Gaining Policy Insight with a System Dynamics Model of Pain Medicine Prescribing, Diversion and Abuse

Misuse of pain medicine is a leading cause of accidental deaths in the USA–over 15 000 deaths annually. A system dynamics model was developed and used to study the impact of three types of policy interventions to reduce adverse outcomes. Besides medical usage, the model also includes the diversion of pain medicines and their nonmedical use. Model behavior compared favourably with historical data at multiple points in the system. A prescription drug monitoring program intervention reduced nonmedical overdoses through supply restriction, and an intervention to reduce popularity of nonmedical usage reduced nonmedical overdoses by curtailing demand. A tamper‐resistant drug formulation intervention resulted in decreased risk to individuals but increased overdose deaths. Key policy insights are that supply and demand must be carefully considered; that the feedback loops, which created the problem, can help to identify solutions; and that outcome metrics must be carefully chosen