ArticleThe lancet. Psychiatry2021
Modelling the intervention effect of opioid agonist treatment on multiple mortality outcomes in people who inject drugs: a three-setting analysis.
Article in The lancet. Psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 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
25 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Dynamic Simulation Models of Suicide and Suicide-Related Behaviors: Systematic Review.JMIR public health and surveillance · 2024Pooled it
- Global coverage of interventions to prevent and manage drug-related harms among people who inject drugs: a systematic review.The Lancet. Global health · 2023Pooled it
- Assessing HIV and overdose risks for people who use drugs exposed to compulsory drug abstinence programs (CDAP): A systematic review and meta-analysis.The International journal on drug policy · 2021Pooled it
- Prescribing methadone in prison predicts linkage to HIV care after release from prison: A randomized and patient preference trial.The International journal on drug policy · 2025Trial
- Health, Social and Recidivism Outcomes Among People Who Have Been Incarcerated in New South Wales, Australia: Study Protocol and Cohort Profile for the Prison Outcomes STudy (POST).Drug and alcohol review · 2026Article
- Optimal provision of opiate substitution therapy and needle and syringe programmes: a multi-method realist evaluation.Health technology assessment (Winchester, England) · 2025Article
- Exploring barriers and potential solutions before implementing a scale-up strategy to expand methadone coverage among people who inject drugs in Tajikistan.Journal of substance use and addiction treatment · 2025Article
- Retention and dropout from sublingual and extended-release buprenorphine treatment: A comparative analysis of data from a nationally representative sample of commercially-insured people with opioid use disorder in the United States.The International journal on drug policy · 2025Article
- Improving implementation of needle and syringe programmes to expand, scale up, and sustain evidence-based prevention interventions for HIV and hepatitis C in prisons.The Lancet. Public health · 2025Article
- Disruptions to HIV Prevention During Armed Conflict in Ukraine and Other Settings.Current HIV/AIDS reports · 2024Review
- Provision of medications to treat opioid use disorder via a mobile health unit: A scoping review.Journal of substance use and addiction treatment · 2024Article
- Unmet need for medication for opioid use disorder among persons who inject drugs in 23 U.S. cities.Drug and alcohol dependence · 2024Article
- Higher methadone dose at time of release from prison predicts linkage to maintenance treatment for people with HIV and opioid use disorder transitioning to the community in Malaysia.The International journal on drug policy · 2024Article
- Article
- Analysis of the UK Government's 10-Year Drugs Strategy-a resource for practitioners and policymakers.Journal of public health (Oxford, England) · 2023Article
- Introducing methadone maintenance therapy into Ukrainian prisons: a qualitative study of criminal subculture, Russia's full-scale invasion, and contested methadone objects.Frontiers in psychiatry · 2023Article
- Implementation opportunities for scaling up methadone maintenance treatment in Kyrgyzstan: Methadone dosage and retention on treatment over two years.Drug and alcohol dependence reports · 2022Article
- Barriers and facilitators to opioid agonist therapy in rural and remote communities in Canada: an integrative review.Substance abuse treatment, prevention, and policy · 2022Review
- Article
- A pilot implementation study to scale-up methadone in incarcerated persons with opioid use disorder and retain them on treatment after release in Moldova.The International journal on drug policy · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
Abstract
backgroundOpioid agonist treatment (OAT) reduces many of the harms associated with opioid dependence. We use mathematical modelling to comprehensively evaluate the overall health benefits of OAT in people who inject drugs in Perry County (KY, USA), Kyiv (Ukraine), and Tehran (Iran).
methodsWe developed a dynamic model of HIV and hepatitis C virus (HCV) transmission, incarceration, and mortality through overdose, injury, suicide, disease-related and other causes. The model was calibrated to site-specific data using Bayesian methods. We evaluated preventable drug-related deaths (deaths due to HIV, HCV, overdose, suicide, or injury) averted over 2020-40 for four scenarios, added incrementally, compared with a scenario without OAT: existing OAT coverage (setting-dependent; community 4-11%; prison 0-40%); scaling up community OAT to 40% coverage; increasing average OAT duration from 4-14 months to 2 years; and scaling up prison-based OAT. OUTCOMES: Drug-related harms contributed differentially to mortality across settings: overdose contributed 27-47% (range of median projections) of preventable drug-related deaths over 2020-40, suicide 6-17%, injury 3-17%, HIV 0-59%, and HCV 2-18%. Existing OAT coverage in Tehran (31%) could have a substantial effect, averting 13% of preventable drug-related deaths, but will have negligible effect (averting <2% of preventable drug-related deaths) in Kyiv and Perry County due to low OAT coverage (<4%). Scaling up community OAT to 40% could avert 12-24% of preventable drug-related deaths, including 13-22% of overdose deaths, with greater effect in settings with significant HIV mortality (Tehran and Kyiv). Improving OAT retention and providing prison-based OAT would have a significant additional effect, averting 27-51% of preventable drug-related deaths.
interpretationOAT can substantially reduce drug-related harms, particularly in settings with HIV epidemics in people who inject drugs. Maximising these effects requires research and investment into achieving higher coverage and provision and longer retention of OAT in prisons and the community.
fundingUK National Institute for Health Research, US National Institute on Drug Abuse.
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