Long-Term Effects of Increasing Buprenorphine Treatment Seeking, Duration, and Capacity on Opioid Overdose Fatalities : A Model-based Analysis
Copyright © 2023 American Society of Addiction Medicine..
OBJECTIVES: Because buprenorphine treatment of opioid use disorder reduces opioid overdose deaths (OODs), expanding access to care is an important policy and clinical care goal. Policymakers must choose within capacity limitations whether to expand the number of people with opioid use disorder who are treated or extend duration for existing patients. This inherent tradeoff could be made less acute with expanded buprenorphine treatment capacity.
METHODS: To inform such decisions, we used a validated simulation model to project the effects of increasing buprenorphine treatment-seeking, average episode duration, and capacity (patients per provider) on OODs in the United States from 2023 to 2033, varying the start time to assess the effects of implementation delays.
RESULTS: Results show that increasing treatment duration alone could cost lives in the short term by reducing capacity for new admissions yet save more lives in the long term than accomplished by only increasing treatment seeking. Increasing provider capacity had negligible effects. The most effective 2-policy combination was increasing capacity and duration simultaneously, which would reduce OODs up to 18.6% over a decade. By 2033, the greatest reduction in OODs (≥20%) was achieved when capacity was doubled and average duration reached 2 years, but only if the policy changes started in 2023. Delaying even a year diminishes the benefits. Treatment-seeking increases were equally beneficial whether they began in 2023 or 2025 but of only marginal benefit beyond what capacity and duration achieved.
CONCLUSIONS: If policymakers only target 2 policies to reduce OODs, they should be to increase capacity and duration, enacted quickly and aggressively.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:17 |
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| Enthalten in: |
Journal of addiction medicine - 17(2023), 4 vom: 15. Juli, Seite 439-446 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Stringfellow, Erin J [VerfasserIn] |
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| Links: |
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| Themen: |
40D3SCR4GZ |
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| Anmerkungen: |
Date Completed 02.11.2023 Date Revised 29.02.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1097/ADM.0000000000001153 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 500 | |a Date Revised 29.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 American Society of Addiction Medicine. | ||
| 520 | |a OBJECTIVES: Because buprenorphine treatment of opioid use disorder reduces opioid overdose deaths (OODs), expanding access to care is an important policy and clinical care goal. Policymakers must choose within capacity limitations whether to expand the number of people with opioid use disorder who are treated or extend duration for existing patients. This inherent tradeoff could be made less acute with expanded buprenorphine treatment capacity | ||
| 520 | |a METHODS: To inform such decisions, we used a validated simulation model to project the effects of increasing buprenorphine treatment-seeking, average episode duration, and capacity (patients per provider) on OODs in the United States from 2023 to 2033, varying the start time to assess the effects of implementation delays | ||
| 520 | |a RESULTS: Results show that increasing treatment duration alone could cost lives in the short term by reducing capacity for new admissions yet save more lives in the long term than accomplished by only increasing treatment seeking. Increasing provider capacity had negligible effects. The most effective 2-policy combination was increasing capacity and duration simultaneously, which would reduce OODs up to 18.6% over a decade. By 2033, the greatest reduction in OODs (≥20%) was achieved when capacity was doubled and average duration reached 2 years, but only if the policy changes started in 2023. Delaying even a year diminishes the benefits. Treatment-seeking increases were equally beneficial whether they began in 2023 or 2025 but of only marginal benefit beyond what capacity and duration achieved | ||
| 520 | |a CONCLUSIONS: If policymakers only target 2 policies to reduce OODs, they should be to increase capacity and duration, enacted quickly and aggressively | ||
| 650 | 4 | |a Journal Article | |
| 650 | 7 | |a Buprenorphine |2 NLM | |
| 650 | 7 | |a 40D3SCR4GZ |2 NLM | |
| 650 | 7 | |a Narcotic Antagonists |2 NLM | |
| 650 | 7 | |a Analgesics, Opioid |2 NLM | |
| 700 | 1 | |a Lim, Tse Yang |e verfasserin |4 aut | |
| 700 | 1 | |a DiGennaro, Catherine |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Ziyuan |e verfasserin |4 aut | |
| 700 | 1 | |a Paramasivam, Pritika |e verfasserin |4 aut | |
| 700 | 1 | |a Bearnot, Benjamin |e verfasserin |4 aut | |
| 700 | 1 | |a Humphreys, Keith |e verfasserin |4 aut | |
| 700 | 1 | |a Jalali, Mohammad S |e verfasserin |4 aut | |
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