LAnea George opens the steel security door and enters a windowless room, where a device resembling a commercial-grade refrigerator awaits. Dubbed the Bodhi, it dispenses seven small plastic bottles, each containing precisely 70ml of methadone, an alternative to morphine or heroin in addiction treatment.
She takes the bottles from the tray, bundles them with rubber bands, and places them on the shelf. It’s not even 10 am, and George, the nurse manager at Man Alive—a well-known opioid treatment program in Baltimore—has already prepared doses for about 100 patients set to arrive the following day. “Bodhi has transformed my life and the lives of my patients,” she states.
Preparing these prescriptions requires more than merely pouring medication into bottles. This process involves printing each label individually, measuring the amounts accurately, sealing the bottles, and capping them securely. If there are spills, the nurse must stop to collect the lost liquid, measure it, document the incident, and dispose of it properly.
Repeating this procedure over 100 times illustrates why the task can take an entire day before Bodhi even arrives. George notes that many nurses leave the profession, often due to issues like carpal tunnel syndrome from repeatedly screwing caps on multiple bottles daily.
“I’ve seen nurses just walk off shifts and never return,” she reflects on her previous clinic.
Now, with more time freed up, George can focus on patient interaction. “It allows me to be more personal and have deeper conversations,” she remarks. “That’s where we uncover a lot of important information.”
Injecting Humanity into Addiction Treatment
This increase in patient interaction was the motivation behind the machine that George uses daily. Amber Norbeck, a pharmacist in the neonatal intensive care unit at Montana Hospital, noted that 50% of newborns experience withdrawal symptoms due to maternal opioid addiction.
Methadone therapy can help these women become mothers, but access is often problematic. The clinic she visited had a 30-60 day waiting list, and other patients faced three-hour waits despite a shortage of nursing staff during visits. Some patients must return daily for doses.
“It didn’t feel like healthcare; it felt more like a bank teller experience,” she explains. “For working individuals trying to manage their lives, the lengthy process often led them to give up.”
With U.S. overdose deaths from opioids rising from around 8,000 in 2009 to over 114,000 in 2022, Norbeck recognized a nation grappling with the opioid crisis amid a nursing shortage. In 2019, she and engineer Mike Pokolny began devising methods to automate the methadone dosing process.
They developed a robotic device capable of dispensing liquid medication in seconds, sealing, labeling, and capping each bottle. A year later, Norbeck left her hospital position, and in January 2021, the duo founded Opio Connect Inc, with Norbeck serving as CEO and Pokolny as vice-chairman.
They named the device Zing, utilizing components designed for other machines for a quicker assembly. “Existing pharmacy automation solutions weren’t designed for the variations required for dispensing methadone,” states Sam Wilson, Opio’s COO.
Pandemic Era Methadone Rules Support Automation
The introduction of Zing coincided with the Covid-19 pandemic, which provided an unexpected boost. Pre-pandemic, patients labeled “stable” could take home multiple doses, but during lockdowns, federal authorities relaxed these rules, allowing them to receive up to 28 days’ worth of medication.
While this policy shift intensified preparation and nurse workloads, post-Covid data revealed no significant patient benefits. The new take-home rules became permanent in January 2024.
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By then, the first Zing was deployed at Compdrug, an opioid treatment program in Columbus, Ohio, affectionately nicknamed Alfie. Seven additional Zings were installed across the country, each receiving its own name. This humanizing aspect led to naming contests, birthday celebrations, gender awareness events, and Halloween costumes. Together, they have assembled over 1 million methadone doses.
Norbeck anticipates that 30-40 more Zings will be operational by the end of 2025. The company is targeting 2,100 clinics and correctional facilities nationwide, emphasizing that many individuals require treatment, yet attracting nursing staff remains a challenge.
Automated Labor: Job Loss or Mitigating Labor Shortages?
Norbeck is uncertain about job losses attributed to Zing, but some clinics found themselves able to keep open positions unfilled, reallocating savings to other treatment initiatives.
“There was concern that [Zing] would replace nurses, but its true purpose is to liberate them,” explains Pokolny.
Compdrug previously employed six nurses to administer methadone throughout the day. Currently, with Zing’s assistance, only three handle dosing while the other three focus on telehealth. All six remain employed.
At Man Alive, Bodhi’s introduction has allowed George additional time, enabling her to also serve as a home nurse, assisting patients in connecting with medical care and following up on medication and health concerns.
However, it’s important to recognize another facet to these scenarios. Unfilled positions, whether in telehealth or home health, may exist regardless of robotic assistance. According to the Health Resources and Services Administration, the nursing workforce is projected to face a shortage of over 63,720 nurses by 2030, not accounting for losses incurred during the pandemic.
Norbeck believes that robotics can be a means to alleviate employment shortages rather than exacerbate them.
In Baltimore, George and her fellow nurses at Man Alive have organized educational initiatives in the community, further connecting with patients through participation in in-house group therapy sessions. Simply put, George states, “Bodhi has allowed me to rediscover my role as a nurse.”
Source: www.theguardian.com
