Key Data Gaps for Understanding Trends in Prescription Opioid Analgesic Abuse and Diversion Among Chronic Pain Patients and Nonmedical Users

Population dynamics of medical and nonmedical prescription opioid usage and adverse outcomes were modeled. Critical parameter values were determined by their amount of influence on model behavior. Results suggest that closing these data gaps would help researchers to better identify ways to reduce the risk of adverse outcomes

CubeSat Active Thermal Control via Microvascular Carbon Fiber Channel Radiator

Small spacecraft rarely have space for any thermal control subsystems and often must perform operations in “burst” mode as a result. The few spacecraft who do have control rely on low-complexity thermal control systems which conduct heat to the bus structure and then radiate the heat away. These simplistic techniques are sufficient for low power missions in Low Earth Orbit (LEO) but are not capable of dumping the heat produced in new mission profiles that are in development. This is due to small spacecraft incorporating increasingly advanced subsystems which have difficult thermal control requirements such as propulsion systems or high-power antennas. The University of Illinois at Urbana-Champaign, in partnership with NASA Ames Research Center, is developing a thermal control system for small spacecraft. This control system uses a deployable radiator panel made from carbon fiber with micro-vascular circulatory system for coolant. This paper is a follow-up on the previous year’s SmallSat conference. A bench prototype of the thermal control subsystem was designed and built. The prototype underwent a range of thermal and vibration tests at NASA Ames. Test results and lessons learned are presented. Moving forward, test conclusions will require some design parameters to be changed and the subsystem will reach TRL 6 by the end of the two-year program

A System Dynamics Model of Pharmaceutical Opioids: Medical Use, Diversion, and Nonmedical Use

A dramatic rise in the nonmedical of pharmaceutical opioids has presented the United States with a substantial public health problem. Nonmedical use of prescription pain relievers has become increasingly prevalent in the US over the last two decades, and diversion of medicines obtained by prescription is assumed to be a major source of supply for nonmedical opioid use. Policymakers striving to protect population health by ameliorating the adverse outcomes of nonmedical use of opioid analgesics could benefit from a systems-level model which reflects the complexity of the system and incorporates the full range of available data. To address this need, the current project describes the conceptualization and development of a System Dynamics model that is used to complement and leverage results from existing research. Additional testing is needed to authenticate preliminary intervention simulation results, which suggest that a reduction in the initiation of nonmedical use may have a more profound impact on the total number of opioid overdose deaths than more tamper-resistant formulations, decreases in opioid prescribing, or decreases in rates of abuse among medical users. Results indicate that System Dynamics can help to identify points of high leverage for policy interventions as well as bring attention to the unanticipated negative consequences of these interventions

Modeling the Impact of Simulated Educational Interventions on the Use and Abuse of Pharmaceutical Opioids in the United States: A Report on Initial Efforts

Three educational interventions were simulated in a system dynamics model of the medical use, trafficking, and nonmedical use of pharmaceutical opioids. The study relied on secondary data obtained in the literature for the period of 1995 to 2008 as well as expert panel recommendations regarding model parameters and structure. The behavior of the resulting systems-level model was tested for fit against reference behavior data. After the base model was tested, logic to represent three educational interventions was added and the impact of each intervention on simulated overdose deaths was evaluated over a 7-year evaluation period, 2008 to 2015. Principal findings were that a prescriber education intervention not only reduced total overdose deaths in the model but also reduced the total number of persons who receive opioid analgesic therapy, medical user education not only reduced overdose deaths among medical users but also resulted in increased deaths from nonmedical use, and a “popularity” intervention sharply reduced overdose deaths among nonmedical users while having no effect on medical use. System dynamics modeling shows promise for evaluating potential interventions to ameliorate the adverse outcomes associated with the complex system surrounding the use of opioid analgesics to treat pain