ArticleAddiction (Abingdon, England)2025
Improving racial/ethnic health equity and naloxone access among people at risk for opioid overdose: A simulation modeling analysis of community-based naloxone distribution strategies in Massachusetts, United States.
Article in Addiction (Abingdon, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- The association between naloxone distribution, buprenorphine treatment and retention and incident high-risk opioid prescribing with opioid overdose death in Kentucky, Massachusetts, New York and Ohio, United States: An exploratory community-level cohort study of data from the HEALing Communities Study.Addiction (Abingdon, England) · 2026Observational
- A descriptive study of drug overdose epidemics, overdose prevention efforts, and opioid settlement fund distribution across six states.The International journal on drug policy · 2026Article
- Improving racial/ethnic health equity and naloxone access among people at risk for opioid overdose: A simulation modeling analysis of community-based naloxone distribution strategies in Massachusetts, United States.Addiction (Abingdon, England) · 2025Article
- Transforming Opioid Overdose Prevention in the United States: Leveraging FDA's Narcan Approval to Foster a Culture of Health.Risk management and healthcare policy · 2025Article
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Authors and funding
13 authors.
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Abstract
BACKGROUND AND
aimsDuring the COVID-19 pandemic, there was a surge in opioid overdose deaths (OODs) in Massachusetts, USA, particularly among Black and Hispanic/Latinx populations. Despite the increasing racial and ethnic disparities in OODs, there was no compensatory increase in naloxone distributed to these groups. We aimed to evaluate two community-based naloxone expansion strategies, with the objective of identifying approaches that could mitigate mortality and racial and ethnic disparities in OODs.
designIndividual-based simulation model. We measured naloxone availability using naloxone kits per OOD and evaluated scenarios of achieving higher benchmarks for naloxone availability (i.e. 40, 60 and 80 kits per OOD) from 2022 levels (overall: 26.0, White: 28.8, Black: 17.3, Hispanic/Latinx: 18.9). We compared two naloxone distribution strategies: (1) proportional distribution: achieving the benchmark ratio at the overall population level while distributing additional kits proportional to the 2022 level for each racial/ethnic group (at 40 kits per OOD benchmark: overall: 40, White: 44.3, Black: 26.6, Hispanic/Latinx: 29.1), and (2) equity-focused distribution: achieving the benchmark ratio among each racial/ethnic group (at 40 kits per OOD benchmark: 40 for all groups).
settingMassachusetts, United States.
participantsPeople at risk of OOD. MEASUREMENTS: Annual number and rate of OODs, total healthcare costs of increasing naloxone availability.
findingsBoth naloxone distribution strategies yielded comparable predicted reductions in total OODs in 2025 and incurred similar incremental costs. However, the relative reduction in the rate of OODs differed across groups. For achieving an 80 kits per OOD benchmark, proportional distribution resulted in a projected 6.7%, 6.5% and 7.1% reduction in annual OODs in 2025 among White, Black and Hispanic/Latinx populations, respectively. In contrast, equity-focused distribution achieved a reduction of 5.7%, 11.3% and 10.2% in the respective groups. In all scenarios, the cost per OOD averted was lower than the generally accepted thresholds for cost per life saved.
conclusionsAn equity-focused naloxone distribution strategy designed to reduce racial and ethnic disparities in naloxone availability could improve health equity among racial and ethnic groups while potentially improving overall population health at lower healthcare costs per opioid overdose death averted than a proportional distribution strategy.
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