Stepping onto East Hastings Street in Vancouver, on the way to my most interesting meetings of the fortnight, was an exercise in sensory overload and immediate psychological defence.

I remember looking down at my phone for directions, vaguely wondering when I would start to smell the pungent aroma of cannabis, as I crossed a street from Vancouver as I know it and… bam! I was in a wholly different world. Police cars on the kerbside. Drug users everywhere: asleep on every sidewalk, slumped on every bench, standing stationary right there in the street, bent over in that unmistakeable gait of the fentanyl user, or shouting — whether at themselves or at passers-by, I could not tell — from a makeshift seat or wheelchair, mat or cardboard bed. Single people, young and old. Groups of people. Desperate sights. Lives I did not want to imagine. And no scent of cannabis that I can remember — this was way beyond that.

I felt fear for my safety. I felt as if I was an illicit voyeur, mesmerized as I peeked into these private lives. I felt guilty for all that I had. I felt judgemental of the self-inflicted damage on these gaunt faces. I felt shame that this suffering was perpetuating right here under our noses. And then, like so many before me, I followed my instincts and found great interest in my surroundings: the blue sky above; a strange pattern of cracks in the sidewalk; the details of old-style architecture crammed in between two more modern buildings on the other side of the road, and I became particularly focused on the specific directions laid out on my phone.

In short, I looked away.

Welcome to DTES — Downtown Eastside, Vancouver. I averted my gaze from those individuals, my fellow humans, huddled in the doorways and I hurried on by. My first destination was the tranquil oasis that is the Dr. Sun Yat-Sen Classical Chinese Garden on Carrall Street, which my AI Life Sciences group colleagues and I were using as a meeting point. From there we stepped across the road — seeing more very interesting architecture and fascinating small white clouds in the bright blue sky — before arriving at 159 East Hastings Street, site of the former Balmoral Hotel. It is an empty lot now, dominated by the giant, part-complete community mural taking shape on the nine-storey eastern wall. Artists were at work on painting platforms and on a giant cherry picker as I looked around to see that the lot had been transformed from rubble to a clear social space. And then, my attention finally returned to the here and now as the extraordinary Sarah Blyth from the Overdose Prevention Society walked towards me, greeting on full beam.

Sarah came to our AI Life Sciences meeting last month to tell us about DTES in her role as Chief Executive of the Overdose Prevention Society — one of the most important harm reduction resources on the DTES. Today's visit was the follow-up event for ten of us to see for ourselves. Crucially, and in line with the group's objectives, we were here on a fact-finding mission to work out how AI could make a contribution.

Cut now, in good old Vancouver film industry style, to supper…

One of our group members owns a vegan restaurant and market a little way up the road from the mural and we convened there after the tour to compare notes, the sights and sounds of East Hastings echoing in our minds. We got to work and in no time had identified three genuine projects where we could employ our technology to actually make a difference:

This felt like the easy bit: we spotted how data was being collected on paper with names and tick boxes filled in by the staff on each reception desk. These data recorded volume of visits to the Recovery Centre, purpose of visits, frequency of visits, services requested and other information. Manual data collection fitted the needs but data input and processing was proving to be extremely time-consuming and inefficient. Now THAT we can solve — with a bit of image processing and data analytics — helping the leadership team provide performance data to address queries from funders and others on demand. We could also work out if a few additional data points could make the output more useful. But more of that later.

One of the surprising issues that Sarah had made very clear when she came to see us last month, and which she reiterated during our visit, was that political support is not always as helpful as you might think, and this month's campaign season brings it to a head. Support from one party means criticism and investigation by the others, with film crews turning up at all times of day and night to prove it. One major frustration for the Overdose Prevention Society team is the frequent injection of incorrect information in public reports by visitors and commentators — for example, suggesting (incorrectly) that the incumbent government had made it legal to consume drugs in a public place. Rapid fact checking, perhaps with an agent scanning news reports and press releases on an ongoing basis, is a tougher task than data capture but… we have the skills to deliver.

