Expanding the Opioids System Model to more comprehensively incorporate fentanyl, stimulants use, polysubstance use and associated outcomes.

In 2018, OPSA launched an effort to develop of a quantitative system-dynamic model of the opioid crisis to help FDA a) understanding the complexity of the interconnected mechanisms of the crisis, and b) assess potential impacts (intended and unintended) of possible policy actions to address the crisis. In Sept 2019, OPSA awarded a 1-year cooperative agreement (Harvard/Mass General; FDA's RFA-FD-19-026) to complete an initial version of the model ready for policy analysis, and in Aug 2020, OPSA awarded a 1-year cooperative agreement (Harvard/Mass General; FDA's RFA-FD-20-031) to account for societal outcomes beyond overdose as well as cost-effectiveness of potential policies. The current proposal will expand the FDA's model to more comprehensively incorporate fentanyl, stimulants and polysubstance use and their interactive effects on opioids use, misuse, addiction, use disorder treatment, and associated outcomes. The main focus of this project would be on modeling the growing number of opioid overdose deaths involving people who are primarily stimulant or polysubstance users, as an important emerging aspect of the opioids crisis. The research will also include quantification of the effects of harm reduction approaches (e.g., naloxone distribution to opioid users, increasing treatment availability for Opioid Use Disorder [OUD]) on overdoses involving fentanyl and other polysubstance use . Additionally the research will identify and incorporate aspects of mental health that are feasible for inclusion into the model.