From a social network for addicts to robots that test sewage water for traces of drugs, startups and private companies are applying innovative solutions to one of the nation’s most pressing problems — its opioid epidemic. Over 11.4 million people have misused prescription opioids, and more than 130 people die daily from opioid-related drug overdoses, according to the U.S. Department of Health and Human Services

Startups have a unique advantage over healthcare systems in tackling the crisis. Startups are nimble and apply new technologies, while established, institutional systems may be slow to apply a new idea. 

Investors are taking notice of market-based solutions that are moving the needle on the crisis, said Jaishree Singh, a health researcher for Boundless Impact Investing. The firm is working on helping investors identify impactful ideas to back.

“Investors are really interested in healthcare and the opioid crisis especially, ” Singh told Karma. “There are a lot of disruptive technologies that are effectively and creatively addressing the crisis,” she said, but investors don’t know how to allocate dollars and maximize investments.

The social network Sobergrid, for example, is using natural language processing to monitor what is said among addicts in its app and predict when a person in recovery might relapse. The company has received a $1 million grant from the National Institutes of Health for its concept. 

In addition to the human cost of lost lives, broken families and dashed ambitions, companies have a financial incentive to find answers. The epidemic is hitting them in the pockets: by next year, the epidemic is expected to cost the nation $1.5 trillion in lost wages, productivity adn health care costs, according to Altarum.

MedicaSafe founder Matt Ervin said insurance companies have an incentive to invest in ideas such as his. The startup has raised $7 million and manufactures a tamper-resistant medication cartridge that releases a single dose at a time only when accessed via a SmartKey — verifying that the right patient is taking the medicine. The SmartKey relays access data to medical professionals, letting them know whether the patient is complying with treatment. 

“To an insurance company, a person who is properly controlled to meet their needs might be a $20,000 a year patient, versus someone who is uncontrolled who might be a $60,000 a year patient,” he said. “You’re talking about a big gulf that we can potentially save.”

Although startups alone cannot eliminate the opioid epidemic, many of the startups interviewed by Karma are helping reduce the toll opioids take both on individual lives and in their cost to society and the healthcare system.

Biobot Analytics, which has raised $2.5 million for its robots that collect wastewater samples for testing, worked in Cary, North Carolina, to reduce overdose deaths by 40% last year. The company used test results to build a map of the city that identified neighborhoods where opioids were most present, which officials used to improve awareness campaigns and better target programming.

“The private sector should be just as invested as the public sector in solving social problems,” founders Mariana Matus and Newsha Ghaeli told Karma in an email interview. “Startups are particularly well-poised because they’re founded on the premise of building better solutions for existing problems.”

Dozens of startups are now involved in addressing the opioid epidemic. In July, six came together to form the Opioid Crisis Working Group, a group of entrepreneurs aiming to end addiction and the overall epidemic. They are sharing data and collaborating on ways to achieve that goal.

Some of the entrepreneurs who have launched companies targeting the epidemic have firsthand experience. 

Script Health founder James Lott had the idea for his company, which offers a mail-order service for the opioid antagonist Naloxone — commonly known as Narcan — when he was a pharmacist in Bonney Lake, Wash., in 2014. He was filling upwards of 50 to 75 prescriptions for oxycodone daily and “knew that wasn’t normal,” he said. 

Lott drew inspiration from a national survey that found many people are uncomfortable interacting with healthcare professionals about substance use because of the stigma around it. The company, which launched last year with $85,000, offers mail order naloxone, video tutorials on using the medication, the ability to query a pharmacist via email to minimize human interaction. It operates in Texas, West Virginia and Pennsylvania, with plans to expand nationally once more funding is secured.

“The country has been looking at a problem that has been getting worse in an exponential manner and they are using the same old solutions,” Lott said. “Startups are probably the most willing and they have the most flexibility to come up with the most innovative solutions to scale quickly.”

Nishi Rawat is a physician-turn-entrepreneur who said the healthcare system is plagued with inertia in addressing even obvious problems. As a critical care doctor, she routinely sent patients with opioid overdoses home rather than into treatment. 

“As medical workers, we often think that the behavioral health issues are not our problem. We are there to deal with the medical issues,” she said. “It’s not something I’ve been trained to deal with.”

Her company, OpenBeds, has created digital patient marketplaces in seven states that make referring addicts to treatment facilities and social services easier for doctors and other health-care professionals. The company has received about $1.7 million in funding since starting in 2015 through a small business grant from the National Institute of Drug Abuse.

“One of the things that makes me feel good everyday is looking at our system and watching people get connected to treatment,” she said. 

Fortune 500 companies are also involved in addressing the crisis. The Hartford has invested $100 million in a claims system that uses predictive analytics to identify opioid misuse among patients on workers comp leave. Since 2014, the company has cut opioid prescriptions for policyholders by 45%. 

Hartford’s system flags opioid prescriptions and monitors them to see if they are refilled. Nurses will reach out to doctors to discuss alternative treatments, such as behavioral therapies, or weaning plans if use continues. Although opioids can be effective in treating immediate pain related to surgeries or injuries, about 20% of individuals who start a 10-day supply become longer-term users, the company notes.

“When you think of people who have the opportunity to get addicted, injured workers are way up there,” Mary Nasenbenny, senior vice president of claims, told Karma. “In that sliver of that population, we think we make a big impact.” 

Critics say Hartford is looking out for its bottom line more than addicts, but Nasenbenny points out that alternative therapies may be more expensive than allowing patients to continue misusing opioids. 

“If you do it right, the individual will recover to their full function. It’s good for them, it’s good for us, and it’s good for the employer,” she said. “When it comes to this particular crisis, each and every one of us has a responsibility to help our friends and family and do whatever we can to prevent this from getting worse.”