Evidence map›Paper›PMID 40606798›Full record

ArticleDrug and alcohol dependence reports2025

Emergency medical system response, emergency department visits, and hospital admissions in response to non-fatal opioid overdoses reported by a cohort of overdose survivors in San Francisco and Boston, 2019 - 2022.

Rachel J Smith, Vanessa M McMahan, Nicole C McCann, Sarah Kosakowski, Sarah Brennan, Xochitl Luna Marti, Alexander Y Walley, Phillip O Coffin

Abstract read
In one paragraph

Article in Drug and alcohol dependence reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Observational
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

8 authors.

Rachel J SmithClinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine and Boston University School of Medicine, Boston Medical Center, One Boston Medical Center Place, Boston, MA 02118, United States.
Vanessa M McMahanCenter on Substance Use and Health, San Francisco Department of Public Health, 25 Van Ness Avenue, San Francisco, CA 94102, United States.
Nicole C McCannBoston University School of Public Health, Department of Health Law, Policy and Management, 715 Albany Street, Boston, MA 02118, United States.
Sarah KosakowskiClinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine and Boston University School of Medicine, Boston Medical Center, One Boston Medical Center Place, Boston, MA 02118, United States.
Sarah BrennanCenter on Substance Use and Health, San Francisco Department of Public Health, 25 Van Ness Avenue, San Francisco, CA 94102, United States.
Xochitl Luna MartiCenter on Substance Use and Health, San Francisco Department of Public Health, 25 Van Ness Avenue, San Francisco, CA 94102, United States.
Alexander Y WalleyClinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine and Boston University School of Medicine, Boston Medical Center, One Boston Medical Center Place, Boston, MA 02118, United States.
Phillip O CoffinCenter on Substance Use and Health, San Francisco Department of Public Health, 25 Van Ness Avenue, San Francisco, CA 94102, United States.

Funding

Repeated-dose behavioral intervention to reduce opioid overdose: a two-site randomized-controlled efficacy trialR01DA045690 · NIDA · PUBLIC HEALTH FOUNDATION ENTERPRISES · PI COFFIN, PHILLIP O · 2018 to 2022
$4.0M
Midcareer K24 Award for Mentoring and Patient-Oriented ResearchK24DA042720 · NIDA · SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH · PI PHILLIP O COFFIN · 2016 to 2026
$1.6M
NIDA NIH HHS K24 DA042720NIDA NIH HHS R01 DA045690
6 · The paper itself

Abstract

Background: Non-fatal opioid overdoses that do not result in an emergency medical system (EMS), emergency department or hospital encounter are not tracked. We aimed to understand the proportion of non-fatal overdoses with and without a healthcare encounter. Methods: We used data from the REpeated-dose Behavioral intervention to reduce Opioid Overdose inTervention (REBOOT) trial among opioid overdose survivors in San Francisco and Boston. Participants reported the number of non-fatal overdoses over the prior 4-months at baseline and follow-up visits over 16 months. We asked details about the three most recent overdoses, including naloxone administration, EMS attendance, transport to an emergency department, or hospitalization. Results: A total of 268 individuals completed 1163 assessments. Across the assessments, 150 participants reported a total of 504 overdoses. Complete details were collected for 384 of the overdose events. Naloxone was administered at 306 out of 384 (80 %) overdose events. EMS attended the scene in 177 out of 384 (46 %) of events, with naloxone administration occurring in 159 of these events (90 %); 130 of the 384 (34 %) events resulted in transportation to the emergency department, and only 18 (5 %) led to hospital admission. Conclusions: Among opioid overdose survivors in urban settings, EMS were present at less than half of self-reported overdoses, emergency department visits occurred in about one third, and admission to the hospital occurred in one of twenty overdoses. Most overdoses involved naloxone administration, frequently by lay responders. Estimating non-fatal overdose prevalence should not rely solely on measures of EMS attendance, emergency department or hospital admissions.

Indexed as

NaloxoneNon-fatal overdoseOpioidSubstance use

Identifiers

PMID40606798
PMCPMC12219355

What OpenQuestion holds

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Registered trials

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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.