Mathematica Policy Research, self-described as a “nonpartisan research organization dedicated to improving public well-being,” has developed tools designed to help healthcare providers, states, and policymakers address the opioid crisis.1

The first of these tools, Stopping the Transmission of Opioids to the Next Generation (S.T.Op NextGen), in the form of a dynamic dashboard, allows clinicians treating women of childbearing age with opioid use disorder to estimate risks associated with pregnancies in this patient population.2 By the patient’s Zip code, as well as demographic information, including age, race, ethnicity, pregnancy status, and education level, the tool provides an estimate of the risks for opioid misuse (and associated factors) and opioid-related deaths (in the Zip code compared with the national average), as well as a locator of facilities offering treatments for opioid use disorder (based on data from the US Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration). 

This tool thus provided clinicians with information to make evidence-based clinical decisions. “By letting data speak, we expand the possible insights that can be had and allow for unexpected answers,” noted Aparna Keshaviah, MS, senior statistician at Mathematica.

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The second tool, municipal wastewater testing, allows to gain rapid and cost-effective information ($100-$150/sample) on up to a dozen drugs on each sample (including opioids).3 Such wastewater studies have been initiated in several states and have provided information on so-called geographic “hotspots” of drug use, have served as early warning of substances newly used in a community, and have helped to identify use of multiple drugs and associated risks for exposure and to evaluate the effectiveness of programs targeting drug use (based on before/after program implementation drug concentrations). “When used in combination with geospatial mapping and advanced analytics, wastewater-based epidemiology has the potential to help officials predict rather than react to changes in drug use,” noted Ms Keshaviah in the report.

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Ms Keshaviah reached out to policymakers to stress to them how both of these tools could be used in the fight against the opioid epidemic. Unprecedented funds have been allocated to this issue, first, as part of the 21st Century Cures Act ($500 million) in 2016, and then following the declaration by President Trump the next year that the opioid crisis constitutes a public health emergency ($4 billion). “With an influx of additional resources, policymakers are faced with the daunting task of figuring out how best to use those resources to have the greatest effect,” remarked Ms Keshaviah.


  1. Keshaviah A. The role of evidence in the opioids epidemic. October 25, 2018. Accessed November 7, 2018.
  2. Mathematica Policy Research. Stopping the transmission of opioids to the next generation (S.T.Op NextGen). Accessed November 7, 2018.
  3. Keshaviah A. Identifying the next drug epidemic by testing municipal wastewater. June 1, 2018. Accessed November 7, 2018.

This article originally appeared on Clinical Pain Advisor