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Agent-Based Model of Combined Community- and Jail-Based Take-Home Naloxone Distribution.
Eric Tatara1,2, Jonathan Ozik1,2,3,4, Harold A Pollack3,5,6
1Decision and Infrastructure Sciences Division, Argonne National Laboratory, Lemont, Illinois.
JAMA Network Open
|December 10, 2024
Summary
Distributing take-home naloxone (THN) at jail release can significantly reduce opioid overdose deaths. This cost-effective intervention relies on bystander preparedness to maximize its impact.
Area of Science:
- Public Health
- Epidemiology
- Health Policy
Background:
- Opioid-related overdose causes nearly 80,000 US deaths annually.
- Individuals released from jail are at high risk for opioid overdose.
- Take-home naloxone (THN) distribution may reduce overdose mortality.
Purpose of the Study:
- To estimate the population-level impact of THN distribution at jail release.
- To assess the effectiveness of THN in reversing opioid-related overdoses among people with opioid use disorders.
Main Methods:
- Developed the agent-based Justice-Community Circulation Model (JCCM).
- Modeled a synthetic population using 2014-2020 Cook County, Illinois data.
- Examined 27 scenarios of THN distribution strategies and performed sensitivity analysis.
Main Results:
- THN distribution at jail release averted a median of 11.70% of opioid overdose deaths.
- Bystander presence probability significantly influenced deaths averted.
- Cost-effectiveness was high, with costs under $15,000 per averted death across all scenarios.
Conclusions:
- THN distribution at jail release is an economical and feasible strategy to reduce opioid overdose mortality.
- Training bystanders is crucial for maximizing the intervention's effectiveness.
- This approach offers a substantial public health benefit.
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