Supervised injectable heroin treatment and fatal overdose: a system dynamics model to assess the impact of supervised injectable heroin treatment on fatal overdoses in Bergen, Norway

Abstract

The city of Bergen, Norway, is troubled by a large number of deaths caused by opioid related overdoses. The number of deaths is also an indication of drug addict suffering, close family worries, drug trade and other criminal activities, costs of policing and health care etc. While all of these are important problems, focus in this thesis is on the number of deaths and on the effects of a policy called Supervised Injectable Heroin (SIH) treatment.A system dynamics model is built in order to explain the high mortality rate among heroin users in Bergen and to test the impact of SIH treatment. The model explains the flow of drug users from recruitment, through imprisonment and opioid substitution treatment (OST), to quitting or death. In particular the model is explicit about which periods the drug users are most susceptible to overdose deaths, when leaving prison and when leaving OST. The data comes from existing literature and interviews with drug users. The model behavior is analyzed with and without the policy impact, in order to understand how such a policy could contribute to a lower death rate among opioid users.