A Public Health Model for Simulating Policy Interventions to Reduce Nonmedical Opioid Use

Abstract

Reports on the development of a system dynamics simulation model of initiation and nonmedical use of pharmaceutical opioids in the US. The study relies on historical trend data as well as expert panel recommendations that inform model parameters and structure. The model was used to assess simulated public health interventions for reducing initiation and nonmedical use of opioids. Results indicate that interventions which reduce the likelihood of informal sharing of leftover medicine could significantly reduce initiation and nonmedical use. Less effective are supply restrictions, such as drug take-back days, and interventions aimed at reducing the likelihood that nonusers would decide to initiate nonmedical use based on their interactions with nonmedical users. We conclude that system dynamics is an effective approach for evaluating potential interventions to this complex system where the use of pharmaceutical opioids to treat pain can lead to unintended distal outcomes in the public sphere.