The Impact of the Good Behavior Game on Risk for Drug Use Disorder in an Agent-Based Model of Southern Sweden

Sara L. Lönn, Maryg Krauland, Abigail A. Fagan, Jan Sundquist, Kristina Sundquist, Mark S. Roberts, Kenneth S. Kendler

Research output: Contribution to journalArticlepeer-review


Objective: Drug use disorder (DUD) is aworldwide problem, and strategies to reduce its incidence are central to decreasing its burden. This investigation seeks to provide aproof of concept for the ability of agent-based modeling to predict the impact of the introduction of an effective school-based intervention, the Good Behavior Game (GBG), on reducing DUD in Scania, Sweden, primarilythrough increasing school achievement. Method: We modified anexisting agent-based simulation model of opioid use disorder to represent DUD inScania County, southernSweden. The model represents every individual in the population and is calibrated with the linked individual data from multiple sources including demographics, education, medical care, and criminal history. Risks for developing DUD were estimated from the population in Scania. Scenarios estimated the impact of introducing the GBG in schools located in disadvantaged areas. Results: The model accurately reflected the growth of DUD in Scania over amultiyear period and reproduced the levels of affected individuals in various socioeconomic strata over time. The GBG was estimated to improve school achievement and lower DUD registrations over time in males residing in disadvantaged areas by 10%, reflecting adecrease of 540 cases of DUD. Effects were considerably smaller in females. Conclusions: This work provides sup-portfor the impact of improvingschool achievement on long-termrisks of developing DUD. Italso demonstrated the value of using simulation modeling calibrated with data from areal population to estimate the impact of an intervention applied at apopulation level.

Original languageEnglish
Pages (from-to)863-873
Number of pages11
JournalJournal of Studies on Alcohol and Drugs
Issue number6
StatePublished - Nov 2023


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