FRED (A Framework for Reconstructing Epidemiological Dynamics) is an agent-based simulation modeling system for exploring the spatial and temporal patterns of epidemics. In this application, we have incorporated a detailed representation of opioid use disorder (OUD) and overdose into FRED and have calibrated the model from multiple data sources relevant to each county represented. The disease model of OUD, representing possible disease states at an individual-level, is described in more detail here. The model currently estimates the impact of two evidence-based strategies for preventing opioid overdose deaths: 1) the provision of Naloxone, an opioid antidote that can reverse the effects of an opioid overdose, and 2) the availability of office-based buprenorphine as medication for opioid use disorder (MOUD). These two strategies are part of the HHS 5-point strategy to combat the opioid crisis.
In the current model, increasing the availability of naloxone at a county level decreases the probability that an individual will die from an overdose. Increasing the number of office-based buprenorphine prescriptions will increase the availability of MOUD, which will increase the probability that a person with OUD will enter treatment. In the model, individuals in treatment do not experience an overdose unless they relapse.
We are currently developing an advanced Phase II model, details available here.
Please note that because there are multiple pathways among the disease states in the OUD model, a single intervention may impact multiple disease states. For example, increasing naloxone availability will not only decrease overdose deaths but also increase the number of agents (i.e., individuals) in the disease state of OUD and the number of agents receiving MOUD treatment.
Below, you can choose a state/county to simulate the impact of the two interventions considered on OUD prevalence and opioid overdose. The policy sliders, originally set to baseline levels, can then be used to select a desired level of intervention. The accompanying maps visualize the geographic locations of individuals with opioid use disorder and overdose deaths. The map on the left predicts the expected number of opioid deaths with the county’s current levels of Naloxone and MOUD available, while the map on the right estimates the expected number of opioid deaths under the combination of Naloxone and MOUD selected in the policy sliders.
This website is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.