At first glance, the world of Fallout: New Vegas looks bleak and inhospitable. The world is a ruin, monsters and raiders roam the landscape, and there's danger in every direction. Thing is, though, there are tons of friendly characters and plenty of pockets of safety. You can carry oodles of weapons around and quickly become an unstoppable killing machine. All things considered, it's really not so bad.
The Dust mod changes that considerably. It's built on the notion that the courier, after taking a pill to the dome, wakes up 20 years later. The world, already in rough shape, has been ravaged by a plague that's killed just about all those friendly NPCs you remember, and mutated the rest. Settlements are ghost towns in the truest sense. What few survivors there are have become cannibals, tribal warriors, or other desperate people who won't greet you warmly or charm you with their quirky ways. They'll try to put you down before you do the same to them. It's not the post-apocalypse, it's the post-post apocalypse.
There are no quests: Dust turns Fallout: New Vegas into a survival simulator. Your only goal is to survive, and if possible, find some way out of the Mojave. And it's not going to be easy.
Dust introduces a ton of gameplay tweaks and changes. You absolutely need to find food and water, and both are scarce. You're much more susceptible to enemy weapons, but human NPCs are as well. Speaking of weapons, most of them are in bad shape to begin with and you'll want to be very careful with your ammunition, as there isn't much around and most of it is damaged. You won't be able to schlep an arsenal around, either, because your carry weight has been severely reduced.
I played a bit, and I can confirm it is pretty tough going. I started in Goodsprings, where those once welcoming buildings were only staffed with plague victims and some random items to be scrounged. I could barely carry anything, just the clothes I was wearing, a melee weapon, a couple guns, a handful of ammo, and a few other assorted items.
Wild dogs roamed the streets, but no living humans were to be found. I did spot some familiar-looking NPCs, but they weren't in any shape to greet me. The last time I saw so many dead bodies in Goodsprings was that time I killed everyone in Goodsprings. Looks like the plague has saved me the trouble this time around.
Finding some living humans elsewhere wasn't exactly good news. I ran into some tribals who flung tomahawks at me. I came across a crazed pack of cannibals who quickly turned me into dinner. I found a small pocket of survivors, but they opened fire immediately. This is a truly hostile world.
The Dust mod is available over at nexusmods. It does rely on another mod: Roleplayer's Alternative Start. Which, in turn, requires NVSE. So, you've got a little extra downloading to do. Be sure to also read the installation instructions on the mod's page: Dust requires the Dead Money, Honest Hearts, and Lonesome Road DLC. You'll also need to put Alternative Start below Dust in your load order the first time you play it, or if you're starting a new game of Dust, but put Dust at the bottom of the load order if you're continuing a game.
Thanks to Nathan at Kotaku, which is where I first heard about this!