Center to Advance Research Excellence (OPTIC)

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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.