Problem Solving Court Project
Project Description
Individuals arrested for drug misuse can be sentenced to traditional correctional facilities or, in some cases, can participate in Problem Solving Courts – specialized dockets that seek to treat the underlying problems contributing to criminal behavior. In 2019, the Research Team received a grant from the Centers for Disease Control and Prevention to evaluate and model interventions offered by adult Problem Solving Courts from January 01, 2018 – June 30, 2021 that may affect morbidity and mortality. The Problem Solving Court Project homepage is linked here.
FRED Opioid Simulator Explanation
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 deaths 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 the following strategies for preventing opioid overdose deaths:
- The provision of Naloxone, an opioid antidote that can reverse the effects of an opioid overdose
- The availability of office-based buprenorphine as medication for opioid use disorder (MOUD)
- The availability of a Problem Solving Court (PSC) in the County
In the 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. A Problem Solving Court being available decreases the probability that an individual will die from an overdose AND increase the probability that a person with OUD will receive treatment.
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 an Indiana county to simulate the impact of the 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 (presented as an percent increase of availability of the intervention). The toggle button represents the availability (or not) of a Problem Solving Court in the given county. 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 as well as the impact of the availability of a Problem Solving Court (PSC) in the county.