We report development of a systems level dynamic model of initiation and nonmedical use of pharmaceutical opioids in the US. The model calibrated to 1995-2005 National Survey of Drug Use and Health (NSDUH) data, predicts 2006-2011 data well. Preliminary findings indicate that interventions which reduce the perceived attractiveness of opioids for recreational use may be able to reduce initiation and nonmedical use most significantly, while supply restriction effected through drug take back days and prescribing changes may have more modest effects. We argue that system dynamics is an effective approach for evaluating potential interventions to this complex system where the use of pharmaceutical opioids to treat pain is fraught with undesirable distal outcomes.
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