2019 MCM C：The Opioid Crisis

Background: The United States is experiencing a national crisis regarding the use of synthetic and non- synthetic opioids, either for the treatment and management of pain (legal, prescription use) or for recreational purposes (illegal, non-prescription use). Federal organizations such as the Centers for Disease Control (CDC) are struggling to “save lives and prevent negative health effects of this epidemic, such as opioid use disorder, hepatitis, and HIV infections, and neonatal abstinence syndrome.”1 Simply enforcing existing laws is a complex challenge for the Federal Bureau of Investigation (FBI), and the U.S. Drug Enforcement Administration (DEA), among others.

There are implications for important sectors of the U.S. economy as well. For example, if the opioid crisis spreads to all cross-sections of the U.S. population (including the college-educated and those with advanced degrees), businesses requiring precision labor skills, high technology component assembly, and sensitive trust or security relationships with clients and customers might have difficulty filling these positions. Further, if the percentage of people with opioid addiction increases within the elderly, health care costs and assisted living facility staffing will also be affected.

The DEA/National Forensic Laboratory Information System (NFLIS), as part of the Drug Enforcement Administration's (DEA) Office of Diversion Control, publishes a data-heavy annual report addressing "drug identification results and associated information from drug cases analyzed by federal, state, and local forensic laboratories." The database within NFLIS includes data from crime laboratories that handle over 88% of the nation's estimated 1.2 million annual state and local drug cases. For this problem, we focus on the individual counties located in five (5) U.S. states: Ohio, Kentucky, West Virginia, Virginia, and Tennessee. In the U.S., a county is the next lower level of government below each state that has taxation authority.

Supplied with this problem description are several data sets for your use. The first file (MCM_NFLIS_Data.xlsx) contains drug identification counts in years 2010-2017 for narcotic analgesics (synthetic opioids) and heroin in each of the counties from these five states as reported to the DEA by crime laboratories throughout each state. A drug identification occurs when evidence is submitted to crime laboratories by law enforcement agencies as part of a criminal investigation and the laboratory’s forensic scientists test the evidence. Typically, when law enforcement organizations submit these samples, they provide location data (county) with their incident reports. When evidence is submitted to a crime laboratory and this location data is not provided, the crime laboratory uses the location of the city/county/state investigating law enforcement organization that submitted the case. For the purposes of this problem, you may assume that the county location data are correct as provided.

The additional seven (7) files are zipped folders containing extracts from the U.S. Census Bureau that represent a common set of socio-economic factors collected for the counties of these five states during each of the years 2010-2016 (ACS_xx_5YR_DP02.zip). (Note: The same data were not available for 2017.)

A code sheet is present with each data set that defines each of the variables noted. While you may use other resources for research and background information, THE DATA SETS PROVIDED CONTAIN THE ONLY DATA YOU SHOULD USE FOR THIS PROBLEM.

1 Centers for Disease Control website, (https://www.cdc.gov/features/confronting-opioids/index.html ), accessed 4 September 2018.

Page 2 of 3 Problem:

Part 1. Using the NFLIS data provided, build a mathematical model to describe the spread and characteristics of the reported synthetic opioid and heroin incidents (cases) in and between the five states and their counties over time. Using your model, identify any possible locations where specific opioid use might have started in each of the five states.

If the patterns and characteristics your team identified continue, are there any specific concerns the U.S. government should have? At what drug identification threshold levels do these occur? Where and when does your model predict they will occur in the future?

Part 2. Using the U.S. Census socio-economic data provided, address the following questions:

There are a good number of competing hypotheses that have been offered as explanations as to how opioid use got to its current level, who is using/abusing it, what contributes to the growth in opioid use and addiction, and why opioid use persists despite its known dangers. Is use or trends-in-use somehow associated with any of the U.S. Census socio-economic data provided? If so, modify your model from Part 1 to include any important factors from this data set.

Part 3. Finally, using a combination of your Part 1 and Part 2 results, identify a possible strategy for countering the opioid crisis. Use your model(s) to test the effectiveness of this strategy; identifying any significant parameter bounds that success (or failure) is dependent upon.

In addition to your main report, include a 1-2 page memo to the Chief Administrator, DEA/NFLIS Database summarizing any significant insights or results you identified during this modeling effort.

Your submission should consist of:

Glossary: analgesic

ACS_10_5YR_DP02.zip ACS_12_5YR_DP02.zip ACS_14_5YR_DP02.zip ACS_16_5YR_DP02.zip

ACS_11_5YR_DP02.zip ACS_13_5YR_DP02.zip ACS_15_5YR_DP02.zip MCM_NFLIS_Data.xlsx

– pain relieving medication
county – (in the U.S.) an administrative or political subdivision of a state; a region

having specific boundaries and some level of governmental authority.

heroin – an illegal, euphoria producing, highly addictive analgesic drug processed from morphine (a naturally occurring substance extracted from the seed pods of certain varieties of poppy plants).

non-synthetic opioids – a class of drugs made from extracting chemicals in opium leaves, e.g. morphine, codeine, heroin.

Page 3 of 3
opioids – pain relieving drugs that are often highly addictive

socio-economic factors – factors within a society that describe the relationship between social and economic status and class such as education, income, occupation, and employment.

synthetic opioid – man-made opioids

Problem Notes:
The NFLIS data set provided was extracted from a much larger data set involving the five (5) states noted using "Narcotic Analgesics" and "Heroin" reports as the target. The variable DrugReports indicates the number of identified drug cases corresponding to these target search topics in each county of each state. The variable TotalDrugReportsCounty shows the total number of ALL identified drug cases in a county, of which 'Narcotic Analgesics' and 'Heroin' are a part, if they occurred. Because 'Narcotic Analgesics' and 'Heroin' are only two of many types of controlled substances, the sum of DrugReports will not necessarily equal TotalDrugReportsCounty for a specific county in a state for each reported year. Similarly, the variable TotalDrugReportsState indicates the total of all drug reports for the state noted. However, since the database query was targeting 'Narcotic Analgesics' and 'Heroin' only, if a county had no such identified drug cases but had numerous drug cases of other types, the county will not appear in this dataset. Thus, the sum of all TotalDrugReportsCounty for all counties in a state shown in this dataset for a particular year will not necessarily equal TotalDrugReportsState. All three variable values shown in the dataset are accurate.

Additional variables derived from the data provided is acceptable. Map data (coordinates, distances, adjacency of counties and states) is acceptable from outside sources. Additional explanatory or response variables from other sources are not acceptable.

Tennessee data: The data set was altered to include Pennsylvania to replace Tennessee. Use the Pennsylvania data.