Abstract for: Advancing Understanding of Opioid-Related Overdose Mortality in Connecticut Through Simulation

In recent years, the state of Connecticut has experienced rapid changes in morbidity and mortality related to opioid-involved overdose which are influenced by numerous factors that are hard to quantify and examine. State agencies and public health organizations have sought to improve responses to opioid morbidity and mortality through evidence-based interventions, but due to the complexity of the problem, it may be hard to measure the impact of such interventions. A simulation model was developed at the Connecticut state level based on previously validated model structure. The simulation model was calibrated to historic data and validated by content experts and other partners. Scenarios were developed in order to better understand the primary factors driving overdose fatalities. These scenarios were (1) limiting any drop in potency of opioid supply (2) limiting medications for opioid use disorder (MOUD) availability (3) limiting statewide naloxone distribution. The scenario which prevented any drop in potency of opioid supply after 2021 had the greatest influence on overdose fatalities. The policy scenario, which limited distribution of naloxone distribution to 2019-level had a moderate effect. In comparison, the scenario which limited growth of MOUD availability had little effect. The most prominent factor affecting opioid-involved overdose was preventing a change in potency, which caused an additional 362 opioid-involved overdoses to occur each year on average compared to the base run simulation. The limited effect of expansion of MOUD may have been due to its primary effect on reducing OUD prevalence and subsequent long-term effects on reducing fatalities. Scenario testing proved valuable in helping to identify potency as the most prominent factor.