Evidence map›Paper›PMID 41386037›Full record

ArticleDrug and alcohol dependence2026

Micro-costing analysis of harm reduction services in office-based addiction treatment.

Austen Markus, Margaret Shang, Olivia Studnicki, Ariana Freund, Jessica Merlin, Jane M Liebschutz, Vikram K Raghu, Raagini Jawa

Abstract read
In one paragraph

Article in Drug and alcohol dependence, 2026. 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. 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

8 authors.

Austen MarkusCenter for Research on Healthcare, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. Electronic address: erm209@pitt.edu.
Margaret ShangCenter for Research on Healthcare, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Olivia StudnickiCenter for Research on Healthcare, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Ariana FreundCenter for Research on Healthcare, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Jessica MerlinCenter for Research on Healthcare, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Jane M LiebschutzCenter for Research on Healthcare, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Vikram K RaghuDepartment of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Raagini JawaCenter for Research on Healthcare, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Funding

University of Pittsburgh Clinical and Translational Science InstituteUL1TR001857 · NCATS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REIS, STEVEN E · 2016 to 2025
$129.3M
Tailored Retention and Engagement for Equitable Treatment of OUD and Pain (TREETOP)RM1DA055311 · NIDA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI HAMM, MEGAN, MERLIN, JESSICA S · 2021 to 2025
$12.7M
University of Pittsburgh Collaboration in Addiction Training Scholars (PittCATS) ProgramK12DA050607 · NIDA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Jane M. Liebschutz, Erin L Winstanley · 2020 to 2026
$3.2M
NCATS NIH HHS UL1 TR001857NIDA NIH HHS K12 DA050607NIDA NIH HHS RM1 DA055311
6 · The paper itself

Abstract

objectivesThe U.S. opioid crisis, driven by rising polysubstance use and limited access to treatment, continues to strain healthcare systems with nearly 87 % of people with substance use disorders (SUD) lacking addiction treatment and SUD-related hospitalizations increasing. Integration of harm reduction services (HRS) into office-based addiction treatment (OBAT) can reduce high-risk drug use, overdose, infection, and healthcare utilization. However, stigma and reimbursement barriers have hindered adoption. To inform future implementation, we conducted a micro-costing analysis of HRS integration in OBAT settings.

methodsUsing a retrospective, ingredients-based, micro-costing approach from the health system perspective, we estimated the upfront and operational costs associated with distributing pre-packaged harm reduction kits in three OBAT clinics in Pittsburgh, PA, and assessed the absolute costs of the program to determine affordability.

resultsBetween February 2024 and June 2024, a total of 784 kits were distributed, averaging 261 kits per site. The most popular kits distributed included fentanyl test strips (n = 155), wound care (n = 146), and xylazine test strips (n = 122). Total upfront costs were $1962.03, and 5-month operational costs were $5480.68 across all three sites. Thus, we estimated that HRS integration into OBAT settings would cost one site $654.01 upfront and $365.38 and $4384.54 to operate monthly and annually, respectively.

conclusionsWe found that the estimated costs of HRS integration into OBAT sites was affordable and on par with other medical supplies kept in clinic spaces. More research needs to be done to assess HRS cost-effectiveness in reducing healthcare utilization and patient morbidity.

Indexed as

Harm ReductionSubstance-Related DisordersCosts and Cost AnalysisHealth Care CostsHumansOpioid-Related DisordersRetrospective StudiesCost analysisHarm reductionMicro-costing

Identifiers

PMID41386037
PMCPMC13560360

What OpenQuestion holds

Textmetadata
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.