Evidence map›Paper›PMID 38807226›Full record

ArticleHarm reduction journal2024

Reducing overdose deaths among persons with opioid use disorder in connecticut.

Joy D Scheidell, Tarlise N Townsend, Qinlian Zhou, Prima Manandhar-Sasaki, Ramon Rodriguez-Santana, Mark Jenkins, Marianne Buchelli, Dyanna L Charles, Jillian M Frechette, Jasmine I-Shin Su and 1 more

Abstract read
In one paragraph

Article in Harm reduction journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Joy D ScheidellDepartment of Health Sciences, University of Central Florida, PO Box 160000, Orlando, FL, 32816, USA. Joy.Scheidell@ucf.edu.
Tarlise N TownsendDepartment of Population Health, New York University Grossman School of Medicine, 227 E. 30th St, New York, NY, 10016, USA.
Qinlian ZhouDepartment of Population Health, New York University Grossman School of Medicine, 227 E. 30th St, New York, NY, 10016, USA.
Prima Manandhar-SasakiDepartment of Population Health, New York University Grossman School of Medicine, 227 E. 30th St, New York, NY, 10016, USA.
Ramon Rodriguez-SantanaHIV Prevention Program, Connecticut Department of Public Health, 410 Capitol Avenue, MS #11APV, Hartford, CT, 06134-0308, USA.
Mark JenkinsConnecticut Harm Reduction Alliance, 28 Grand St, Hartford, CT, 06106, USA.
Marianne BuchelliHIV Prevention Program, Connecticut Department of Public Health, 410 Capitol Avenue, MS #11APV, Hartford, CT, 06134-0308, USA.
Dyanna L CharlesDepartment of Population Health, New York University Grossman School of Medicine, 227 E. 30th St, New York, NY, 10016, USA.
Jillian M FrechetteDepartment of Population Health, New York University Grossman School of Medicine, 227 E. 30th St, New York, NY, 10016, USA.
Jasmine I-Shin SuDepartment of Population Health, New York University Grossman School of Medicine, 227 E. 30th St, New York, NY, 10016, USA.
R Scott BraithwaiteDepartment of Population Health, New York University Grossman School of Medicine, 227 E. 30th St, New York, NY, 10016, USA.

Funding

Reducing morbidity and mortality from overdose, HIV, and hepatitis C in opioid-using personsR01DA043815 · NIDA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI BRAITHWAITE, RONALD SCOTT · 2018 to 2022
$3.3M
NIDA NIH HHS R01 DA043815
6 · The paper itself

Abstract

backgroundPeople in Connecticut are now more likely to die of a drug-related overdose than a traffic accident. While Connecticut has had some success in slowing the rise in overdose death rates, substantial additional progress is necessary.

methodsWe developed, verified, and calibrated a mechanistic simulation of alternative overdose prevention policy options, including scaling up naloxone (NLX) distribution in the community and medications for opioid use disorder (OUD) among people who are incarcerated (MOUD-INC) and in the community (MOUD-COM) in a simulated cohort of people with OUD in Connecticut. We estimated how maximally scaling up each option individually and in combinations would impact 5-year overdose deaths, life-years, and quality-adjusted life-years. All costs were assessed in 2021 USD, employing a health sector perspective in base-case analyses and a societal perspective in sensitivity analyses, using a 3% discount rate and 5-year and lifetime time horizons.

resultsMaximally scaling NLX alone reduces overdose deaths 20% in the next 5 years at a favorable incremental cost-effectiveness ratio (ICER); if injectable rather than intranasal NLX was distributed, 240 additional overdose deaths could be prevented. Maximally scaling MOUD-COM and MOUD-INC alone reduce overdose deaths by 14% and 6% respectively at favorable ICERS. Considering all permutations of scaling up policies, scaling NLX and MOUD-COM together is the cost-effective choice, reducing overdose deaths 32% at ICER $19,000/QALY. In sensitivity analyses using a societal perspective, all policy options were cost saving and overdose deaths reduced 33% over 5 years while saving society $338,000 per capita over the simulated cohort lifetime.

conclusionsMaximally scaling access to naloxone and MOUD in the community can reduce 5-year overdose deaths by 32% among people with OUD in Connecticut under realistic budget scenarios. If societal cost savings due to increased productivity and reduced crime costs are considered, one-third of overdose deaths can be reduced by maximally scaling all three policy options, while saving money.

Indexed as

Cost-Benefit AnalysisDrug OverdoseNaloxoneNarcotic AntagonistsOpioid-Related DisordersAdultConnecticutFemaleHarm ReductionHumansMaleOpiate OverdosePrisonersQuality-Adjusted Life YearsNaloxoneNarcotic AntagonistsCost-effectiveness analysisHarm reductionModelingOpiate medication-assisted treatmentOpiate overdoseOpioid use disorder

Identifiers

PMID38807226
PMCPMC11131266

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.