Scoping Review Maps System Dynamics in Opioid Crisis

A new scoping review published in the Harm Reduction Journal examines how system dynamics modeling and related feedback-based approaches have been applied to the opioid crisis.

The opioid crisis is characterized by behavioral complexity, delayed system responses, and a diverse range of stakeholders. In Canada, for example, 6,601 apparent opioid toxicity deaths were reported between April 2024 and March 2025, averaging 18 deaths per day.

System dynamics modeling simulates how different parts of a system influence each other over time. It captures feedback mechanisms, time delays, and interactions between sub-systems, allowing researchers to forecast the potential outcomes of various interventions and policies. The review followed the JBI Manual and reported its findings using PRISMA-ScR guidelines. The authors searched five databases for studies published from 2019 to 2025, focusing on literature that applied system dynamics or similar feedback-based modeling to opioid-related issues.

The review yielded 23 studies that employed system dynamics or related modeling approaches. These studies explored a variety of interventions, including various treatment options, Good Samaritan laws, and other harm reduction strategies. The most common outcome of the modeling was overdose deaths. Geographically, the majority of the models were based in the United States, with a smaller number originating from Canada, Australia, Iran, and Ukraine.

The models that focused on specific interventions generally demonstrated improvements in outcomes, such as lower mortality rates and higher treatment engagement. On the other hand, models that focused on the qualitative understanding of the system documented the interdependencies between different factors.

Despite these advancements, the review identifies several gaps in the current literature. There is a notable lack of modeling regarding supervised consumption sites, long-term recovery, equity impacts, and the lived experience of individuals affected by opioid use disorder.

In conclusion, the scoping review underscores the potential of system dynamics modeling to address the opioid crisis. By mapping the relationships between policies, interventions, and outcomes, these models offer a powerful tool for evidence-based decision-making.

Subject of Research: System dynamics modeling of opioid use and interventions

Article Title: System dynamics and related modeling of opioid use and interventions: a scoping review

Article References: Johnstone, H., Johnson, E., Khadka, A., & Rittenbach, K. (2026). System dynamics and related modeling of opioid use and interventions: a scoping review. Harm Reduction Journal. https://doi.org/10.1186/s12954-026-01540-9

Image Credits: AI Generated

DOI: 10.1186/s12954-026-01540-9

Keywords: system dynamics, opioid crisis, scoping review, public health, harm reduction, modeling, policy, intervention, System, dynamics, related, opioid