An Epidemic Model of Nonmedical Opioid Use with Simulated Public Health Interventions

We report development of a generalized epidemic 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. Derived from current policies, simulated public health interventions are assessed using the model regarding their leverage for reducing initiation and nonmedical use. Preliminary findings indicate that interventions which reduce the perceived attractiveness of opioids for recreational use may significantly reduce initiation and nonmedical use most significantly, while supply restriction effected through drug take back days and prescribing changes may have more modest effects. We argue that system dynamics is an effective approach for evaluating potential interventions to this complex system where the use of pharmaceutical opioids to treat pain is fraught with potentially undesirable distal outcomes in the public sphere.