ArticleAddiction (Abingdon, England)2022
Modeling the cost-effectiveness and impact on fatal overdose and initiation of buprenorphine-naloxone treatment at syringe service programs.
Article in Addiction (Abingdon, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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.
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Who cites it
9 citing papers in PubMed, 14 citations in OpenAlex.
- "Now that I'm here, I actually have the stability and the time to really think about stuff like that": Perspectives on medications for opioid use disorder in low-threshold harm reduction housing.Journal of substance use and addiction treatment · 2025Article
- Perspectives on medication for opioid use disorder (MOUD) access and service delivery among a community sample of people who use opioids in Los Angeles.Journal of substance use and addiction treatment · 2025Article
- Health and Economic Outcomes of Offering Buprenorphine in Homeless Shelters in Massachusetts.JAMA network open · 2024Article
- Economic evaluation of the effect of needle and syringe programs on skin, soft tissue, and vascular infections in people who inject drugs: a microsimulation modelling approach.Harm reduction journal · 2024Article
- Use of Big Data and Ethical Issues for Populations With Substance Use Disorder.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2023Article
- Three decades of research in substance use disorder treatment for syringe services program participants: a scoping review of the literature.Addiction science & clinical practice · 2023Article
- Commentary on Adams et al.: using administrative big data for the public good.Addiction (Abingdon, England) · 2022Article
- Expert views on state-level naloxone access laws: a qualitative analysis of an online modified-Delphi process.Harm reduction journal · 2022Article
- Low-Threshold Buprenorphine in Non-Traditional Settings: A Scoping Review.Substance use : research and treatmentReview
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 1 country.
Funding
Abstract
aimTo estimate the number of treatment initiations, averted fatal opioid overdoses and the cost-effectiveness associated with offering buprenorphine-naloxone (buprenorphine) treatment on-site within existing syringe service programs (SSPs) in Massachusetts, USA. DESIGN, SETTING AND
participantsThis was a cohort-based mathematical model and cost-effectiveness analysis. We derived model inputs from state and national surveillance data, clinical trials and observational cohort studies. We compared an intervention scenario where 30% of SSP clients initiated buprenorphine treatment on-site at least once annually to a status quo scenario where no buprenorphine was available on-site among community treatment providers in Massachusetts, 2020-30. In individuals with opioid use disorder (OUD) we assumed that 80% of SSP clients had recently injected drugs and that treatment within SSPs would have similar or improved retention compared with standard-of-care buprenorphine programs, but higher rates of active opioid use while in treatment. MEASUREMENTS: Number of treatment initiations (i.e. individuals began treatment on a medication for opioid use disorder or entered medically managed withdrawal), averted fatal opioid overdoses, quality-adjusted life-years (QALYs) and life-time discounted costs from a health sector and a limited societal perspective.
findingsThe status quo scenario resulted in 23 051 fatal overdoses and 1 511 613 treatment initiations over a 10-year simulation period. An intervention scenario with on-site SSP buprenorphine treatment averted 4797 (-20.8%) fatal opioid overdoses and resulted in 129 359 (+8.6%) additional treatment initiations compared with the status quo. The intervention scenario was the dominating scenario: providing OUD treatment through Massachusetts SSPs cost less (-$3612 per person) with patients accumulating more QALYs (0.2 per person) compared with the status quo scenario.
conclusionsOffering buprenorphine treatment on-site within syringe service programs has the potential to decrease fatal overdoses substantially, improve treatment engagement and save on costs.
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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.