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Am J Public Health. 2018 Oct;108(10):1394-1400. doi: 10.2105/AJPH.2018.304590. Epub 2018 Aug 23.

Modeling Health Benefits and Harms of Public Policy Responses to the US Opioid Epidemic.

Author information

1
Allison L. Pitt and Margaret L. Brandeau are with the Department of Management Science and Engineering, Stanford University, Stanford, CA. Keith Humphreys is with the Center for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, CA, and the Department of Psychiatry and Behavioral Sciences, Stanford University.

Abstract

OBJECTIVES:

To estimate health outcomes of policies to mitigate the opioid epidemic.

METHODS:

We used dynamic compartmental modeling of US adults, in various pain, opioid use, and opioid addiction health states, to project addiction-related deaths, life years, and quality-adjusted life years from 2016 to 2025 for 11 policy responses to the opioid epidemic.

RESULTS:

Over 5 years, increasing naloxone availability, promoting needle exchange, expanding medication-assisted addiction treatment, and increasing psychosocial treatment increased life years and quality-adjusted life years and reduced deaths. Other policies reduced opioid prescription supply and related deaths but led some addicted prescription users to switch to heroin use, which increased heroin-related deaths. Over a longer horizon, some such policies may avert enough new addiction to outweigh the harms. No single policy is likely to substantially reduce deaths over 5 to 10 years.

CONCLUSIONS:

Policies focused on services for addicted people improve population health without harming any groups. Policies that reduce the prescription opioid supply may increase heroin use and reduce quality of life in the short term, but in the long term could generate positive health benefits. A portfolio of interventions will be needed for eventual mitigation.

Comment in

PMID:
30138057
PMCID:
PMC6137764
DOI:
10.2105/AJPH.2018.304590
[Indexed for MEDLINE]
Free PMC Article

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