Truth Decay

Opioids Uncharted

A RAND initiative to map the unexplored consequences of America's opioid crisis—and discover big-picture solutions.

Opioid overdoses claim the lives of 130 Americans each day. And yet the devastating effects of the opioid crisis don't stop there.

The social and economic consequences of opioid overdoses and addiction are disrupting human lives and societal systems in ways that have yet to be fully explored—until now.

This RAND research initiative is a multifaceted, interdisciplinary effort to map the contours of America's opioid problems. Our goal is to chart a holistic understanding of the crisis and help inform and create policy solutions.

Research Questions

  • How did the opioid crisis get to this point, and what could the future look like?
  • Which major systems affect—and are affected by—the opioid crisis?
  • How do these systems interact?
  • How do the parts of each system affect individuals and families?
  • What are the barriers and opportunities to positive change?

Mapping Underexplored Consequences

The uncharted territory of the opioid crisis is comprised of a series of deeply connected systems, including

  • people who use opioids and their families
  • specialty treatment system for opioid use disorders
  • medical care
  • criminal legal system
  • illegal supply and supply control
  • harm reduction and community-initiated interventions
  • first responders
  • child welfare
  • income support and homeless services
  • employment
  • education.

There are countless ripple effects that occur within these systems, spurring new problems and complicating potential solutions to the opioid crisis.

That's why RAND researchers are adopting a holistic perspective, rather than the siloed approach that has allowed the opioid crisis to worsen.

Latest Publications

  • Closeup of six water drops surrounding a larger drop on a green leaf, photo by ThomasVogel/Getty Images

    Report

    America's Opioid Ecosystem

    This comprehensive RAND book provides a nuanced assessment of America's opioid ecosystem and includes chapters on ten major components: substance use disorder treatment, harm reduction, medical care, the criminal legal system, illegal supply and supply control, first responders, the child welfare system, income support and homeless services, employment, and education. Researchers offer several portfolios of action that could help decisionmakers prioritize and organize their efforts to address problems associated with opioid use.

  • Visualization representing the opioids ecosystem—A person who uses opioids and their family are at the center and there are ten components in a circle around them including medical care, criminal legal system, illegal supply and supply control, harm reduction, first responders, child welfare, income support and homeless services, employment, education, and substance use disorder treatment.

    Visualization

    The Ecosystem Approach to Opioid Policy

    Researchers at the RAND Corporation are thinking beyond traditional silos to solve problems within America's Opioid Ecosystem. This framework can help federal, state, and local policymakers better understand the dynamics of our opioid-involved problems—and explore innovative and evidence-based solutions.

Project Leaders

More from Opioids Uncharted

  • Report

    Synthetic Opioids: An Unprecedented Crisis

    The rise of fentanyl and other synthetic opioids is unlike any drug crisis in U.S. history. Limiting policy responses to existing approaches will likely be insufficient and may condemn many people to early deaths.

  • Extended hand showing a representation of link between points, photo by vegefox.com/AdobeStock

    Testimony

    Approaching the U.S. Opioid Crisis as an Ecosystem

    Policymakers should think of the opioid crisis as an ecosystem and consider how its many parts interact—especially in unexpected ways. A broader view of the crisis will help those confronting it better prepare for the challenges ahead.

  • Fentanyl in a vial, photo by designer491/Getty Images

    Commentary

    What Will the Opioid Crisis Look Like in Five Years?

    Evidence suggests that once a synthetic opioid like fentanyl becomes dominant in a drug market, it stays that way. With that in mind, the United States should prepare for these drugs as a lasting phenomenon.

  • Bags of fentanyl and heroin that were seized by authorities, photo by United States DEA

    Commentary

    Tackle Fentanyl like a Poisoning Outbreak, Not a Drug Epidemic

    America's fentanyl problem is far deadlier than past crises with other illegal drugs. New ideas, be they public policies, technologies or law enforcement strategies, are desperately needed. Continuing to treat fentanyl just like previous drug epidemics will likely be insufficient and may condemn thousands more to early deaths.

  • Overdose rescue kits on a table during an Opioid Overdose Prevention Training class provided by Lourdes Hospital in Binghamton, New York, April 5, 2018

    Report

    Synthetic Opioid Surge Is a U.S. Public Health Emergency

    In less than six years, the number of fatal overdoses in the United States that involve synthetic opioids has increased tenfold. Where are synthetic opioids concentrated? And to what extent is the problem spreading?

  • RAND physician policy researcher Tisamarie Sherry discusses the U.S. opioid crisis at a RAND event in Pittsburgh, April 10, 2019, photo by Michael Reed Photography

    Blog

    A Holistic Approach to Solving the Opioid Crisis

    While federal, state and, local governments deploy strategies to tackle the opioid crisis, the problem continues to proliferate. RAND researchers suggest that these strategies fail to solve the larger problem because they've largely been developed in silos. The opioid crisis is an ecosystem, and mitigating the problem will require a holistic approach.

  • Bryce Pardo gives an overview of testimony presented before the House Committee on Homeland Security, Subcommittee on Intelligence and Counterterrorism and Subcommittee on Border Security, Facilitation, and Operations, on July 25, 2019.

    Multimedia

    Illicit Supply of Fentanyl and Other Synthetic Opioids

    An overview of testimony by Bryce Pardo presented before the House Committee on Homeland Security, Subcommittee on Intelligence and Counterterrorism and Subcommittee on Border Security, Facilitation, and Operations, on July 25, 2019.

Explore more RAND research on opioids

Funding for This Project

Funding for the Opioids Uncharted project was provided by gifts from RAND supporters and income from operations. Philanthropic contributions support RAND’s ability to take the long view, tackle tough and often-controversial topics, and share our findings in innovative and compelling ways.