Modeling the population‐level impact of opioid agonist treatment on mortality among people accessing treatment between 2001 and 2020 in New South Wales, Australia.
Saved in:
| Title: | Modeling the population‐level impact of opioid agonist treatment on mortality among people accessing treatment between 2001 and 2020 in New South Wales, Australia. |
|---|---|
| Authors: | Chaillon, Antoine (AUTHOR), Bharat, Chrianna (AUTHOR), Stone, Jack (AUTHOR), Jones, Nicola (AUTHOR), Degenhardt, Louisa (AUTHOR), Larney, Sarah (AUTHOR), Farrell, Michael (AUTHOR), Vickerman, Peter (AUTHOR), Hickman, Matthew (AUTHOR), Martin, Natasha K. (AUTHOR), Bórquez, Annick (AUTHOR) |
| Source: | Addiction. May2022, Vol. 117 Issue 5, p1338-1352. 15p. 1 Diagram, 3 Charts, 3 Graphs. |
| Subjects: | Opioid abuse, Narcotic agonists, Mortality, Therapeutic use of narcotics, Methadone treatment programs, Drug overdose, Prisoners, Buprenorphine |
| Abstract: | Background and Aims: The individual‐level effectiveness of opioid agonist treatment (OAT) in reducing mortality is well established, but there is less evidence on population‐level benefits. We use modeling informed with linked data from the OAT program in New South Wales (NSW), Australia, to estimate the impact of OAT provision in the community and prisons on mortality and the impact of eliminating excess mortality during OAT initiation/discontinuation. Design Dynamic modeling. Setting and participants: A cohort of 49 359 individuals who ever received OAT in NSW from 2001 to 2018. Measurements Receipt of OAT was represented through five stages: (i) first month on OAT, (ii) short (1–9 months) and (iii) longer (9+ months) duration on OAT, (iv) first month following OAT discontinuation and (v) rest of time following OAT discontinuation. Incarceration was represented as four strata: (i) never or not incarcerated in the past year, (ii) currently incarcerated, (iii) released from prison within the past month and (iv) released from prison 1–12 months ago. The model incorporated elevated mortality post‐release from prison and OAT impact on reducing mortality and incarceration. Findings Among the cohort, mortality was 0.9 per 100 person‐years, OAT coverage and retention remained high (> 50%, 1.74 years/episode). During 2001–20, we estimate that OAT provision reduced overdose and other cause mortality among the cohort by 52.8% [95% credible interval (CrI) = 49.4–56.9%] and 26.6% (95% CrI =22.1–30.5%), respectively. We estimate 1.2 deaths averted and 9.7 life‐years gained per 100 person‐years on OAT. Prison OAT with post‐release OAT‐linkage accounted for 12.4% (95% CrI = 11.5–13.5%) of all deaths averted by the OAT program, primarily through preventing deaths in the first month post‐release. Preventing elevated mortality during OAT initiation and discontinuation could have averted up to 1.4% (95% CrI = 0.8–2.0%) and 3.0% (95% CrI = 2.1–5.3%) of deaths, respectively. Conclusion: The community and prison opioid agonist treatment program in New South Wales, Australia appears to have substantially reduced population‐level overdose and all‐cause mortality in the past 20 years, partially due to high retention. [ABSTRACT FROM AUTHOR] |
| Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
|
Full text is not displayed to guests.
Login for full access.
