Large Data Spatiotemporal Modeling of Optimal Combinations of Interventions to Reduce Opioid Harm in the United States

The goal of this project is to prevent and reduce deaths and injuries due to opioids in the United States by determining the best combination of state and local laws regulating overdose and infectious disease prevention services that are needed to reduce overdose rates and save lives. To do this, we will: 1) conduct original review of laws regulating overdose and infectious disease prevention services in the 482 U.S. municipalities with >75,000 people and in the states in which they are located; 2) create an extensive national dataset by merging data on state and local laws regulating overdose and infectious disease prevention services; emergency department and fatality data; information on local overdose and infectious disease prevention services; and socioeconomic indicators; 3) use the merged dataset to determine which combinations of state and local laws have resulted in the biggest decreases in overdoses and related health outcomes; and 4) determine which local characteristics enhanced those effective combinations of laws. Overdose deaths in the United States increased more than six-fold since 2001, and now account for more loss of life than high blood pressure, AIDS, and pneumonia. States and municipalities are combating this epidemic by passing laws to reduce overdoses, and by investing in access to overdose and infectious disease prevention services, including lifesaving overdose reversal medications (e.g., naloxone) and testing supplies (e.g., fentanyl and xylazine test strips). But these efforts are often undertaken in isolation and without considering how the different state and local laws interact or how local factors like access to overdose and infectious disease prevention services influence their effectiveness. This project will help answer those questions by using large data and powerful analytics to bring together all the evidence on this complicated topic. At the end of the project, we will be able to answer the following questions: What combinations of state and local laws regulating overdose and infectious disease prevention services most effectively prevent and reduce opioid deaths and injuries in the United States? And how can local jurisdictions most effectively implement these legal frameworks to maximize public health benefit?