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

Nisha Nataraj¹, S Michaela Rikard¹, Kun Zhang¹

¹Division of Overdose Prevention, National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia.

JAMA Network Open

|April 3, 2024

Summary

Public health interventions can significantly reduce opioid overdose deaths. Harm reduction strategies offer the most immediate impact on fatal overdoses, while increasing medication for opioid use disorder (MOUD) treatment shows long-term benefits.

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Area of Science:

Public Health
Epidemiology
Health Policy

Background:

Opioid overdose deaths remain a critical public health crisis in the US.
Opioid use disorder (OUD) presents complex epidemiological challenges.
Systems models can identify effective public health interventions for OUD.

Purpose of the Study:

To project the 3-year impact of public health interventions on opioid overdose outcomes.
To analyze the association between interventions and outcomes for individuals with OUD.

Main Methods:

A decision analytical simulation model of the US population (aged 12+) with OUD was developed.
The model was parameterized and calibrated using 2019-2020 data.
Simulated interventions were implemented between 2021-2023 to estimate outcome changes.

Main Results:

Without interventions, over 16 million persons with OUD were projected to not receive MOUD treatment by 2023.
Over 5 million nonfatal and 145,000 fatal opioid-involved overdoses were projected between 2021-2023.
Simulated interventions reducing overdose rates by 50% projected up to 36.6% decrease in fatal overdoses; MOUD initiation/retention interventions reduced OUD prevalence by 23.4%.

Conclusions:

Harm reduction interventions show the greatest potential for short-term reduction in fatal opioid overdoses.
Increasing MOUD initiation and retention can improve MOUD/OUD prevalence but requires a longer timeframe for overdose reduction.
Evidence-based interventions are crucial for mitigating the impact of OUD and opioid-involved overdoses.