ArticleThe International journal on drug policy2021
Effectiveness and implementability of state-level naloxone access policies: Expert consensus from an online modified-Delphi process.
Article in The International journal on drug policy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
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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
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Priority setting for Canadian Take-Home Naloxone best practice guideline development: an adapted online Delphi method.Harm reduction journal · 2022Guideline
- Creating a Classification System of Opioid Use Disorder Treatment Policies: A Research Protocol.Substance use & addiction journal · 2025Article
- Opioid use disorder, pain, and cognitive impairment in older adults who have experienced homelessness.Innovation in aging · 2025Article
- Implementation of Medication Disposal Programs and Availability of Same-Day Naloxone at Community Pharmacies: Protocol for a Secret Shopper Caller Approach.JMIR research protocols · 2025Article
- Naloxone dosing by non-medical first-responders at opioid overdoses: findings from a qualitative interview study.Harm reduction journal · 2025Article
- A qualitative exploration of harm reduction in practice by street-based peer outreach workers.Harm reduction journal · 2024Article
- Hospital Quality Indicators for Opioid-Exposed Infants: Results From an Expert Consensus Panel.Pediatrics · 2024Article
- ROMPER: The RAND/USC OPTIC Method for Policy Expert Ratings.MethodsX · 2024Article
- The policy landscape for naloxone distribution in four states highly impacted by fatal opioid overdoses.Drug and alcohol dependence reports · 2023Article
- Expert Panel Consensus on State-Level Policies to Improve Engagement and Retention in Treatment for Opioid Use Disorder.JAMA health forum · 2022Article
- Expert views on state-level naloxone access laws: a qualitative analysis of an online modified-Delphi process.Harm reduction journal · 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
2 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundNaloxone distribution, a key global strategy to prevent fatal opioid overdose, has been a recent target of legislation in the U.S., but there is insufficient empirical evidence from causal inference methods to identify which components of these policies successfully reduce opioid-related harms. This study aimed to examine expert consensus on the effectiveness and implementability of various state-level naloxone policies.
methodsWe used the online ExpertLens platform to conduct a three-round modified-Delphi process with a purposive sample of 46 key stakeholders (advocates, healthcare providers, human/social service practitioners, policymakers, and researchers) with naloxone policy expertise. The Effectiveness Panel (n = 24) rated average effects of 15 types of policies on naloxone pharmacy distribution, opioid use disorder (OUD) prevalence, nonfatal opioid-related overdoses, and opioid-related overdose mortality. The Implementation Panel (n = 22) rated the same policies on acceptability, feasibility, affordability, and equitability. We compared ratings across policies using medians and inter-percentile ranges, with consensus measured using the RAND/UCLA Appropriateness Method Inter-Percentile Range Adjusted for Symmetry technique.
resultsExperts reached consensus on all items. Except for liability protections and required provision of education or training, experts perceived all policies to generate moderate-to-large increases in naloxone pharmacy distribution. However, only three policies were expected to yield substantive decreases on fatal overdose: statewide standing/protocol order, over-the-counter supply, and statewide "free naloxone." Of these, experts rated only statewide standing/protocol orders as highly affordable and equitable, and unlikely to generate meaningful population-level effects on OUD or nonfatal opioid-related overdose. Across all policies, experts rated naloxone prescribing mandates relatively lower in acceptability, feasibility, affordability, and equitability.
conclusionExperts believe statewide standing/protocol orders are an effective, implementable, and equitable policy for addressing opioid-related overdose mortality. While experts believe many other broad policies are effective in reducing opioid-related harms, they also believe these policies face implementation challenges related to cost and reaching vulnerable populations.
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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.