@article{ref1,
title="Reducing overdose deaths among persons with opioid use disorder in connecticut",
journal="Harm reduction journal",
year="2024",
author="Scheidell, Joy D. and Townsend, Tarlise N. and Zhou, Qinlian and Manandhar-Sasaki, Prima and Rodriguez-Santana, Ramon and Jenkins, Mark and Buchelli, Marianne and Charles, Dyanna L. and Frechette, Jillian M. and Su, Jasmine I.-Shin and Braithwaite, R. Scott",
volume="21",
number="1",
pages="e103-e103",
abstract="BACKGROUND: People in Connecticut are now more likely to die of a drug-related overdose than a traffic accident. While Connecticut has had some success in slowing the rise in overdose death rates, substantial additional progress is necessary. <br><br>METHODS: We developed, verified, and calibrated a mechanistic simulation of alternative overdose prevention policy options, including scaling up naloxone (NLX) distribution in the community and medications for opioid use disorder (OUD) among people who are incarcerated (MOUD-INC) and in the community (MOUD-COM) in a simulated cohort of people with OUD in Connecticut. We estimated how maximally scaling up each option individually and in combinations would impact 5-year overdose deaths, life-years, and quality-adjusted life-years. All costs were assessed in 2021 USD, employing a health sector perspective in base-case analyses and a societal perspective in sensitivity analyses, using a 3% discount rate and 5-year and lifetime time horizons. <br><br>RESULTS: Maximally scaling NLX alone reduces overdose deaths 20% in the next 5 years at a favorable incremental cost-effectiveness ratio (ICER); if injectable rather than intranasal NLX was distributed, 240 additional overdose deaths could be prevented. Maximally scaling MOUD-COM and MOUD-INC alone reduce overdose deaths by 14% and 6% respectively at favorable ICERS. Considering all permutations of scaling up policies, scaling NLX and MOUD-COM together is the cost-effective choice, reducing overdose deaths 32% at ICER $19,000/QALY. In sensitivity analyses using a societal perspective, all policy options were cost saving and overdose deaths reduced 33% over 5 years while saving society $338,000 per capita over the simulated cohort lifetime. <br><br>CONCLUSIONS: Maximally scaling access to naloxone and MOUD in the community can reduce 5-year overdose deaths by 32% among people with OUD in Connecticut under realistic budget scenarios. If societal cost savings due to increased productivity and reduced crime costs are considered, one-third of overdose deaths can be reduced by maximally scaling all three policy options, while saving money.<p /> <p>Language: en</p>",
language="en",
issn="1477-7517",
doi="10.1186/s12954-024-01026-6",
url="http://dx.doi.org/10.1186/s12954-024-01026-6"
}