ArticleThe Milbank quarterly2020
Situating the Continuum of Overdose Risk in the Social Determinants of Health: A New Conceptual Framework.
Article in The Milbank quarterly, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 89 papers.
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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.
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Who cites it
89 citing papers in PubMed.
- Factors Associated With Opioid-Involved Overdose: Descriptive Data From a Randomized Controlled Trial Evaluating Extended-Release Buprenorphine for Perinatal Opioid Use Disorder.Substance use & addiction journal · 2026Trial
- Recent incarceration and minoritized racial status as barriers to the effectiveness of recovery management checkups.Substance abuse treatment, prevention, and policy · 2025Trial
- Baseline characteristics of people experiencing homelessness with a recent drug overdose in the PHOENIx pilot randomised controlled trial.Harm reduction journal · 2023Trial
- Daily polysubstance use associated with HIV, HCV, and non-fatal overdose among people who inject drugs: A latent class analysis using nationwide data.Drug and alcohol dependence · 2026Article
- Psychopathy Facets Differentially Predict Drug- and Alcohol-Related Problems Following Violent Injury.Behavioral sciences (Basel, Switzerland) · 2026Article
- Medical Toxicology is the Overdose Specialty: Implications for the Dimensions and Continuum of Overdose Care.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2026Article
- Spatial Patterns of Opioid Overdose Mortality Risk Across Urban, Transitional, and Rural Communities Using Satellite-Derived and Socioeconomic Indicators.Journal of urban health : bulletin of the New York Academy of Medicine · 2026Article
- Reasoning, Contrastive, and In-Context Strategies for Opioid Use Stage Detection on Social Media.Proceedings of the ... Workshop on Patient-Oriented Language Processing · 2026Article
- Feasibility and Acceptability of Restroom Motion Sensors for Detecting Overdoses.Substance use & addiction journal · 2026Article
- The geography of risk: understanding disparities in nonmedical opioid mortality and the role of socio-built environments in New Jersey.Harm reduction journal · 2026Article
- Sociodemographic, behavioral, and geospatial factors associated with syringe services program use in San Francisco, California.Drug and alcohol dependence · 2026Article
- Unintentional benzodiazepine use and frequency of drug checking service utilization: a cross-sectional study.Harm reduction journal · 2026Article
- Co-Designing the PATH Harm Reduction Training for the Peer Workforce: A Community-Based Participatory Approach.Research square · 2025Article
- Common data elements for criminal legal system involvement for people who use drugs.Harm reduction journal · 2025Article
- Extreme vulnerability to overdose mortality: Intersections of detailed race/ethnicity, educational attainment, age, sex, and nativity.Drug and alcohol dependence · 2025Article
- Trajectories of neighborhood-level overdose risk predictions for prioritization of harm reduction services: Results from the PROVIDENT study.Drug and alcohol dependence · 2025Article
- Fatal Opioid Overdoses by Historical and Contemporary Neighborhood-Level Structural Racism.JAMA health forum · 2025Article
- Non-fatal Overdose and Associated Factors Among People Who Use Opioids: Findings From a Cross-sectional Study.Journal of community health · 2025Article
- Demographic, Social, Behavioral, and Clinical Characteristics Associated with Long-Term Opioid Therapy and Any Opioid Prescription in High-Risk VA Patients.Journal of general internal medicine · 2025Article
- Self-reported pathways through which illicitly manufactured fentanyl enters the stimulant supply: Novel insights from people incarcerated for drug manufacturing and distribution.SSM. Qualitative research in health · 2025Article
29 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
Policy Points This article reconceptualizes our understanding of the opioid epidemic and proposes six strategies that address the epidemic's social roots. In order to successfully reduce drug-related mortality over the long term, policymakers and public health leaders should develop partnerships with people who use drugs, incorporate harm reduction interventions, and reverse decades of drug criminalization policies. CONTEXT: Drug overdose is the leading cause of injury-related death in the United States. Synthetic opioids, predominantly illicit fentanyl and its analogs, surpassed prescription opioids and heroin in associated mortality rates in 2016. Unfortunately, interventions fail to fully address the current wave of the opioid epidemic and often omit the voices of people with lived experiences regarding drug use. Every overdose death is a culmination of a long series of policy failures and lost opportunities for harm reduction.
methodsIn this article, we conducted a scoping review of the opioid literature to propose a novel framework designed to foreground social determinants more directly into our understanding of this national emergency. The "continuum of overdose risk" framework is our synthesis of the global evidence base and is grounded in contemporary theories, models, and policies that have been successfully applied both domestically and internationally.
findingsDe-escalating overdose risk in the long term will require scaling up innovative and comprehensive solutions that have been designed through partnerships with people who use drugs and are rooted in harm reduction.
conclusionsWithout recognizing the full drug-use continuum and the role of social determinants, the current responses to drug overdose will continue to aggravate the problem they are trying to solve.
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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.