The crisis is projected to claim more than half a million more lives from 2020 to 2032, although yearly deaths are on course to start falling before 2025.
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The model relied heavily on feedback loops: an increase in fatal overdoses due to the presence of fentanyl, for instance, might raise concern within a community and decrease overall use. This design successfully replicated how certain factors and interventions affected use, treatment, relapse and overdose deaths over 20 years. “We are dealing with a complex web of interconnected factors,” Jalali says. “As soon as you touch one part of the system, other parts are touched as well.
The researchers also determined which policy interventions were likely to have the greatest impact. Restricting prescriptions, for instance, would have very little effect, as most deaths are now caused by illicit fentanyl. But distributing naloxone or increasing the availability of addiction treatment would push the projections towards the more optimistic scenario.