The opioid crisis: need for systems science research

Abstract

The opioid epidemic in the United States has had a devastating impact on millions of people as well as on their families and communities. The increased prevalence of opioid misuse, use disorder and overdose in recent years has highlighted the need for improved public health approaches for reducing the tremendous harms of this illness. In this paper, we explain and call for the need for more systems science approaches, which can uncover the complexities of the opioid crisis, and help evaluate, analyse and forecast the effectiveness of ongoing and new policy interventions. Similar to how a stream of systems science research helped policy development in infectious diseases and obesity, more systems science research is needed in opioids.

Dynamics of Parental Opioid Use and Children's Health and Well-Being: An Integrative Systems Mapping Approach

“…Considering that many readers may be new to systems thinking in general, and that only a handful of studies have conducted systems mapping of the opioid epidemic in particular (Jalali et al, 2020), we begin by describing the basic components of systems thinking and systems mapping. We then detail the specific methodology applied to the development and refinement of the causal loop diagram that is the focus of the current study.…”

Data Needs in Opioid Systems Modeling: Challenges and Future Directions

“…Simulation modeling accomplishes this by drawing on disparate data sources, including qualitative structural data on system functioning, to help answer "what if" policy questions through policy projections. 18 Simulation models that integrate a systems perspective and whose model outcomes result from the inter-relationship of risk factors as a function of time (e.g., system dynamics, agent-based, dynamic compartment-hereafter, systems modeling or systems models) provide further insight by accounting for the dynamic interactions of complex systems, which can produce unintended consequences, policy resistance, and "worse before better" scenarios. 19 Systems modeling is unique in its ability to support a trade-off analysis of prospective policy decisions where time-varying outcomes are critical to consider.…”

“…19 Systems modeling is unique in its ability to support a trade-off analysis of prospective policy decisions where time-varying outcomes are critical to consider. It can assist researchers and policymakers in surfacing counterintuitive insights and potential interactive and synergistic effects of policies 18 (both negative and positive) and conducting economic evaluation (E Beaulieu, MA, unpublished data, May 2020) (e.g., cost-effectiveness analysis) before policy implementation in the real world. For instance, opioid systems models 20 have been developed to test the simultaneous expansion of different evidence-based interventions that reduce overdose mortality, such as widespread naloxone distribution and increased access to medications for opioid use disorder (OUD).…”

“…More discussion about the benefits, weaknesses, and uses of different modeling methods, as well as the type of policy questions they can answer, can be found elsewhere. 18,23,24 Systems modeling has been applied widely to public health issues and epidemics for which insufficient data or high levels of uncertainty make more traditional analytic approaches infeasible. 25−27 Examples include large-scale models developed by multiple teams such as the Cancer Intervention and Surveillance Modeling Network for cancer, 28 Framework for Reconstructing Epidemiological Dynamics for infectious diseases, 29 CommunityFlu for influenza, 30 and projects that have developed models for obesity 31 and post-traumatic stress disorder.…”

“…More discussion about the benefits, weaknesses, and uses of different modeling methods, as well as the type of policy questions they can answer, can be found elsewhere. 18 , 23 , 24…”