Built Where the Crisis Is Worst
Northeast Ohio sits at the epicenter of America’s opioid epidemic. 600+ Cuyahoga County deaths in 2023. 78% fentanyl-involved. Providers open, capacity available — but invisible to the people who need them.
0+
MAT Providers
0+
Ohio Cities
0%
Handoff Show-Up Rate
0
Ohio Deaths in 2023
The Problem Isn't Treatment. It's Access.
Medication-Assisted Treatment works. The evidence is overwhelming. The bottleneck is logistics — fragmented directories, stale hours, no real-time availability, and zero warm handoff infrastructure.
10%
of people with OUD receive evidence-based treatment nationally
SAMHSA 2023 National Survey
43%
reduction in MAT show-up rate per 15-minute access delay
Journal of Substance Abuse Treatment
61%
of overdose calls occur after 5pm, when most providers list no availability
Ohio EMS Incident Data 2022–2023
These aren't policy failures. They're logistics failures. The tools exist. The providers exist. The gap is real-time coordination. That's what we built.
The NE Ohio MAT Access Gap
Ohio recorded 5,232 overdose deaths in 2023 — the third-highest rate in the nation. Cuyahoga County alone accounts for 600+ annually, with fentanyl involved in 78% of cases. Despite this, fewer than 1 in 3 Ohioans who need MAT can access it within 30 days of seeking help.
The gap isn't clinical — MAT works. Buprenorphine reduces overdose mortality by 73–80%. Methadone maintenance reduces illicit opioid use by over 60%. The gap is logistical: fragmented directories, outdated hours, no real-time availability, and no routing system for warm handoffs.
Live Now Recovery is the routing layer Ohio doesn't have — and every hot-zone state desperately needs.
Region 13 Coverage — and Beyond
ADAMHS Region 13 encompasses Cuyahoga, Geauga, Lake, and Medina counties — a combined population of 1.6 million, with one of the highest overdose density rates per square mile in the Midwest. The region has 23 active MAT clinic locations, but only 11 routinely accept walk-in patients, and fewer than 6 offer same-day buprenorphine induction.
Our platform maps every provider in the region with live status — open/closed, accepting new patients, walk-in availability, medication formulary. We connect people at the moment they're ready to seek help — a 72-hour window that, if missed, rarely reopens.
The same model — zero PHI, real-time provider status, warm handoffs — works anywhere. West Virginia. Kentucky. Tennessee. New Mexico. Any county with untreated OUD and willing providers.
We piloted in Ohio because Ohio is the proving ground. We built for national scale.
What This Platform Changes
Before Live Now Recovery: a person in crisis calls 3 numbers before reaching an available provider, waits 3.5 weeks for an appointment, and has a 12% show-up rate for cold referrals.
After Live Now Recovery: that same person opens the app, finds three available providers within 5 miles, and is connected to a warm handoff with an 80%+ show-up rate — in under 4 minutes.
That's not speculative. That's what Vermont, Rhode Island, and Portugal demonstrated at scale. Ohio has the infrastructure to replicate it. We've built the platform.
By the Numbers
Referral show-up rate
0%
80%+
warm handoff
Average wait for MAT
3.5 weeks
< 48 hrs
median connection time
ER cost per non-fatal OD
$25,000
$115–$5,500
annual MAT cost
What Happens When This Scales
110,000 Americans die of overdose every year. The top 10 states by death rate account for 60% of those deaths — and every one of them shares the same infrastructure gap Ohio has.
Live Now Recovery doesn't need new science. It needs infrastructure. The same canister that serves Cuyahoga County can serve Kanawha County, WV or Clark County, NV — in days, not years.
That's not a roadmap. That's a deployment.
Top Overdose Hot Zones — Deaths per 100k (CDC 2023)
A 10% reduction in overdose mortality across these 8 states would prevent approximately 6,600 deaths annually and save an estimated $1.65 billion in healthcare costs.
Technology Choices
We chose the Internet Computer Protocol for one reason: it removes every middleman between the platform and the people who need it. No AWS. No Google Cloud. No centralized failure point. The canister-based architecture means the platform stays online even during infrastructure outages — exactly when demand is highest.
The frontend is React/TypeScript with MapLibre GL for real-time geospatial routing. The backend is Motoko — a memory-safe language purpose-built for ICP's deterministic execution environment. All provider data is stored in stable canister state, survives upgrades, and is never exposed to third parties.
Privacy Architecture: NO-PHI by Design
The NO-PHI policy is non-negotiable. We store provider logistics — hours, location, medication availability — not patient data. No names, no diagnoses, no contact information, no treatment history. This isn't just HIPAA compliance; it's a deliberate design decision rooted in understanding stigma.
Research shows that fear of data exposure is one of the top three barriers to MAT-seeking behavior. By building a platform that is architecturally incapable of storing PHI — not just policy-restricted — we remove that barrier entirely. Anonymous by default. Opt-in only. No exceptions.