|
|
| FullText | Links: – Type: pdflink Text: Availability: 1 |
|---|---|
| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 156112687 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
| IllustrationInfo | |
| Items | – Name: Title Label: Title Group: Ti Data: Modeling the population‐level impact of opioid agonist treatment on mortality among people accessing treatment between 2001 and 2020 in New South Wales, Australia. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Chaillon%2C+Antoine%22">Chaillon, Antoine</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bharat%2C+Chrianna%22">Bharat, Chrianna</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Stone%2C+Jack%22">Stone, Jack</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Jones%2C+Nicola%22">Jones, Nicola</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Degenhardt%2C+Louisa%22">Degenhardt, Louisa</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Larney%2C+Sarah%22">Larney, Sarah</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Farrell%2C+Michael%22">Farrell, Michael</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Vickerman%2C+Peter%22">Vickerman, Peter</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hickman%2C+Matthew%22">Hickman, Matthew</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Martin%2C+Natasha+K%2E%22">Martin, Natasha K.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bórquez%2C+Annick%22">Bórquez, Annick</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Addiction%22">Addiction</searchLink>. May2022, Vol. 117 Issue 5, p1338-1352. 15p. 1 Diagram, 3 Charts, 3 Graphs. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Opioid+abuse%22">Opioid abuse</searchLink><br /><searchLink fieldCode="DE" term="%22Narcotic+agonists%22">Narcotic agonists</searchLink><br /><searchLink fieldCode="DE" term="%22Mortality%22">Mortality</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutic+use+of+narcotics%22">Therapeutic use of narcotics</searchLink><br /><searchLink fieldCode="DE" term="%22Methadone+treatment+programs%22">Methadone treatment programs</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+overdose%22">Drug overdose</searchLink><br /><searchLink fieldCode="DE" term="%22Prisoners%22">Prisoners</searchLink><br /><searchLink fieldCode="DE" term="%22Buprenorphine%22">Buprenorphine</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Background and Aims: The individual‐level effectiveness of opioid agonist treatment (OAT) in reducing mortality is well established, but there is less evidence on population‐level benefits. We use modeling informed with linked data from the OAT program in New South Wales (NSW), Australia, to estimate the impact of OAT provision in the community and prisons on mortality and the impact of eliminating excess mortality during OAT initiation/discontinuation. Design Dynamic modeling. Setting and participants: A cohort of 49 359 individuals who ever received OAT in NSW from 2001 to 2018. Measurements Receipt of OAT was represented through five stages: (i) first month on OAT, (ii) short (1–9 months) and (iii) longer (9+ months) duration on OAT, (iv) first month following OAT discontinuation and (v) rest of time following OAT discontinuation. Incarceration was represented as four strata: (i) never or not incarcerated in the past year, (ii) currently incarcerated, (iii) released from prison within the past month and (iv) released from prison 1–12 months ago. The model incorporated elevated mortality post‐release from prison and OAT impact on reducing mortality and incarceration. Findings Among the cohort, mortality was 0.9 per 100 person‐years, OAT coverage and retention remained high (> 50%, 1.74 years/episode). During 2001–20, we estimate that OAT provision reduced overdose and other cause mortality among the cohort by 52.8% [95% credible interval (CrI) = 49.4–56.9%] and 26.6% (95% CrI =22.1–30.5%), respectively. We estimate 1.2 deaths averted and 9.7 life‐years gained per 100 person‐years on OAT. Prison OAT with post‐release OAT‐linkage accounted for 12.4% (95% CrI = 11.5–13.5%) of all deaths averted by the OAT program, primarily through preventing deaths in the first month post‐release. Preventing elevated mortality during OAT initiation and discontinuation could have averted up to 1.4% (95% CrI = 0.8–2.0%) and 3.0% (95% CrI = 2.1–5.3%) of deaths, respectively. Conclusion: The community and prison opioid agonist treatment program in New South Wales, Australia appears to have substantially reduced population‐level overdose and all‐cause mortality in the past 20 years, partially due to high retention. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
| PLink | https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=156112687 |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/add.15736 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 15 StartPage: 1338 Subjects: – SubjectFull: Opioid abuse Type: general – SubjectFull: Narcotic agonists Type: general – SubjectFull: Mortality Type: general – SubjectFull: Therapeutic use of narcotics Type: general – SubjectFull: Methadone treatment programs Type: general – SubjectFull: Drug overdose Type: general – SubjectFull: Prisoners Type: general – SubjectFull: Buprenorphine Type: general Titles: – TitleFull: Modeling the population‐level impact of opioid agonist treatment on mortality among people accessing treatment between 2001 and 2020 in New South Wales, Australia. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Chaillon, Antoine – PersonEntity: Name: NameFull: Bharat, Chrianna – PersonEntity: Name: NameFull: Stone, Jack – PersonEntity: Name: NameFull: Jones, Nicola – PersonEntity: Name: NameFull: Degenhardt, Louisa – PersonEntity: Name: NameFull: Larney, Sarah – PersonEntity: Name: NameFull: Farrell, Michael – PersonEntity: Name: NameFull: Vickerman, Peter – PersonEntity: Name: NameFull: Hickman, Matthew – PersonEntity: Name: NameFull: Martin, Natasha K. – PersonEntity: Name: NameFull: Bórquez, Annick IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 05 Text: May2022 Type: published Y: 2022 Identifiers: – Type: issn-print Value: 09652140 Numbering: – Type: volume Value: 117 – Type: issue Value: 5 Titles: – TitleFull: Addiction Type: main |
| ResultId | 1 |
