Report: Opioid crisis will get worse before it gets better

A research simulation examining the opioid crisis predicts that it will get worse before it gets better — and will cost 500,000 lives over the next 10 years. The number of people misusing prescription opioids or heroin is declining, but the risk of overdose has increased dramatically since 2013 due to the spread of fentanyl.

Mohammad Jalali, Ph.D., an investigator at Massachusetts General Hospital and an assistant professor at Harvard Medical School, in collaboration with the FDA has created a data-driven simulation model for the opioid crisis that incorporates feedback such as social influence and risk perceptions. Called SOURCE, the model has projected three key strategies that could save more than 100,000 lives over the next 10 years.

The three strategies must be implemented together and consist of fentanyl harm reduction, naloxone distribution, and recovery support for people in remission from opioid use disorder — the group at highest risk of overdose.

SOURCE found that reducing fentanyl risks from drug-checking services that support people to use drugs safely could dramatically reduce overdose deaths. It also shows that while increased distribution of the overdose reversal drug naloxone has helped mitigate this growing risk, naloxone’s positive effects still lag far behind the growing fentanyl threat. However, naloxone should nonetheless remain a key part of the nation’s overdose deaths prevention strategy, according to the researchers.

An article analyzing lifesaving strategies was published in Science Advances, while SOURCE is described in a research paper published in the Proceedings of the National Academy of Sciences.

SOURCE works by replicating 22 years worth of data on prescription opioid use and misuse, heroin use, overdose deaths and other related information. SOURCE can explain historical shifts in opioid use and determine, for example, that opioid risks deter potential users, shifting the biggest risks to those in remission in danger of relapse.

Researchers warn that a significant challenge in addressing the country’s opioid crisis is that policies based on past patterns of behavior may have unintended consequences because those patterns change over time.