System dynamics modeling as a potentially useful tool in analyzing mitigation strategies to reduce overdose deaths associated with pharmaceutical opioid treatment of chronic pain.
Pain Med
; 12 Suppl 2: S49-58, 2011 Jun.
Article
in En
| MEDLINE
| ID: mdl-21668757
ABSTRACT
OBJECTIVE:
To illustrate a system-level, simulation-based approach for evaluating mitigation strategies to address the dramatic rise in abuse, addiction, and overdose deaths associated with the use of pharmaceutical opioid analgesics to treat chronic pain. SIMULATEDINTERVENTIONS:
Making available drug formulations with increased tamper-resistance, prescriber education programs, and programs that reduce rates of medical user-related abuse and addiction. SIMULATED OUTCOMEMEASURE:
Number of overdose deaths of medical users of pharmaceutical opioid analgesics, including those who abuse or have become addicted.METHODS:
A demonstration system dynamics model is developed, tested, and used to evaluate the impact of candidate mitigation strategies on the outcome measures.RESULTS:
Tamper-resistant drug products will likely reduce overdose death rates but may not reduce overall deaths if there is increased prescribing. Prescriber education would likely reduce deaths through a reduction in patient access to pharmaceutical opioid analgesics.CONCLUSIONS:
The system dynamics approach may have potential for opioid-related policy evaluation. However, metrics must be carefully selected, and trade-offs may be involved. For example, it may be difficult to limit negative outcomes associated with pharmaceutical opioids without adversely affecting chronic pain patients' access to pharmaceutical treatment. Ultimately, a combination of metrics and value judgments will be needed to properly evaluate mitigation strategies.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pain
/
Drug Overdose
/
Analgesics, Opioid
/
Models, Theoretical
Type of study:
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Pain Med
Journal subject:
NEUROLOGIA
/
PSICOFISIOLOGIA
Year:
2011
Document type:
Article
Affiliation country:
United States