PT - JOURNAL ARTICLE AU - Shriya Srinivasan AU - Khalil B. Ramadi AU - Andrea Ippolito AU - Rifat Atun TI - Democratizing innovation through grass-roots entrepreneurship: lessons from efforts to address the opioid epidemic in the United States AID - 10.1136/bmjgh-2019-002079 DP - 2019 Dec 01 TA - BMJ Global Health PG - e002079 VI - 4 IP - 6 4099 - http://gh.bmj.com/content/4/6/e002079.short 4100 - http://gh.bmj.com/content/4/6/e002079.full SO - BMJ Global Health2019 Dec 01; 4 AB - The nationwide opioid epidemic has substantially impacted economically-depressed regions in the USA. Eastern Appalachia has some of the lowest socioeconomic indicators in the USA and has suffered the highest rate of opioid-related fatality in 2016. Despite devoting considerable federal and state resources towards public health initiatives, the region continued to experience one of the highest death rates and sought alternative approaches to address the opioid crisis. Here, we describe a community-based co-creation initiative that convened diverse sectors and utilised design thinking principles to generate sustainable public health ventures towards addressing the opioid crisis. Participants of diverse backgrounds came together to attack key challenges and developed and implemented solutions, including a mobile application for naloxone delivery and exercise programs for high schools to promote healthy habits. Grassroots innovation efforts catalysed by the event strengthened community engagement and facilitated a sense of agency among participants. Through specific examples of initiatives that were launched, we provide evidence to encourage and highlight the value of healthcare innovation efforts in low-resource settings.