Reducing Opioid Use Disorder and Overdose in the United States: Model Development and Policy Analysis

Mohammad Jalali, PhD
Harvard University

Wayne Wakeland, PhD
Portland State University

ABSTRACT:
The opioid crisis is one of the most pressing public health issues in the U.S. today. Opioid overdoses are the proverbial “tip of the iceberg,” arising within a complex adaptive system characterized by rapidly changing dynamics combined with significant time lags and large uncertainties in the data. System dynamics modeling is a critical tool to guide policymaking and avoid unintended consequences. We developed a simulation model of the opioid system, spanning from medical use of prescription opioids to opioid misuse and heroin use, use disorder, treatment, and remission. The model aims to help policymakers address the crisis by aiding in policy analysis and decision-making under uncertainty. We project the effects of several policies to reduce opioid use disorder and overdose, and analyze intended and unintended effects of the policies over the next 10 years. Model simulations suggest most policies implemented on their own will achieve only modest reduction in either fatal overdoses or prevalence of OUD.