Online Program

Simulating health policy interventions to reduce nonmedical use of pharmaceutical opioids

Tuesday, November 5, 2013 : 12:30 p.m. - 12:50 p.m.

Alexandra Nielsen, Systems Science Graduate Program, Portland State University, Portland, OR
Wayne Wakeland, PhD, Systems Science Graduate Program, Portland State University, Portland, OR
Teresa Schmidt, MA, Systems Science Graduate Program, Portland State University, Portland, OR
A system dynamics simulation model helps explain historical trends in the United States regarding the nonmedical use of pharmaceutical opioids and its associated adverse outcomes. Drawing data from the National Survey of Drug Use and Health and guided by a panel of experts, model parameters were calibrated to replicate opioid use data from 1995-2005, and various policy interventions were simulated between 2006 and 2011. The simulation reproduces historical trends in nonmedical opioid use. Differential equations represent each of the three major components: 1) Peer initiation is modeled as the “infection” of a susceptible population by peers, which functions as a reinforcing feedback loop;2) Global availability of opioids for nonmedical use varies as a function of the number of opioid users and the amount of free leftover medicine obtained from prescription holders; and 3) limited personal accessibility motivates users to transition to alternative opioid sources that require payment. Interventions that have already been implemented, such as prescription drug take back days and school-based educational initiatives, are assessed for their downstream impacts on initiation and negative outcomes. Interventions currently under consideration, such as expanding and simplifying prescription drug returns, and rescheduling hydrocodone products to Schedule II, are also assessed for distal impacts. We conclude that system dynamics is an effective method for evaluating potential interventions and for understanding the complex system of pharmaceutical opioid misuse and its adverse outcomes.

Learning Areas:

Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Assess the relative impact of interventions to reduce the initiation of nonmedical use of prescription opioid analgesics and the progression from obtaining nonmedically used opioids for free to paying for opioids. Describe the benefits of the use of simulation to investigate interventions aimed at the reduction of nonmedical use of opioid analgesics.

Keyword(s): Drug Abuse, Prescription Drug Use Patterns

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a PhD student in the Systems Science Graduate Program at Portland State University. For the past two years I have been a junior and now principal analyst on a federally funded grant focusing on simulating prescription opioid use, abuse, diversion, and interventions to mitigate negative outcomes. I am interested in using various systems models (system dynamics and agent based models) to investigate policy options regarding prescription drug abuse.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.