Abstract for: Reducing Opioid Use Disorder and Overdose in the United States: Model Development and Estimation

The opioid crisis is a major public health challenge in the United States, killing about 50,000 people a year. The crisis is a dynamically complex problem, with long delays and behavioural feedbacks playing an important role. In 2017, the National Academies of Science, Engineering, and Medicine recommended the development of a quantitative systems model to guide Federal government policy to address the crisis. Here we present an opioid systems model [OSM] developed in response to that charge. This paper presents model structure, specification, and estimation; forward‐looking policy analyses are presented in another paper. Our baseline model estimates highlight the role of various drivers of the crisis, including the impact of supply‐side changes, behavioural risk responses, and the competing influences of illicit fentanyl and overdose prevention efforts. These estimates yield the most thorough quantitative understanding of the historical trajectory of the crisis available to date.