Abstract for: Modeling Opioid Crisis in Canada: a Systems Approach to Policy and Intervention Strategies

The opioid crisis remains a public health burden, with recent trends in Canada paralleling those in the US. This study builds on SOURCE (Simulation of Opioid Use, Response, Consequences, and Effects), a national-level model developed to guide policy decisions in the US. Recognized for its evidence-driven approach, SOURCE incorporates feedback mechanisms—drug availability, social influence, and risk perception—that capture the dynamic nature of opioid use and overdose. We adapted and calibrated SOURCE to the Canadian context, incorporating differences in opioid use patterns, such as the availability and coverage of medications for opioid use disorder. Using data from surveys, IQVIA, and public health datasets from 2009 to 2023, the model estimates number of people who use opioids and with opioid use disorder, and overdose rates. The model evaluates the future impacts of nine strategies, spanning harm reduction, reducing use disorder, and recovery support. Twelve-year projection results indicate that prescription opioid-related overdoses will continue to decline, but heroin/illegal synthetic deaths will remain high. Trade-offs can occur while implementing the strategies, such as fentanyl risk reduction lowering overdoses but increasing opioid use disorder insidence. A combined approachoffers the greatest impact. This model helps policymakers assess interventions to address Canada’s opioid crisis.