Abstract
The objective of the study was to develop a system dynamics model of the medical use of pharmaceutical opioids, and the associated diversion and nonmedical use of these drugs. The model was used to test the impact of the a tamper resistance intervention in this complex system. The study relied on secondary data obtained from the literature and from other public sources for the period 1995 to 2008. In addition, an expert panel provided recommendations regarding model parameters and model structure. The behavior of the resulting systems-level model compared favorably with reference behavior data. After the base model was tested, logic to simulate the replacement of all opioids with tamper resistant formulations was added and the impact on overdose deaths was evaluated over a seven-year period, 2008-2015. Principal findings were that the introduction of tamper resistant formulations unexpectedly increased total overdose deaths. This was due to increased prescribing which counteracted the drop in the death rate. We conclude that it is important to choose metrics carefully, and that the system dynamics modelling approach can help to evaluate interventions intended to ameliorate the adverse outcomes in the complex system associated with treating pain with opioids.
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Nielsen, A., Wakeland, W. (2014). Dynamic Simulation of the Effect of Tamper Resistance on Opioid Misuse Outcomes. In: Obaidat, M., Filipe, J., Kacprzyk, J., Pina, N. (eds) Simulation and Modeling Methodologies, Technologies and Applications. Advances in Intelligent Systems and Computing, vol 256. Springer, Cham. https://doi.org/10.1007/978-3-319-03581-9_12
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DOI: https://doi.org/10.1007/978-3-319-03581-9_12
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