Researching Effective Strategies to Prevent Opioid Death (RESPOND)

项目总结 在2021年4月至2022年3月期间，美国有超过10万人死于药物过量。作为阿片类药物 疫情扩大，过量用药的流行病学正在发生变化。在全国范围内，黑人和女性服药过量的比率 拉丁裔人口的增长速度是白人人口增长速度的五倍多。同样，在1999年- 2015年，女性处方阿片类药物过量使用率是男性的两倍多。 虽然阿片类药物供应的差异可以解释一些种族和性别差异，但我们 实施阿片类药物治疗也可能推动他们。因此，我们必须调查如何 实施应对阿片类药物危机的政策和干预措施影响健康公平。 研究预防阿片类药物死亡(RESPONSE)的有效策略是模拟模型和模拟模型 在一种状态下提供治疗。Response利用对扩展的公共卫生数据基础设施的投资来 通知模型参数，并促进NIDA资助的执行研究中的数据的新用途。我们 使用Response调查政策选择和健康的健康收益、成本和成本效益 预防阿片类药物过量的护理提供模式。在之前的资助期间，我们开发了Response和 已发表的研究预测了扩大可获得性的公共卫生和卫生经济影响 在各种环境下治疗阿片使用障碍(Moud)的药物。我们目前正在扩大响应范围 模拟肯塔基州、俄亥俄州和纽约州的结果。 我们现在建议加强对特别关注的人群的调查结果的反应 阿片类反应：1)有色人种社区和2)女性社区。然后我们将使用该模型来调查健康状况 规范OUD和INVERVICATION用药政策对经济和卫生公平的影响 为OUD患者提供护理服务的模式。我们将进行分销成本效益分析，这是 一种新兴的创新方法，用于调查最大化人口水平的利益和 确保公平分配成本和收益。我们的具体目标是： 目标1：加强应对模式，并将其调整为种族和性别分层目标，以便 关注关注阿片类药物危机的人群：有色人种和妇女 目标2：使用RESPONSE对不断变化的政策进行分布式成本效益分析 规范穆德方剂 目标3：雇用RESPONSE来调查临床、种族公平影响和经济价值 在OUD护理的每一步都支持吸毒者的干预措施。 我们使用响应来生成证据，以指导政策和干预措施的大规模实施 防止服药过量。在接下来的5年里，我们将继续成为OUD仿真建模领域的领导者。 并将把RESPESS作为阿片类药物危机中伸张正义的重要工具。

PROJECT SUMMARY Between April 2021 and March 2022, the U.S. endured over 100,000 drug overdose deaths. As the opioid epidemic expands, the epidemiology of overdose is changing. Nationally, the rate of overdose in Black and Latinx people is growing more than five times faster than it is among white people. Similarly, between 1999- 2015, the prescription opioid overdose rate among women increased at more than twice the rate for men. While differences in opioid supply could explain some racial and gender disparities, the ways that we implement opioid treatment could also drive them. It is therefore essential that we investigate how implementation of policy and interventions to address the opioid crisis impacts health equity. The Researching Effective Strategies to Prevent Opioid Death (RESPOND) is simulation model OUD and OUD treatment delivery in a state. RESPOND leverages investments in expanded public health data infrastructure to inform model parameters, and it catalyzes new uses of data from NIDA-funded implementation studies. We use RESPOND to investigate the health benefits, costs, and cost-effectiveness of policy choices and health care delivery models to prevent opioid overdose. In the previous funding period, we developed RESPOND and published studies projecting public health and health economic impacts of expanding the availability of medications for opioid use disorder (MOUD) in a variety of settings. We are currently expanding RESPOND to simulate outcomes in Kentucky, Ohio, and New York. We now propose to enhance RESPOND to investigate outcomes among populations of special interest to opioid response: 1) communities of color and 2) women. We will then use the model to investigate health economic and health equity impacts of policies regulating prescribing for medications for OUD and innovative care delivery models for people with OUD. We will perform distributional cost-effectiveness analyses, which is an emerging and innovative method to investigate trade-offs between maximizing population-level benefits and ensuring equitable distribution of costs and benefits. Our specific aims are: Aim 1: To enhance the RESPOND model and calibrate it to race and gender stratified targets in order to focus on populations of interest in the opioid crisis: people of color and women Aim 2: To use RESPOND to perform distributional cost-effectiveness analyses of changing policies regulating MOUD prescribing Aim 3: To employ RESPOND to investigate the clinical, racial equity impact, and economic value of interventions that support people who use drugs along each step of the OUD care cascade. We use RESPOND to generate evidence to guide large-scale implementation of policies and interventions to prevent overdose. In the coming 5-years we will continue to be leaders in the field of OUD simulation modeling and will employ RESPOND as an important tool for justice in the opioid crisis.