Purpose: We aimed to help community stakeholders develop a shared understanding of the opioid crisis through qualitative system dynamics (SD) modeling to inform local strategies for prevention and treatment. Methods: As part of the HEALing Communities Study-New York State, we used secondary qualitative data from community stakeholder interviews and coalition meeting notes to develop qualitative SD models that elucidate the interdependencies and feedback structures underlying the opioid epidemic in each community. Results: The synthesized model revealed multiple balancing and reinforcing feedback loops that influenced the adoption and reach of evidence-based practices to reduce opioid overdose and fatality. Conclusion: SD modeling is a novel approach to helping community stakeholders to see the inter-connectedness of actors, factors and sectors and the need for multiple mutually reinforcing strategies to avert opioid overdose and fatality. Social workers could play a key role in linking actions across sectors in such a complex system.

目的：我们旨在通过定性系统动力学 (SD) 建模帮助社区利益相关者对阿片类药物危机达成共识，从而为当地的预防和治疗策略提供信息。方法：作为纽约州治愈社区研究的一部分，我们使用来自社区利益相关者访谈和联盟会议记录的二级定性数据来开发定性 SD 模型，以阐明每个社区中阿片类药物流行的相互依赖性和反馈结构。结果：合成模型揭示了多个平衡和加强反馈循环，这些循环影响了循证实践的采用和范围，以减少阿片类药物过量和死亡。结论：SD 建模是一种新颖的方法，可帮助社区利益相关者了解参与者、因素和部门之间的相互联系，以及需要多种相辅相成的策略来避免阿片类药物过量和死亡。在这样一个复杂的系统中，社会工作者可以在将跨部门的行动联系起来方面发挥关键作用。