An Agent-Based Social Impact Theory Model to Study the Impact of In-Person School Closures on Nonmedical Prescription Opioid Use among Youth.

Substance use behavior among youth is a complex peer-group phenomenon shaped by many factors. Peer influence, easily accessible prescription opioids, and a youth's socio-cultural environment play recognized roles in the initiation and persistence of youth nonmedical prescription opioid use. By altering the physical surroundings and social environment of youth, in-person school closures may change risk factors for youth drug use. Acknowledging past research on the importance of the presence of peers in youth substance use risk behavior, this paper reports the findings from the use of an agent-based simulation grounded in social impact theory to investigate possible impacts of in-person school closures due to COVID-19 on the prevalence of nonmedical prescription opioid use among youth. The presented model integrates data from the Ontario Student Drug Use and Health Survey and characterizes the accessibility of within-home prescription opioids. Under the status quo, the lifting of in-person school closures reliably entails an increase in the prevalence of youth with nonmedical prescription opioid use, but this effect is ameliorated if the prescription opioids are securely stored during the in-person school closures period.