SynthesisLancet (London, England)2019
Global patterns of opioid use and dependence: harms to populations, interventions, and future action.
Synthesis in Lancet (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 437 papers, 13 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
437 citing papers in PubMed, 13 syntheses or guidelines pooled it, 801 citations in OpenAlex.
- Evaluating comparative effect of non-pharmacological interventions adjunctive to opioid agonist therapy for opioid use disorder: A systematic review with network meta-analysis.Addiction (Abingdon, England) · 2026Pooled it
- Preoperative Nonopioid Analgesia Reduces Postoperative Opioid Consumption After Arthroscopic Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials.The American journal of sports medicine · 2026Pooled it
- The global epidemiology of injecting drug use, HIV, viral hepatitis and tuberculosis among people who are incarcerated: a multistage systematic review.The International journal on drug policy · 2026Pooled it
- Drug use among people in prison: A global review of epidemiology, harms and interventions.Addiction (Abingdon, England) · 2026Pooled it
- Global coverage of interventions for reduction of injecting drug use-related harm, HIV, viral hepatitis and tuberculosis in prisons and other carceral settings: A systematic review.The International journal on drug policy · 2026Pooled it
- Consensus practice guidelines on sacroiliac joint complex pain from a multispecialty, international working group.Pain medicine (Malden, Mass.) · 2025Guideline
- Predictive Models for Identifying Adult Patients at High Risk of Developing Opioid-Related Harms: a Systematic Review.Drug safety · 2025Pooled it
- Guideline
- Dynamic Simulation Models of Suicide and Suicide-Related Behaviors: Systematic Review.JMIR public health and surveillance · 2024Pooled it
- Management of opioid use disorder: 2024 update to the national clinical practice guideline.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Guideline
- Interventions to reduce harms related to drug use among people who experience incarceration: systematic review and meta-analysis.The Lancet. Public health · 2024Pooled it
- Examining inequities in access to opioid agonist treatment (OAT) take-home doses (THD): A Canadian OAT guideline synthesis and systematic review.The International journal on drug policy · 2024Pooled it
- Psychosocial factors associated with overdose subsequent to Illicit Drug use: a systematic review and narrative synthesis.Harm reduction journal · 2024Pooled it
- The Opioid Safety Toolkit: An interactive prescription opioid safety toolkit to increase opioid safety literacy and behaviours among people prescribed opioids for pain-a randomised controlled trial.Addiction (Abingdon, England) · 2026Trial
- From access to sustainability: understanding telemedicine-based buprenorphine induction through a RE-AIM lens.Addiction science & clinical practice · 2026Trial
- Integrating Methadone Services Into Primary Care in Ukraine: Two-Year Outcomes From a Randomized Trial.Annals of internal medicine · 2026Trial
- Trial
- Reduced opioids after total joint replacement surgery (REPAIRS): a pilot randomized controlled trial.Journal of orthopaedic surgery and research · 2025Trial
- Barriers and facilitators to scaling up medications for opioid use disorder in Kentucky: qualitative perspectives of treatment organization staff.Substance abuse treatment, prevention, and policy · 2025Trial
- Opioid consumption frequency and its associations with potential life problems during opioid agonist treatment in individuals with prescription-type opioid use disorder: exploratory results from the OPTIMA Study.Harm reduction journal · 2025Trial
377 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
11 authors at 6 institutions in 5 countries.
Funding
Abstract
We summarise the evidence for medicinal uses of opioids, harms related to the extramedical use of, and dependence on, these drugs, and a wide range of interventions used to address these harms. The Global Burden of Diseases, Injuries, and Risk Factors Study estimated that in 2017, 40·5 million people were dependent on opioids (95% uncertainty interval 34·3-47·9 million) and 109 500 people (105 800-113 600) died from opioid overdose. Opioid agonist treatment (OAT) can be highly effective in reducing illicit opioid use and improving multiple health and social outcomes-eg, by reducing overall mortality and key causes of death, including overdose, suicide, HIV, hepatitis C virus, and other injuries. Mathematical modelling suggests that scaling up the use of OAT and retaining people in treatment, including in prison, could avert a median of 7·7% of deaths in Kentucky, 10·7% in Kiev, and 25·9% in Tehran over 20 years (compared with no OAT), with the greater effects in Tehran and Kiev being due to reductions in HIV mortality, given the higher prevalence of HIV among people who inject drugs in those settings. Other interventions have varied evidence for effectiveness and patient acceptability, and typically affect a narrower set of outcomes than OAT does. Other effective interventions focus on preventing harm related to opioids. Despite strong evidence for the effectiveness of a range of interventions to improve the health and wellbeing of people who are dependent on opioids, coverage is low, even in high-income countries. Treatment quality might be less than desirable, and considerable harm might be caused to individuals, society, and the economy by the criminalisation of extramedical opioid use and dependence. Alternative policy frameworks are recommended that adopt an approach based on human rights and public health, do not make drug use a criminal behaviour, and seek to reduce drug-related harm at the population level.
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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.