Extending drug ethno‐epidemiology using agent‐based modelling

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Abstract
Aims To show how the inclusion of agent‐based modelling improved the integration of ethno‐epidemiological data in a study of psychostimulant use and related harms among young Australians. Methods Agent‐based modelling, ethnographic fieldwork, in‐depth interviews and epidemiological surveys. Setting Melbourne, Perth and Sydney, Australia. Participants Club drug users in Melbourne, recreational drug users in Perth and street‐based injecting drug users in Sydney. Participants were aged 18–30 years and reported monthly or more frequent psychostimulant use. Findings Agent‐based modelling provided a specific focus for structured discussion about integrating ethnographic and epidemiological methods and data. The modelling process was underpinned by collective and incremental design principles, and produced ‘SimAmph’, a data‐driven model of social and environmental agents and the relationships between them. Using SimAmph, we were able to test the probable impact of ecstasy pill‐testing on the prevalence of harms—a potentially important tool for policy development. The study also navigated a range of challenges, including the need to manage epistemological differences, changes in the collective design process and modelling focus, the differences between injecting and non‐injecting samples and concerns over the dissemination of modelling outcomes. Conclusions Agent‐based modelling was used to integrate ethno‐epidemiological data on psychostimulant use, and to test the probable impact of a specific intervention on the prevalence of drug‐related harms. It also established a framework for collaboration between research disciplines that emphasizes the synthesis of diverse data types in order to generate new knowledge relevant to the reduction of drug‐related harms.