This one falls right in my own wheelhouse. We soon recognized that new interventions are needed because the current treatments are getting outdated, because fentanyl is a higher-impact drug than heroin and because the supply is seemingly endless due to ease of production and transport in comparatively low and easily concealed volumes.

During the visit I was struck by the idea that GLP-1 approaches, proving so effective in obesity, could be repurposed to address drug addiction. GLP-1s like Ozempic and Wegovy suppress appetite and reduce cravings. Could this work for fentanyl addiction? My research later confirmed that this is not such a far-fetched idea and a team at Penn State is applying just this mechanism. Meanwhile a team at Cessation Therapeutics in San Jose, California has taken a different, novel route and identified a monoclonal antibody that binds to fentanyl molecules in the bloodstream. The result? The combined molecule is too large to cross the blood-brain barrier, blocking its effect. This sequestration provides a fruitful line of enquiry. So what about a combination therapy? This is worthy of investigation.

Many other areas are revealing their potential in this biotech space, such as the opportunity to provide more powerful forms of methadone to counter the high doses of fentanyl that are so common, or the need for alternative delivery or extended-release naloxone that binds with the brain receptors targeted by fentanyl and helps address overdoses. There are so many avenues to explore.

I felt a surge of hope for our long-term commitment to help in the DTES, not least because we use AI in my own company to address similar research identifying and, if necessary, interrupting the causal biology in cancer, neurodegeneration, infection, metabolic disease, autoimmune diseases and many others. We need to focus our research lens on addiction. Luckily, my trusty ChatGPT assistant and I even found suitable data in the public domain.

Catching up with Sarah after the event, she was quick to remind me of another point: the potential benefit from better technology access. "Vulnerable communities are often left behind when it comes to technology and it is important that we look at how they can be supported," she said. "Can you source and set up kit to make it easier for people to get on-demand info — like toxic drug trends or mapping the recovery services they can use?"

So our data admin task now includes the sourcing of suitable kit too.

It doesn't take long before one starts to tot up the costs. I don't mean the astounding cost per day paid by the fentanyl users — from $50 to $150 being common, bridged by the institutionalized grinding of the underground economy in binning, scrap-metal collection, selling bartered goods at the open-air street markets and sometimes selling themselves. Instead, I refer to the costs of our three programs — even with help from our data-enabling friends at Data For Good BC. This is where our charity funding abilities come in with the challenge of the Vancouver Macnab program of fundraising events, planned for the spring. But we don't have time to discuss that here.

We did however have time to meet some of the workers that keep the facilities running, managing upwards of 400 visits a day on each site. As one might expect, many of the workers had once stepped through the recovery doors in a different capacity — as their first step in seeking help. I asked one team member what the catalyst had been on that special day two years ago when she herself made that step. This opens up a whole new area of research related to motivation, combining long-term incentive and a catalytic trigger. Theory has it that there are two primary categories of trigger: an event crisis such as a hospitalization or overdose, and a personal identity crisis when a user realizes that this life on the street is not who they really are. For the worker I connected with, it was a moment of realization that her relationship would die if she didn't take action. This "catalyst of recovery" concept is probably the research theme where our additional data collection in Project 1 could make the greatest impact — learning about the personal journey of an individual seeking recovery on that specific, fateful day. What happened that enabled them to take that action? We need to see if we can observe, plan for and support such events, of which so little is currently known.

Leaving the Ashtrey Recovery Centre, we walked with Sarah along those now familiar, battered streets. It was a moving and eye-opening experience. It seems like she knows everyone in what is obviously a close, local community. I would have noticed the tightly-knit community nature of the place earlier in the day myself if I had not been too busy looking away: just before I arrived at the Chinese garden, a crouched figure was shuffling along the street, out in the road and heading towards oncoming traffic. A car had stopped a few feet away and the driver was beginning to back up. A shout came from the shadows of a nearby tree. "Oi! Josh! You are in the road!" shouted the voice from his pallet. The bent figure rocked and lifted an arm in thanks. "Thank you, Bob!" he shouted and shambled slowly to the sidewalk as the car sped away. Josh and Bob are part of a community that we don't even see. Apparently, staying local — perhaps within a single block — is normal in these parts because everyone knows where and from whom to get help in their chosen space.

