Current policy interventions aiming to curb opioid-related deaths are unlikely to be effective in the coming years, according to a study published in JAMA Network Open.
Investigators sought to examine the short-term effects of interventions intended to minimize misuse of prescription opioids. Employing a system dynamics model of the opioid epidemic in the United States, the researchers projected outcomes of simulated individuals using opioids illicitly or nonmedically from 2016 to 2025. The researchers developed a mathematical model, the Opioid Policy Model, by gathering data from the National Survey on Drug Use and Health, the Centers for Disease Control and Prevention, and other published sources on opioid overdose deaths that occurred between 2002 and 2015. Individuals were categorized into 3 groups: those taking prescription opioids for nonmedical purposes and who had not been diagnosed with opioid use disorder (OUD), those with prescription OUD, and those taking illicit opioids with or without prescription OUD.
In 2015, there were 33,100 deaths in the United States from opioid overdose. According to the Opioid Policy Model, the total number of opioid-related deaths is projected to rise to 81,700 annually by 2025, (a 147% increase from 2015), with 67,900 of these deaths are predicted to result from illicit opioid use (1 259% increase from 2015). The model predicts that overdose deaths from prescription opioids (with or without OUD) will decrease from 14,200 in 2015 to 13,800 in 2025, corresponding with a 3% decrease from 2015.
A total of 700,400 opioid overdose deaths are predicted to occur between 2016 and 2025, 80% of which will be caused by illicit opioid use. The number of illicit opioid users is projected to increase by 61% from 0.93 million in 2015 to 1.50 million in 2025.
An additional 50% lowering of prescription opioid misuse incidence from 2015 levels would be associated with a 3.0% to 5.3% decrease in overdose deaths.
Study limitations include a possible underestimation of current opioid overdose deaths.
“Given these findings, policymakers will need to take a stronger and multipronged approach, such as improving access to treatment, expanding harm-reduction interventions, and lowering exposure to illicit opioids, to curb the trajectory of the opioid overdose epidemic in the United States,” concluded the study authors.
Chen Q, Larochelle MR, Weaver DT, et al. Prevention of prescription opioid misuse and projected overdose deaths in the United States. JAMA Netw Open. 2019;2:e187621.