FRED Simulator for Opioid Use Disorder and Overdose

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 using 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. An earlier version of this tool, is available here. This version, has several new features:

• Increased clinical detail, including individual-level factors (e.g., age, sex, race, mental health history) and location-specific factors (e.g., opioid prescription rates, MOUD availability, naloxone availability, and fentanyl seizures) that influence the clinical progression of OUD
• Inclusion of individual-level polysubstance use characteristics, incorporating cocaine, methamphetamine, and benzodiazepine use alongside opioid use
• Increased representation of US counties

The model currently estimates the impact of three evidence-based strategies for preventing opioid overdose deaths:

1. The availability of office-based buprenorphine as medication for opioid use disorder (MOUD).
2. The provision of Naloxone, an opioid antidote that can reverse the effects of an opioid overdose.
3. Retention in care strategies that reduce chances of early MOUD discontinuation.

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.