Much later, after supper, I was driven back to my own car by Mauricio, my fellow AI Life Sciences teammate. He had been responsible for coordinating the DTES visit and we chatted about the day. We stopped at some lights and a man I had seen earlier on East Hastings glanced in our direction. He was one of those whom Sarah had spoken to and he had leant forward in his wheelchair and shaken my hand when introduced. Did he see and recognize me sitting there at the lights in my warm and comfortable car? I didn't think so. But perhaps he just ignored me? The brief encounter triggered a powerful self-reflection of what it must be like when passers-by systematically look away. What must it feel like to be invisible? A ghost. The averted gaze of the public isn't just a polite social fiction; to the person on the pavement, our refusal to look is a silent confirmation of their exile from our society.

There are almost too many challenges to comprehend and certainly too many to do the issues justice in this article.

As we drove away, I was overwhelmed with ideas. What about prevention? Rather than working out how to keep a person alive after an overdose, how could we avoid the downhill spiral in the first place? Medicine and society as a whole have been appallingly bad at prevention. Just look at how long it took us to revisit the health "benefits" of smoking after all. So how do we bypass East Hastings entirely? I certainly don't know the answer to this one but Sarah is keen to keep our attention on it. Will it take education of our teens, or the driving out of suppliers in the school yard? Do we start with mental health, breaking down the prejudices that ostracize so many? Or do we focus on adoption and care? And what about the critical issue of housing? Food provision? And where on earth do we start when it comes to policing of drug supplies?

There are simply too many issues piled up in one tight space. As a group, my AI Life Sciences colleagues, Data for Good friends and I could easily be overrun with such concerns. But we are determined to keep our focus and take action. Straight away. Where we are able.

We need you to do the same.

If you can contribute in some way to the three programs we have initiated, then I need your help. If you are far away, then I bet your local city needs your help too. Do you have access to relevant data or hold relevant medical knowledge? Or perhaps you have personal experience of that catalytic moment of recovery, or expertise in mental health, social isolation, human motivation or addiction. Perhaps you have had success (or failure) addressing these same issues in your own locality. If there is something we need to know, then please get in touch.

Now is not the time to look away.

Contact: Simon Haworth | [email protected] | +1 236 989 9555

About the author: Dr. Simon Haworth BSc PhD is a British entrepreneur and investor now located in Vancouver, Canada. His primary role is as CEO of international drug discovery company Intellomx. His secondary role is as founder of the AI Life Sciences subgroup within the BC+AI artificial intelligence ecosystem. LinkedIn

About BC+AI Life Sciences subgroup: The AI Life Sciences subgroup meets monthly to address two objectives: at the global level, we seek to put BC on the AI Life Sciences map alongside Boston, San Francisco, Cambridge UK, Zurich and Shanghai. At the local level, we seek to apply our AI capabilities to make a difference in BC. This means addressing mental health and addiction, minority health discrimination and opportunities. Group membership crosses the life sciences sector: from doctors to investors, from business leaders to lawyers, from biotech scientists to AI experts, all within the umbrella organisation that is BC+AI.ca, founded by Kris Krug. bc-ai.ca/communities/life-sciences-ai

About Intellomx: Intellomx (Intelligent OMICS Limited) is a global drug discovery company originating from the UK. The company uses machine learning and AI to unravel the mysteries of causal biology and then to use that knowledge to identify novel drug targets, drug candidates and patient stratification for companion diagnostics across multiple disease areas — now including drug addiction. intellomx.com

About Data for Good: Data for Good was founded in 2013 and has 10 chapters and 8,000 volunteers across Canada from diverse fields — data engineering, analytics, data science, AI, etc. The organisation equips non-profits with the tools and expertise to better collect, analyse, and act on data, enabling them to make informed decisions, improve programme effectiveness, and demonstrate impact. vancouver.dataforgood.ca