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Digging out of the opioid epidemic won’t be easy, new model illustrates

Even substantial efforts in reducing opioid addiction, preventing overdoses and providing addiction treatment won't curb the crisis any time soon.

It’s taken over a decade to develop an opioid crisis that claimed the lives of an estimated 49,000 Americans last year. And the problem’s not going to go away any time soon, a new model by Stanford researchers suggests.

Margaret Brandeau, PhD, professor of management science and engineering, and her colleagues constructed a predictive statistical model to determine how changes in medical practices and health care policies may help stem the crisis. The results were published in the American Journal of Public Health and the news is not good.

The model recognizes that many people are introduced to opioids, or painkillers, after obtaining a prescription from a physician. But when the prescription runs out, it's often cheaper and easier to turn to street heroin, which has additional dangers associated with it including unknown ingredients and strength of the drug.

According to a Stanford Medicine press release:

If current trends prevail, the model projects that 188 million prescriptions would still be written in 2026, and that by then an estimated 4.3 million Americans would have become addicts through an initial exposure to pills. Pill-connected overdose deaths would likely soar to an estimated 50,000, compared with 38,000 in 2015.

But the researchers also considered a slightly more hopeful scenario. If opioid prescriptions were decreased, and the availability of the overdose antidote and addiction treatments were increased, than 6,000 overdose deaths could be prevented over 10 years.

“To effectively combat the epidemic, we need a portfolio of interventions,” said Brandeau. “We need policies to prevent individuals from becoming addicted in the first place, but we also need policies to treat addiction and mitigate its effects.”

That such great efforts would result in a limited effect is a reflection of the immensity of the opioid crisis, the researchers say. Recognizing that prescriptions must be diminished but that this will lead to more heroin overdoses is part of this complexity, and why this factor is included in the model, the researchers said.

They said they hope it will be used to inform health care policies concerning opioids.

“People want this to be over sooner, but the model shows that we’ve dug ourselves such a deep hole that it will take time to climb out,” Brandeau said.

Photo by Stefano Ghezzi

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