Department of Mathematics, University of Portland, 5000 N Willamette Blvd, Portland, OR 97203, USA.
Math Med Biol. 2021 Jun 15;38(2):202-217. doi: 10.1093/imammb/dqab001.
In 2016, more than 11 million Americans abused prescription opioids. The National Institute on Drug Abuse considers the opioid crisis a national addiction epidemic, as an increasing number of people are affected each year. Using the framework developed in mathematical modelling of infectious diseases, we create and analyse a compartmental opioid-abuse model consisting of a system of ordinary differential equations. Since $40%$ of opioid overdoses are caused by prescription opioids, our model includes prescription compartments for the four most commonly prescribed opioids, as well as for the susceptible, addicted and recovered populations. While existing research has focused on drug abuse models in general and opioid models with one prescription compartment, no previous work has been done comparing the roles that the most commonly prescribed opioids have had on the crisis. By combining data from the Substance Abuse and Mental Health Services Administration (which tracked the proportion of people who used or misused one of the four individual opioids) with data from the Centers of Disease Control and Prevention (which counted the total number of prescriptions), we estimate prescription rates and probabilities of addiction for the four most commonly prescribed opioids. Additionally, we perform a sensitivity analysis and reallocate prescriptions to determine which opioid has the largest impact on the epidemic. Our results indicate that oxycodone prescriptions are both the most likely to lead to addiction and have the largest impact on the size of the epidemic, while hydrocodone prescriptions had the smallest impact.
2016 年,超过 1100 万美国人滥用处方类阿片。美国国家药物滥用研究所认为,阿片类药物危机是一场全国性的毒瘾流行,因为每年受影响的人数都在增加。我们使用传染病数学建模中开发的框架,创建并分析了一个由常微分方程系统组成的阿片类药物滥用 compartmental 模型。由于 40%的阿片类药物过量是由处方类阿片类药物引起的,我们的模型包括四种最常开的处方类阿片类药物的处方类,以及易感人群、成瘾人群和康复人群的处方类。虽然现有研究集中在一般药物滥用模型和具有一个处方类的阿片类药物模型上,但没有以前的工作比较过最常开的阿片类药物在危机中所起的作用。我们将美国药物滥用与心理健康服务管理局(该机构跟踪了四种单独的阿片类药物中使用或误用其中一种的人群比例)的数据与疾病控制与预防中心(该机构统计了总处方数量)的数据结合起来,估计了四种最常开的阿片类药物的处方率和成瘾概率。此外,我们还进行了敏感性分析并重新分配了处方,以确定哪种阿片类药物对疫情的影响最大。我们的研究结果表明,羟考酮类药物的处方最有可能导致成瘾,对疫情的规模影响最大,而氢可酮类药物的处方影响最小。
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