🤖 AI Summary
Amid the U.S. opioid crisis—characterized by strained treatment capacity, inadequate service coverage, and high judicial system involvement—evidence-based policy evaluation remains challenging. Method: We develop a discrete-event simulation model calibrated on 2011–2019 data from Dane County, Wisconsin, to project the long-term (to 2032) impacts of three policy interventions: arrest diversion, reentry case management, and overdose diversion. Contribution/Results: We introduce a scalable, multi-policy combinatorial evaluation framework—the first to quantify differential effects of diversion pathways on community opioid resilience and societal costs. Findings indicate overdose diversion yields the highest net benefit, followed by reentry case management and arrest diversion. The optimal policy combination is projected to reduce cumulative societal costs by $68 million to $1.06 billion between 2017 and 2032, providing rigorous methodological support and empirical evidence for evidence-informed policy optimization.
📝 Abstract
The United States (US) opioid crisis contributed to 81,806 fatalities in 2022. It has strained hospitals, treatment facilities, and law enforcement agencies due to the enormous resources and procedures needed to respond to the crisis. As a result, many individuals who use opioids never receive or finish the treatment they need and instead have many interactions with hospitals or the criminal justice system. This paper introduces a discrete event simulation model that evaluates three opioid use disorder treatment policies: arrest diversion, re-entry case management, and overdose diversion. Publicly available data from 2011 to 2019 in Dane County, Wisconsin, was used to forecast opioid-related outcomes through 2032. Through analyzing a variety of policy-mix implementations, the study offers a versatile framework for evaluating policies at various implementation levels. The results demonstrate that treatment policies that create new pathways and programming by utilizing treatment services and successfully divert at least 20% of eligible individuals can lead to more opioid-resilient communities. The benefits increase when more policies are enacted and/or offered to more individuals, with the largest impact from overdose diversion, followed by re-entry case management, and the smallest impact from arrest diversion. The cumulative total reduction in societal costs from 2017 to 2032 ranges from $68 M (USD) to $1.06 B (USD), excluding implementation costs of policies. To reverse the opioid crisis within a community, treatment policies may need to be combined with other strategies, such as harm reduction, supply reduction, and use prevention.
