

Whether these treatment will be game-changers or useful additions to our limited toolbox remains to be seen.  And whether they will take 15 years to get to market or 5 is what I'm hoping to influence.  But there are some human trials already in progress on exciting stuff.

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John Salter3
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This is one of the most interesting ideas I've seen proposed on the forum. I'd love to see more research on this.

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Nicholas Reville1
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Thanks!  More soon...

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Matt_Lerner2
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I'm also strongly interested in this research topic — note that although the problem is worst in the U.S., the availability and affordability of fentanyl (which appears to be driving OD deaths) suggests that this could easily spread to LMICs in the medium-term, suggesting that preventive measures such as vaccines could even be cost-effective by traditional metrics.

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Nicholas Reville1
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totally agree -- i think fentanyl is rightly understood as a huge a new threat, but i dont think there's a realization generally that fentanyl is essentially a technological advancement.  much stronger, much smaller, cheaper.  makes efforts to prevent drug trafficking much harder and makes harm reduction and social interventions much more difficult as well.  we beat cigarettes largely with price increases, fentanyl is a price decrease.  also it has shorter half life than heroin so people use it more often every day, which creates all sorts of other risks.  all of this is to say-- yes, fentanyl seems more likely to spread to countries that have been ok so far.

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Jason2
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I'm none of the things you're looking for, but please do let us know if you start publishing in a public space! 

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Nicholas Reville1
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I certainly will!  Hoping to get a substack going in the next month or so.

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SummaryBot1
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Executive summary: The author seeks collaborators for a project arguing that breakthrough addiction and overdose treatments are radically underfunded given their potential impact.

Key points:

  1. Emerging medical treatments like vaccines and non-addictive painkillers could effectively solve the addiction crisis but lack funding and urgency.
  2. The negative impacts of addiction are underestimated globally in terms of lives lost, costs, and inhibited development.
  3. Collaborators are sought to build an analytic case for more investment by quantifying costs and impacts.
  4. Help is welcome from those with expertise in biology, health policy, drug development, data analysis, and presentation.
  5. If interested in volunteering, please message the author through the forum.

 

 

This comment was auto-generated by the EA Forum Team. Feel free to point out issues with this summary by replying to the comment, and contact us if you have feedback.

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Nicholas Reville1
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Hi-- I just posted a paid part-time research position for this project, in case you know anyone!

https://docs.google.com/document/d/1STK_E23WneUAT416cKSruCWNVm4SNVI-yP58oSQOdIo/edit?pli=1

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Cade Mataya1
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Hi! I think this seems like a really promising area of research. I have been working in public policy for awhile (admittedly not health policy, though). I am okay at making graphics in Tableau, though not #1 by any stretch. (I am 100% willing to learn, though!). If there is any other help that you may need, I would love to stay in the loop on this project. 

 

Furthermore, I would like to know if you have any particular goals for this research. Do you plan on starting a nonprofit, conducting advocacy, raising funding for more research on these potential treatments, etc.?

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Nicholas Reville1
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Great, I'll DM you and we can stay in touch.  

My goal is to first build the case that the space is underfunded, and assuming that it feels convincing to me and others, try to push for more awareness and funding in the space.  This could mean creating a formal or informal organization or it could just mean creating some kind of movement, momentum, etc.  I'd love to get some of the leading researchers onto the popular health podcasts, help them create more powerful presentations for the public, talk to NIH researchers, politicians, and more.  I think there's a lot of low (and high) hanging fruit here.  

But definitely starting humbly, trying to get the science and the facts right and going from there.

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Nicholas Reville1
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Quick update to let you know that we just launched a new substack:  https://curingaddiction.substack.com/

Hope you will subscribe!

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Benevolent_Rain1
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If you DM me your bio I might be able to help with parts of what you're asking for. Not making any promises though!

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Nicholas Reville1
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OK, I will!  Thanks!

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