Abstract
Drug use and problems change dramatically over time in ways that are often described as reflecting an “epidemic cycle”. We use simulation of a model of drug epidemics to investigate how the relative effectiveness of different types of prevention varies over the course of such an epidemic. Specifically we use the so-called LHY model (see, Discussion Paper No. 251 of the Institute of Econometrics, OR, and Systems Theory, Vienna University of Technology, Vienna, Austria, 2000) which includes both “contagious” spread of initiation (a positive feedback) and memory of past use (a negative feedback), which dampens initiation and, hence, future use. The analysis confirms the common sense intuition that prevention is more highly leveraged early in an epidemic, although the extent to which this is true in this model is striking, particularly for campaigns designed to preserve or amplify awareness of the drug's dangers. The findings also suggest that the design of “secondary” prevention programs should change over the course of an epidemic.
Highlights
This paper uses simulations of mathematical models of drug use to estimate the relative effectiveness of different types of prevention over the course of a drug epidemic
The severity of the epidemic and, the value of prevention can be very different for two drugs that are identical in all respects except their initial reputation levels
The central finding of this paper is that the effectiveness of various types of prevention varies substantially over the course of a drug epidemic such as the recent US cocaine epidemic
Summary
This paper uses simulations of mathematical models of drug use to estimate the relative effectiveness of different types of prevention over the course of a drug epidemic. There is increasing evidence that the effectiveness of different types of interventions, including prevention, can vary dramatically over the course of a drug epidemic (Caulkins et al, 1999; Behrens et al, 2000a; Tragler et al, 2001). This should not be surprising because drug use spreads initially through a positive feedback loop (current users promote initiation of new users) that is eventually overwhelmed by a lagged, negative feedback (e.g., the drug develops a negative reputation which suppresses initiation). If the cost of purchasing any given change is roughly the same from year to year, we will get a sense of how the cost-effectiveness of making that type of change might vary over the course of the epidemic
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
