An Agent‐Based Model of Youth Nonmedical Prescription Opioid Use in Ontario: Forecast Validation and Future Projection

Amid COVID-19-related in-person school closures in 2021, an agent-based simulation grounded in social impact theory was implemented and documented to investigate the effects of in-person school closure on nonmedical prescription opioid use among adolescents in Ontario, Canada. The results of model simulations forecasted an alarming rebound effect in the opioid use prevalence after the lifting of in-person school closures and identified secure medication storage in households as an effective strategy for mitigating associated risks. This study evaluates this result by comparing the baseline projection from the previously published study with newly released 2023 data from the Ontario Student Drug Use and Health Survey. Furthermore, it employs the developed agent-based model to simulate the projection through 2030 and assesses the efficacy of secure medication storage in households for the coming years. The study confirms that the previously published simulation projection for 2023 closely aligns with observed data, showing nonmedical prescription opioid use prevalence among Ontario adolescents nearly doubling from 2021 to 2023. Additionally, the results show that nonmedical prescription opioid use prevalence among youth is projected to remain at these elevated levels. Critically, the findings suggest that the temporal window for effective secure medication storage interventions has elapsed, and these interventions are now expected to have minimal impact on reducing this increase, even when applied extensively. The agreement between reported predictions and observed data demonstrates that a simulation model with relevant conceptual foundation can accurately predict future trends and provide sufficient lead time for policymakers to implement interventions within critical time-sensitive windows to alter undesirable trajectories before public health crises escalate.