ArticleDrug and alcohol dependence2019
Impact of a community-based naloxone distribution program on opioid overdose death rates.
Article in Drug and alcohol dependence, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
56 citing papers in PubMed, 5 syntheses or guidelines pooled it, 104 citations in OpenAlex.
- Part 4: Systems of Care: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.Circulation · 2025Guideline
- Effectiveness of naloxone distribution in community settings to reduce opioid overdose deaths among people who use drugs: a systematic review and meta-analysis.BMC public health · 2025Pooled it
- Injection Drug Use Frequency Before and After Take-Home Naloxone Training.JAMA network open · 2023Pooled it
- Community Distribution of Naloxone: A Systematic Review of Economic Evaluations.PharmacoEconomics - open · 2022Pooled it
- Emergency care with lay responders in underserved populations: a systematic review.Bulletin of the World Health Organization · 2021Pooled it
- Organizational perspectives on the impacts of scaling up overdose education and naloxone distribution in Kentucky.Addiction science & clinical practice · 2025Trial
- A randomized clinical trial of the effects of brief versus extended opioid overdose education on naloxone utilization outcomes by individuals with opioid use disorder.Drug and alcohol dependence · 2022Trial
- A brief telephone-delivered peer intervention to encourage enrollment in medication for opioid use disorder in individuals surviving an opioid overdose: Results from a randomized pilot trial.Drug and alcohol dependence · 2020Trial
- Variation in knowledge and attitudes among overdose prevention collaborations: Insights from fatality review teams.Drug and alcohol dependence · 2026Article
- Customizing and fine-tuning opioid overdose machine learning models for community-specific dashboards.Journal of big data · 2026Article
- Evaluating demographic variation in no-cost naloxone distribution in North Carolina: a cross-sectional survey study.Harm reduction journal · 2026Article
- History of Naloxone Possession Among Rural and Urban Individuals Participating in Prison-Based Treatment: An Observational Study.Substance use & addiction journal · 2026Observational
- Reciprocal influences between overdose experiences and naloxone access among people who use drugs utilizing a syringe services program: a cross-lagged panel model.Harm reduction journal · 2026Article
- Illicit drug supply, naloxone availability, and overdose mortality in the fentanyl era: a systematic review.Health affairs scholar · 2026Review
- Burden of overdoses among persons with opioid use disorder in the United States, 2025-2028: a simulation modeling study.Lancet regional health. Americas · 2026Article
- Expanding access to harm reduction in rural communities through community-informed public health vending machines.Harm reduction journal · 2026Article
- Proportion of Fentanyl Reports in Illicit Drug Seizures and Opioid Mortality.JAMA health forum · 2026Article
- Overdose-Related Cardiac Arrest in the Era of the Opioid Epidemic.Critical care clinics · 2026Review
- Effectiveness, acceptability, and feasibility of naloxone in carceral settings: a scoping review.Harm reduction journal · 2025Article
- Barriers to bystander interventions in suspected opioid-associated out-of-hospital cardiac arrests: A multiple methods study of 9-1-1 calls.Resuscitation · 2025Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundIn August 2013, a naloxone distribution program was implemented in North Carolina (NC). This study evaluated that program by quantifying the association between the program and county-level opioid overdose death (OOD) rates and conducting a cost-benefit analysis.
methodsOne-group pre-post design. Data included annual county-level counts of naloxone kits distributed from 2013 to 2016 and mortality data from 2000-2016. We used generalized estimating equations to estimate the association between cumulative rates of naloxone kits distributed and annual OOD rates. Costs included naloxone kit purchases and distribution costs; benefits were quantified as OODs avoided and monetized using a conservative value of a life.
resultsThe rate of OOD in counties with 1-100 cumulative naloxone kits distributed per 100,000 population was 0.90 times (95% CI: 0.78, 1.04) that of counties that had not received kits. In counties that received >100 cumulative kits per 100,000 population, the OOD rate was 0.88 times (95% CI: 0.76, 1.02) that of counties that had not received kits. By December 2016, an estimated 352 NC deaths were avoided by naloxone distribution (95% CI: 189, 580). On average, for every dollar spent on the program, there was $2742 of benefit due to OODs avoided (95% CI: $1,237, $4882).
conclusionsOur estimates suggest that community-based naloxone distribution is associated with lower OOD rates. The program generated substantial societal benefits due to averted OODs. States and communities should continue to support efforts to increase naloxone access, which may include reducing legal, financial, and normative barriers.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.