Equitable Data-Driven Facility Location and Resource Allocation to Fight the Opioid Epidemic

TL;DR

This paper develops an integrated epidemiological and optimization framework to allocate opioid treatment resources equitably across US states, aiming to reduce overdose deaths and improve treatment access.

Contribution

It introduces a novel combination of neural ODE-based epidemiological modeling with mixed-integer optimization for equitable resource allocation in opioid treatment.

Findings

Reduces opioid overdose deaths by 0.58% after 2 years.

Increases treatment coverage by 88.75%.

Provides policy insights for equitable facility placement.

Abstract

The opioid epidemic is a crisis that has plagued the United States (US) for decades. One central issue is inequitable access to treatment for opioid use disorder (OUD), which puts certain populations at a higher risk of opioid overdose. We integrate a predictive dynamical model and a prescriptive optimization problem to compute high-quality opioid treatment facility and treatment budget allocations for each US state. Our predictive model is a differential equation-based epidemiological model that captures opioid epidemic dynamics. We use a process inspired by neural ODEs to fit this model to opioid epidemic data for each state and obtain estimates for unknown parameters in the model. We then incorporate this epidemiological model into a mixed-integer optimization problem (MIP) that aims to minimize opioid overdose deaths and the number of people with OUD. We develop strong relaxations based on McCormick envelopes to efficiently compute approximate solutions to our MIPs with a mean optimality gap of 3.99%. Our method provides socioeconomically equitable solutions, as it incentivizes investments in areas with higher social vulnerability (from the US Centers for Disease Control's Social Vulnerability Index) and opioid prescribing rates. On average, our approach decreases the number of people with OUD by 9.03 $\pm$ 1.772%, increases the number of people in treatment by 88.75 $\pm$ 26.223%, and decreases opioid-related deaths by 0.58 $\pm$ 0.111% after 2 years compared to baseline epidemiological model predictions. Our solutions show that policy-makers should target adding treatment facilities to counties that have fewer facilities than their population share and are more socially vulnerable. We demonstrate that our optimization approach should help inform these decisions, as it yields population health benefits in comparison to benchmarks based solely on population and social vulnerability.