Dynamic Computational Models and Simulations of the Opioid Crisis: A Comprehensive Survey

Opioids have been shown to temporarily reduce the severity of pain when prescribed for medical purposes. However, opioid analgesics can also lead to severe adverse physical and psychological effects or even death through misuse, abuse, short- or long-term addiction, and one-time or recurrent overdose. Dynamic computational models and simulations can offer great potential to interpret the complex interaction of the drivers of the opioid crisis and assess intervention strategies. This study surveys existing studies of dynamic computational models and simulations addressing the opioid crisis and provides an overview of the state-of-the-art of dynamic computational models and simulations of the opioid crisis. This review gives a detailed analysis of existing modeling techniques, model conceptualization and formulation, and the policy interventions they suggest. It also explores the data sources they used and the study population they represented. Based on this analysis, direction and opportunities for future dynamic computational models for addressing the opioid crisis are suggested.

The Public Health Approach to the Worsening Opioid Crisis in the United States Calls for Harm Reduction Strategies to Mitigate the Harm From Opioid Addiction and Overdose Deaths

ABSTRACT The opioid crisis has devastated the U.S. more than any other country, and the epidemic is getting worse. While opioid prescriptions have decreased by more than 40% from its peak in 2010, unfortunately, opioid-related overdose deaths have not declined but continued to increase. With greater scrutiny on prescription opioids, many users switched to the cheaper and more readily available heroin that drove up heroin-related overdose deaths from 2010 to peak in 2016, being overtaken by the spike in synthetic opioid (mostly fentanyl)-related overdose deaths. The surge in fentanyl-related overdose deaths since 2013 is alarming as fentanyl is more potent and deadly. One thing is certain the opioid crisis is not improving but has become dire with the surge in fentanyl-related overdose deaths. Evidence-based strategies have to be implemented in the U.S. to control this epidemic before it destroys more lives. Other countries, including European countries and Canada, have invested more in harm reduction strategies than the U.S. even though they (especially Europe) do not face anywhere near the level of crisis as the U.S. In the long-run, upstream measures (tackling the social determinants of health) are more effective public health strategies to control the epidemic. In the meantime, however, harm reduction strategies have to be employed to mitigate the harm from addiction and overdose deaths.

The Public Right and Wrongs: Tort Theory and the Problem of Public Nuisance

Tort theory over the past two decades has been characterized by a fruitful dialectic between two models. Instrumentalism, especially, in its deterrence mode, has been promoted by a wide coalition of scholars and jurists. In response, various critics of instrumentalism have argued for the autonomy of tort law, first under the umbrella of corrective justice and later under civil recourse. The success of civil recourse depends in part on its ability to explain emerging areas of focus in tort law. One such area is public nuisance, which, despite some setbacks, is viewed by the plaintiffs bar, state actors, and some members of the academy as an effective tool to address significant social problems, such as the opioid crisis. This article asks whether, and how, civil recourse theory can accommodate modern public nuisance law.