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Principal Investigator: BRADLEY D STEIN
Organization: RAND CORPORATION
Fiscal Year: 2024
Award: $110,475
Funding agency: National Institute on Drug Abuse
Abstract
Federal and state policymakers, advocates, and community officials have implemented multiple strategies,
policies, and initiatives to address dimensions of the rapidly evolving opioid crisis. There has been progress on
many fronts, including increased access to medication treatment for opioid use disorder, decreased
prescription of opioid analgesics, and greater access to naloxone. However, the majority of individuals with
opioid use disorder do not receive the most effective treatments, and rates of fatal opioid overdose continue to
grow, due in part to a shift to illicit opioids and the mixing of fentanyl with other illicit drugs. Societal costs of the
crisis were an estimated $1.02 trillion in 2017. There has been a surge of opioid policy studies, many
enhanced by data, tools, and methods developed by OPTIC. But policymakers and policy researchers remain
challenged by the rapidly evolving nature of the crisis, including the growing recognition that the opioid crisis is
increasingly a polysubstance crisis involving synthetic opioids and the acknowledgement that structural
inequalities and systemic racism have exacerbated the burden for certain populations. We need new methods
to help us better understand the effects of policies at the state level, and we need to understand the longer-
term effects of the crisis on communities, especially how those effects are influenced by structural inequities
and racial/ethnic disparities. OPTIC will continue to meet these needs, building on our achievements of the first
grant cycle. We will describe in detail the policies being adopted that are likely to affect opioid-related
outcomes and the evolving addiction crisis, specifically considering how particular elements differentially
influence at-risk, vulnerable, and historically disadvantaged populations. We will develop resources and
methods to support more robust and rigorous causal inference methods to evaluate policy effectiveness in both
the short and longer term across heterogeneous populations. We will create a series of simulation tools that
will inform and improve the methods opioid policy researchers and policy researchers more broadly utilize to
determine which policies are most effective for whom within the opioid crises. We will also continue to rapidly
and effectively disseminate resources, tools, and findings to the substance abuse research field, policymakers,
other stakeholders, and the general public. Rapid collection and dissemination of reliable data and robust
methods can dramatically increase the speed with which the substance abuse policy field can meet an
escalating demand for science-based information. OPTIC seeks to remain a leader in that effort and to enrich
its contributions as a national resource.
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