Open Access

JAMA network open

, volume 7 , issue 4 , pages e244617

Public Health Interventions and Overdose-Related Outcomes Among Persons With Opioid Use Disorder

Nisha Nataraj ¹

S Michaela Rikard ¹

Kun Zhang ¹

Xinyi Jiang ¹

Gery P. Guy ¹

Ketra Rice ²

Christine L Mattson ¹

R. Matthew Gladden ¹

Desiree M. Mustaquim ¹

Zachary N. Illg ^{1, 3}

Puja Seth ¹

Rita K. Noonan ¹

Jan L Losby ¹

Hide authors affiliations Show authors affiliations: 3 affiliations

Division of Overdose Prevention, National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia |

Division of Injury Prevention, National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia |

Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia |

Publication type: Journal Article

Publication date: 2024-04-03

American Medical Association (AMA)

JAMA network open

scimago Q1

wos Q1

SJR: 3.546

CiteScore: 13.8

Impact factor: 9.7

ISSN: 25743805

DOI: 10.1001/jamanetworkopen.2024.4617

Copy DOI

PubMed ID: 38568691

General Medicine

Abstract

Importance

Given the high number of opioid overdose deaths in the US and the complex epidemiology of opioid use disorder (OUD), systems models can serve as a tool to identify opportunities for public health interventions.

Objective

To estimate the projected 3-year association between public health interventions and opioid overdose-related outcomes among persons with OUD.

Design, Setting, and Participants

This decision analytical model used a simulation model of the estimated US population aged 12 years and older with OUD that was developed and analyzed between January 2019 and December 2023. The model was parameterized and calibrated using 2019 to 2020 data and used to estimate the relative change in outcomes associated with simulated public health interventions implemented between 2021 and 2023.

Main Outcomes and Measures

Projected OUD and medications for OUD (MOUD) prevalence in 2023 and number of nonfatal and fatal opioid-involved overdoses among persons with OUD between 2021 and 2023.

Results

In a baseline scenario assuming parameters calibrated using 2019 to 2020 data remained constant, the model projected more than 16 million persons with OUD not receiving MOUD treatment and nearly 1.7 million persons receiving MOUD treatment in 2023. Additionally, the model projected over 5 million nonfatal and over 145 000 fatal opioid-involved overdoses among persons with OUD between 2021 and 2023. When simulating combinations of interventions that involved reducing overdose rates by 50%, the model projected decreases of up to 35.2% in nonfatal and 36.6% in fatal opioid-involved overdoses among persons with OUD. Interventions specific to persons with OUD not currently receiving MOUD treatment demonstrated the greatest reduction in numbers of nonfatal and fatal overdoses. Combinations of interventions that increased MOUD initiation and decreased OUD recurrence were projected to reduce OUD prevalence by up to 23.4%, increase MOUD prevalence by up to 137.1%, and reduce nonfatal and fatal opioid-involved overdoses among persons with OUD by 6.7% and 3.5%, respectively.

Conclusions and Relevance

In this decision analytical model study of persons with OUD, findings suggested that expansion of evidence-based interventions that directly reduce the risk of overdose fatality among persons with OUD, such as through harm reduction efforts, could engender the highest reductions in fatal overdoses in the short-term. Interventions aimed at increasing MOUD initiation and retention of persons in treatment projected considerable improvement in MOUD and OUD prevalence but could require a longer time horizon for substantial reductions in opioid-involved overdoses.

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Nataraj N. et al. Public Health Interventions and Overdose-Related Outcomes Among Persons With Opioid Use Disorder // JAMA network open. 2024. Vol. 7. No. 4. p. e244617.

GOST all authors (up to 50) Copy

Nataraj N., Rikard S. M., Zhang K., Jiang X., Guy G. P., Rice K., Mattson C. L., Gladden R. M., Mustaquim D. M., Illg Z. N., Seth P., Noonan R. K., Losby J. L. Public Health Interventions and Overdose-Related Outcomes Among Persons With Opioid Use Disorder // JAMA network open. 2024. Vol. 7. No. 4. p. e244617.

RIS |

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RIS Copy

TY - JOUR

DO - 10.1001/jamanetworkopen.2024.4617

UR - https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2817002

TI - Public Health Interventions and Overdose-Related Outcomes Among Persons With Opioid Use Disorder

T2 - JAMA network open

AU - Nataraj, Nisha

AU - Rikard, S Michaela

AU - Zhang, Kun

AU - Jiang, Xinyi

AU - Guy, Gery P.

AU - Rice, Ketra

AU - Mattson, Christine L

AU - Gladden, R. Matthew

AU - Mustaquim, Desiree M.

AU - Illg, Zachary N.

AU - Seth, Puja

AU - Noonan, Rita K.

AU - Losby, Jan L

PY - 2024

DA - 2024/04/03

PB - American Medical Association (AMA)

SP - e244617

IS - 4

VL - 7

PMID - 38568691

SN - 2574-3805

ER -

BibTex |

Cite this

BibTex (up to 50 authors) Copy

@article{2024_Nataraj,

author = {Nisha Nataraj and S Michaela Rikard and Kun Zhang and Xinyi Jiang and Gery P. Guy and Ketra Rice and Christine L Mattson and R. Matthew Gladden and Desiree M. Mustaquim and Zachary N. Illg and Puja Seth and Rita K. Noonan and Jan L Losby},

title = {Public Health Interventions and Overdose-Related Outcomes Among Persons With Opioid Use Disorder},

journal = {JAMA network open},

year = {2024},

volume = {7},

publisher = {American Medical Association (AMA)},

month = {apr},

url = {https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2817002},

number = {4},

pages = {e244617},

doi = {10.1001/jamanetworkopen.2024.4617}

}

MLA

Cite this

MLA Copy

Nataraj, Nisha, et al. “Public Health Interventions and Overdose-Related Outcomes Among Persons With Opioid Use Disorder.” JAMA network open, vol. 7, no. 4, Apr. 2024, p. e244617. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2817002.

Publisher

American Medical Association (AMA)

Journal

JAMA network open

scimago Q1

wos Q1

SJR

3.546

CiteScore

13.8

Impact factor

9.7

ISSN

25743805 (Electronic)