Evaluating diversion and treatment policies for opioid use disorder

The United States opioid crisis contributed to 80,411 fatalities in 2021. It has strained hospitals, treatment facilities, and law enforcement agencies due to the enormous resources and procedures needed to respond to the crisis. As a result, many individuals who use opioids never receive or finish the treatment they need and instead have many interactions with hospitals or the criminal justice system. This paper introduces a discrete event simulation model that evaluates three opioid use disorder treatment policies: arrest diversion, re-entry case management, and overdose diversion. Publicly available data from 2011 to 2019 in Dane County, Wisconsin, was used to forecast opioid-related outcomes through 2032. Through analyzing a variety of policy-mix implementations, the study offers a versatile framework for evaluating policies at various implementation levels. The results demonstrate that treatment policies that create new pathways and programming by utilizing treatment services and successfully divert at least 20% of eligible individuals can lead to more opioid-resilient communities. The benefits increase when more policies are enacted and/or are offered to more individuals. We assume communities invest in increasing treatment capacity to meet increased treatment demand. In policy-mixes where societal savings from decreased opioid use, hospital encounters, and opioid-related arrests outweigh the costs of opioid use disorder treatment, the 2032 total savings range from $7.04 to $29.73 million. To reverse the opioid crisis within a community, treatment policies may need to be combined with other strategies, such as harm reduction, supply reduction, and use prevention.