Mohammad S. Jalali — the principal investigator for a joint simulation modeling project between Harvard researchers and the Food and Drug Administration — presented his lab’s ongoing efforts to accurately model the opioid crisis during a Harvard School of Public Health seminar on Tuesday.
Hosted by the Center for Health Decision Science, the event outlined existing research on opioid usage in America, the model’s development, and tentative results. Health policy professor Joseph S. Pliskin and senior research scientist Lisa A. Robinson served as moderators.
Due to agreements with the FDA, however, the model’s results must remain confidential to the public until publication in roughly four months, according to Jalali.
In an interview after the seminar, Jalali said he believes opioids constitute one of the largest public health emergencies the country faces.
“The opioid crisis is such a complex problem,” he said. “It's the second biggest crisis that we are dealing with after Covid-19, which is affecting a lot of lives.”
Opioids include prescription painkillers like morphine, as well as illicit drugs such as heroin.
Jalali described the opioid crisis as a multi-layered system that includes the health of the individual, those around them, the illicit drug market, legal prescription practices, and the larger healthcare and justice systems. Owing to the complexity of the problem, he said designing and implementing a good intervention or policy strategy is difficult.
“To solve the problem, you have to take a systematic approach,” he said. “You have to understand that if you make an input or a major change in one part of the system, other parts of the system might also be affected.”
To account for that interdependence, Jalali’s research team created a comprehensive “systems model” to mathematically and computationally describe how the layers of the opioid crisis interact.
“The model is tracking the trajectories of opioid use, including initiation, misuse, opioid, heroin and fentanyl disorder development, overdose deaths, remission, and relapse,” he said.
While taking a systems modeling approach to understanding opioid usage is not a new concept, Jalali and his multidisciplinary team from Harvard, MIT, Stanford and the University of Washington considered a much larger data set than previous research efforts, per Jalali.
The model’s increased scope also allowed Jalali and his team to observe “important mechanisms” that previous smaller scale research was unable to capture. Those include feedback loops, social influences, and how the perception of risk varies in different populations.
Jalali added that the model is “grounded in the literature” and “data-driven.”
“The model is ultimately able to replicate historical data, and it can help us explain what's going on,” he said.
Once published, Jalali said he hopes the model will “inform national policymaking” and “high-level population-based decision making” regarding responses to the opioid crisis. He added the FDA will also use the model to inform and expand its “decision making process.”
Though opioid overdoses kill roughly 50,000 people in the U.S. every year, Jalali said these overdoses are only “the tip of the iceberg” when it comes to the opioid crisis in America.
“For every person who dies, there are hundreds more suffering from addiction, or at risk of it,” he said. “Every person who dies and every family ravaged by addiction is a real human tragedy.”