ArticleLancet regional health. Americas2021
Effectiveness of Policies for Addressing the US Opioid Epidemic: A Model-Based Analysis from the Stanford-Lancet Commission on the North American Opioid Crisis.
Article in Lancet regional health. Americas, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 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
50 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Association between state cannabis laws and opioid outcomes: A systematic review.Drug and alcohol dependence · 2026Pooled it
- Barriers and facilitators to initiating and adhering to harm reduction services among people who inject drugs in the United States: a systematic review.Harm reduction journal · 2026Pooled it
- Combatting opioid misuse, overuse and abuse: a systematic review of pharmacists' services and outcomes.Pain management · 2024Pooled it
- Organizational perspectives on the impacts of scaling up overdose education and naloxone distribution in Kentucky.Addiction science & clinical practice · 2025Trial
- Community-Based Cluster-Randomized Trial to Reduce Opioid Overdose Deaths.The New England journal of medicine · 2024Trial
- Reducing perceived barriers to scaling up overdose education and naloxone distribution and medications for opioid use disorder in the United States in the HEALing (Helping End Addiction Long-Term®) communities study.Preventive medicine · 2024Trial
- Evaluating demographic variation in no-cost naloxone distribution in North Carolina: a cross-sectional survey study.Harm reduction journal · 2026Article
- Impact of enhanced practices on opioid overdose deaths: A community-based modeling approach.Addiction (Abingdon, England) · 2026Article
- Regulating quasi-legal markets: Evidence from pain management clinic laws.Journal of public economics · 2025Article
- Advocacy and the Opioid Epidemic: Positioning Providers to Influence Policy and Improve Public Health.Focus (American Psychiatric Publishing) · 2025Article
- Advocacy in Psychiatry: Driving Public Policy Change.Focus (American Psychiatric Publishing) · 2025Article
- Hydrocodone Rescheduling and Opioid Prescribing Disparities in Breast Cancer Patients.Cancers · 2025Article
- Examining geographic disparities in access to no-cost naloxone in North Carolina: A cross-sectional survey of naloxone distribution programs.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- The importance of contextually specific support relationships in implementing programs to link people to medication for opioid use disorder (MOUD) treatment during reentry from county jails.Health & justice · 2025Article
- Naloxone Knowledge, Carrying, Purchase, and Use.JAMA network open · 2025Article
- Predicting fatal opioid-involved overdoses: A social-ecological framework matched to a linked-data warehouse.The International journal on drug policy · 2025Article
- Toward Developing Alternative Opioid Antagonists for Treating Community Overdose: A Model-Based Evaluation of Important Pharmacological Attributes.Clinical pharmacology and therapeutics · 2025Article
- Invited commentary: motivating better methods-and better data collection-for measuring the prevalence of drug misuse.American journal of epidemiology · 2025Article
- Opioid Prescriptions for US Patients Undergoing Long-Term Dialysis or with Kidney Transplant from 2011 to 2020.Journal of the American Society of Nephrology : JASN · 2025Article
- Services for perinatal patients with opioid use disorder: a comprehensive Baltimore City-wide 2023 assessment.Addiction science & clinical practice · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
backgroundThe U.S. opioid crisis has been exacerbated by COVID-19 and the spread of synthetic opioids (e.g., fentanyl).
methodsWe model the effectiveness of reduced prescribing, drug rescheduling, prescription monitoring programs (PMPs), tamper-resistant drug reformulation, excess opioid disposal, naloxone availability, syringe exchange, pharmacotherapy, and psychosocial treatment. We measure life years, quality-adjusted life years (QALYs), and opioid-related deaths over five and ten years.
findingsUnder the status quo, our model predicts that approximately 547,000 opioid-related deaths will occur from 2020 to 2024 (range 441,000 - 613,000), rising to 1,220,000 (range 996,000 - 1,383,000) by 2029. Expanding naloxone availability by 30% had the largest effect, averting 25% of opioid deaths. Pharmacotherapy, syringe exchange, psychosocial treatment, and PMPs are uniformly beneficial, reducing opioid-related deaths while leading to gains in life years and QALYs. Reduced prescribing and increasing excess opioid disposal programs would reduce total deaths, but would lead to more heroin deaths in the short term. Drug rescheduling would increase total deaths over five years as some opioid users escalate to heroin, but decrease deaths over ten years. Combined interventions would lead to greater increases in life years, QALYs, and deaths averted, although in many cases the results are subadditive.
interpretationExpanded health services for individuals with opioid use disorder combined with PMPs and reduced opioid prescribing would moderately lessen the severity of the opioid crisis over the next decade. Tragically, even with improved public policies, significant morbidity and mortality is inevitable.
Identifiers
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.