Evidence map›Paper›PMID 40577017›Full record

ArticleJAMA network open2025

Health and Economic Outcomes of Addressing Encampments of Individuals Using Opioids.

Hana Zwick, Ryan O'Dea, Joshua A Barocas, Juliet Miko Flam-Ross, Avik Chatterjee, Alexander Y Walley, Rebecca Arden Harris, Bruce R Schackman, Laura F White, Stavroula A Chrysanthopoulou and 6 more

Abstract read
In one paragraph

Article in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
  2. The Health Toll of Encampment Sweeps: A Descriptive Analysis of People Who Use Drugs in Massachusetts.Journal of urban health : bulletin of the New York Academy of Medicine · 2026
    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

16 authors.

Hana ZwickSection of Infectious Diseases, Boston Medical Center, Boston, Massachusetts.
Ryan O'DeaSection of Infectious Diseases, Boston Medical Center, Boston, Massachusetts.
Joshua A BarocasUniversity of Colorado Anschutz Medical Campus, Aurora.
Juliet Miko Flam-RossLondon School of Hygiene and Tropical Medicine, London, United Kingdom.
Avik ChatterjeeBoston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts.
Alexander Y WalleyBoston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts.
Rebecca Arden HarrisDepartment of Family Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Bruce R SchackmanWeill Cornell Medicine, New York, New York.
Laura F WhiteBoston University School of Public Health, Boston, Massachusetts.
Stavroula A ChrysanthopoulouBrown University School of Public Health, Providence, Rhode Island.
Sabrina A AssoumouSection of Infectious Diseases, Boston Medical Center, Boston, Massachusetts.
Sean M MurphyBoston University School of Public Health, Boston, Massachusetts.
Jake R MorganBoston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts.
Dimitri BaptisteSection of Infectious Diseases, Boston Medical Center, Boston, Massachusetts.
Matthew CarrollSection of Infectious Diseases, Boston Medical Center, Boston, Massachusetts.
Benjamin Paul LinasSection of Infectious Diseases, Boston Medical Center, Boston, Massachusetts.

Funding

Utilization of health services after engagement with opioid use disorder (OUD) treatment provider by individuals with and without post-traumatic stress disorderP30DA040500 · NIDA · WEILL MEDICAL COLL OF CORNELL UNIV · PI Benjamin P. Linas · 2015 to 2026
$20.7M
Researching Effective Strategies to Prevent Opioid Death (RESPOND)R01DA046527 · NIDA · BOSTON MEDICAL CENTER · PI Benjamin P. Linas · 2018 to 2026
$7.2M
PrEP and MOUD Rapid Access for Persons who Inject Drugs: the CHORUS+ StudyR01DA058367 · NIDA · BOSTON MEDICAL CENTER · PI Sabrina A Assoumou · 2023 to 2026
$4.3M
Development of a novel community-based high-performance surveillance network for drug useDP2DA051864 · NIDA · UNIVERSITY OF COLORADO DENVER · PI BAROCAS, JOSHUA ADAM · 2020 to 2020
$2.3M
Engaging Young People who Inject Drugs into HCV and HIV Care: Administrative Supplement to Promote Research Continuity and RetentionK23DA044085 · NIDA · BOSTON MEDICAL CENTER · PI ASSOUMOU, SABRINA A · 2018 to 2022
$979k
Reducing OUD treatment dropout: Development and pilot test of a peer recovery support intervention in primary careK23DA054157 · NIDA · UNIVERSITY OF PENNSYLVANIA · PI Rebecca Arden Harris · 2022 to 2026
$858k
Strategies to reduce serious bacterial infections and overdose among people who inject drugsK01DA051684 · NIDA · UNIVERSITY OF COLORADO DENVER · PI BAROCAS, JOSHUA ADAM · 2020 to 2024
$809k
NIDA NIH HHS DP2 DA051864NIDA NIH HHS K01 DA051684NIDA NIH HHS K23 DA044085NIDA NIH HHS K23 DA054157NIDA NIH HHS P30 DA040500NIDA NIH HHS R01 DA046527NIDA NIH HHS R01 DA058367
6 · The paper itself

Abstract

Importance: Many US communities face a crisis of people experiencing unsheltered homelessness often intertwined with opioid use. Jurisdictions seek policy options for managing unsanctioned encampments of this population, but their various outcomes are unclear. Objective: To evaluate policy options and their health and economic outcomes for an encampment of people experiencing homelessness and opioid use disorder (OUD). Design, Setting, and Participants: This decision analytical model study conducted a closed-cohort state-transition simulation using the Researching Effective Strategies to Prevent Opioid Death (RESPOND) model from October 2021 to October 2022. The study was based primarily on data from Massachusetts and simulated an urban encampment with a population experiencing homelessness and high-risk opioid use. Data analysis was performed from December 2022 to October 2024. Exposure: The following encampment management strategies were modeled: (1) status quo (no sweep); (2) sweep, a sudden disruption of all residents, followed by no additional resources; (3) housing with medication for opioid use disorder (MOUD) requirement; or (4) housing without MOUD requirement. Main Outcomes and Measures: The primary outcomes were overdose and all-cause mortality per 1000 person-years, weeks spent in housing and taking MOUD, and economic cost from a modified government payer perspective. Sensitivity analyses were conducted by varying uncertain parameters. Results: The simulated cohort included 400 adults (mean [SD] age, 48 [17] years; 232 males [58.0%]). Under the status quo strategy, there were 50.4 (95% uncertainty interval [UI], 48.9-52.2) deaths per 1000 person-years, 15.5 (95% UI, 14.0-17.2) deaths from overdose per 1000 person-years, and 2990 (95% UI, 2897-3081) person-weeks spent taking MOUD for a total cost of $6 583 000 (95% UI, $6 502 000-$6 660 000). A sweep strategy resulted in 53.1 (95% UI, 51.3-55.2) deaths per 1000 person-years, 16.4 (95% UI, 18.2-20.2) deaths from overdose per 1000 person-years, and 1694 (95% UI, 1625-1764) person-weeks spent taking MOUD at a total cost of $6 820 000 (95% UI, $6 736 000-$6 899 000). The housing with medication requirement strategy resulted in 51.2 (95% UI, 49.4-53.0) deaths per 1000 person-years, 16.3 (95% UI, 14.6-18.1) deaths from overdose per 1000 person-years, and 3050 (95% UI, 3025-3075) person-weeks spent taking MOUD and in housing, for a total cost of $7 264 000 (95% UI, $7 188 000-$7 336 000). A housing without MOUD requirement strategy resulted in 49.2 (95% UI, 47.6-51.1) deaths per 1000 person-years, 14.3 (95% UI, 12.7-16.2) deaths from overdose per 1000 person-years, and 5014 (95% UI, 4942-5085) person-weeks spent taking MOUD and 14 511 (95% UI, 14 461-14 562) person-weeks spent in housing, for a total cost of $8 822 000 (95% UI, $8 774 000-$8 868 000). Conclusions and Relevance: In this decision analytical model study of approaches to homeless encampments involving individuals with OUD, sweeps increased mortality and spending. Housing without MOUD requirement was the most costly strategy but saved more lives.

Indexed as

HousingIll-Housed PersonsOpioid-Related DisordersAdultAnalgesics, OpioidFemaleHumansMaleMassachusettsMiddle AgedAnalgesics, Opioid

Identifiers

PMID40577017
PMCPMC12205401

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.