Abstract for: Modeling the Opioid Crisis to Support National Policy Development
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. As part of a collaboration between the U.S. Food and Drug Administration (FDA) and Harvard Medical School, 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. Our model, developed through a series of expert interviews and estimated using historical data and extant literature, replicates several key historical trends, including overdose deaths and incidence and prevalence of various opioid use states. This model could be used to analyze policies in several areas of potential interest to the FDA and other government agencies, and to identify key leverage points for addressing the crisis. Sensitivity analysis also reveals priority areas for further data collection and structural refinement.