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.

翻译：美国阿片类药物危机在2021年导致80,411人死亡。由于应对危机所需的大量资源和程序，医院、治疗机构及执法部门承受着巨大压力。因此，许多阿片类药物使用者从未获得或完成所需的治疗，反而频繁与医院或刑事司法系统产生交互。本文提出了一种离散事件仿真模型，用于评估三种阿片类药物使用障碍治疗政策：逮捕转诊、重返社会个案管理及过量用药转诊。研究采用威斯康星州戴恩县2011年至2019年的公开数据，预测了截至2032年的阿片类药物相关结果。通过分析多种政策组合的实施效果，本研究提供了一个灵活框架，用于评估不同实施层面的政策。结果表明，能够通过利用治疗服务创造新路径和项目，并成功转诊至少20%合格个体的治疗政策，可促成更具阿片类药物抵御力的社区。当实施更多政策或让更多个体受益时，效益会进一步增加。我们假设社区会增加治疗容量投资以满足增长的治疗需求。在政策组合中，如果因减少阿片类药物滥用、医院就诊及阿片类药物相关逮捕而节省的社会成本超过阿片类药物使用障碍的治疗成本，那么截至2032年的总节约金额将在704万至2973万美元之间。要扭转社区内的阿片类药物危机，治疗政策需与其他策略（如伤害减少、供应减少和预防使用）相结合。