Abstract for: A System Dynamics Model of Pharmaceutical Opioids: Medical Use, Diversion, and Nonmedical Use

A dramatic rise in the nonmedical use of pharmaceutical opioids has presented the United States with a substantial public health problem. Nonmedical use of prescription pain relievers has become increasingly popular in the US over the last two decades, and diversion of medical prescriptions is assumed to be a major source of supply for nonmedical use. Policymakers striving to protect population health by ameliorating the adverse outcomes of nonmedical opioid use could benefit from a systems-level model which reflects the complexity of the system and incorporates the full range of available data. To address this need, the current project describes the conceptualization and development of a System Dynamics model that is used to complement and leverage results from existing research. Additional testing is needed to authenticate preliminary intervention simulation results, which suggest reducing the initiation of nonmedical use may have a more profound impact on the total number of opioid overdose deaths than more tamper resistant formulations, decreases in opioid prescribing, or decreases in rates of nonmedical use among medical users. Results indicate that System Dynamics can help to identify points of high-leverage for policy interventions as well as bring attention to the unanticipated negative consequences of these interventions.