Making Sense: Treating Patients with Opioid Use Disorder through the Lens of Game Theory.

The opioid epidemic continues to influence the field of medicine, creating new challenges and obstacles to quality care. Patients with injection drug use are marginalized individuals who received poor quality of care and often discharged without safe recovery plan. Cooperation between physicians and patients allow the best outcomes for the patient, the physician, and society, however we often see patient-directed discharges and inadequate care. We believe that this result is due to an incentive model in the decision-making process that ultimately makes cooperation difficult. We use different game theory models (assurance model, prisoner's dilemma, centipede model, conflicting interest coordination) in this paper to describe common scenarios within a hospitalization when caring for patient with opioid use disorder, from admission through discharge. When physician and patient are driven away from cooperation, the outcome is the worst and most harmful for society. In today's worsening opioid crisis, game theory can help physician provide high quality care to a complex high-risk population.