Projected Estimates of Opioid Mortality After Community-Level Interventions
Benjamin P Linas1,2, Alexandra Savinkina1, R W M A Madushani1
1Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts.
JAMA Network Open
|February 15, 2021
Summary
Achieving a 40% reduction in opioid overdose deaths requires combining medication for opioid use disorder (MOUD) with increased naloxone distribution. This involves initiating MOUD for 10-15% of the untreated population monthly and ensuring 45-60% retention.
Area of Science:
- Public Health
- Epidemiology
- Health Services Research
Background:
- The United States faces a critical opioid overdose crisis.
- The US Department of Health and Human Services aims to cut overdose mortality by 40% by 2022.
Purpose of the Study:
- To identify combinations of interventions for reducing opioid overdose deaths.
- To evaluate the impact of initiating medications for opioid use disorder (MOUD), increasing MOUD retention, and boosting naloxone distribution.
Main Methods:
- A dynamic, population-level state-transition model was employed.
- Simulated urban and rural communities in Massachusetts were analyzed over a 2-year period.
- Intervention scenarios were compared against a no-intervention counterfactual.
Main Results:
- No single intervention achieved the 40% overdose mortality reduction goal.
- A 40% reduction necessitates combining MOUD initiation (10-15% monthly) and retention (45-60% for 6 months) with increased naloxone distribution.
- All scenarios achieving the goal required at least 10% of the untreated opioid use disorder (OUD) population to initiate MOUD monthly.
Conclusions:
- Community-level reductions in overdose mortality require enhanced MOUD treatment capacity and improved retention rates.
- Findings offer a framework for developing effective community-based strategies to combat opioid overdose deaths.
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