{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T20:48:34Z","timestamp":1790455714663,"version":"4.1.0"},"reference-count":56,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi241367-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Opioid-related overdose accounts for almost 80\u202f000 deaths annually across the US. People who use drugs leaving jails are at particularly high risk for opioid-related overdose and may benefit from take-home naloxone (THN) distribution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241367-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate the population impact of THN distribution at jail release to reverse opioid-related overdose among people with opioid use disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241367-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This study developed the agent-based Justice-Community Circulation Model (JCCM) to model a synthetic population of individuals with and without a history of opioid use. Epidemiological data from 2014 to 2020 for Cook County, Illinois, were used to identify parameters pertinent to the synthetic population. Twenty-seven experimental scenarios were examined to capture diverse strategies of THN distribution and use. Sensitivity analysis was performed to identify critical mediating and moderating variables associated with population impact and a proxy metric for cost-effectiveness (ie, the direct costs of THN kits distributed per death averted). Data were analyzed between February 2022 and March 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241367-7\">\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Modeled interventions included 3 THN distribution channels: community facilities and practitioners; jail, at release; and social network or peers of persons released from jail.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241367-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>The primary outcome was the percentage of opioid-related overdose deaths averted with THN in the modeled population relative to a baseline scenario with no intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241367-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Take-home naloxone distribution at jail release had the highest median (IQR) percentage of averted deaths at 11.70% (6.57%-15.75%). The probability of bystander presence at an opioid overdose showed the greatest proportional contribution (27.15%) to the variance in deaths averted in persons released from jail. The estimated costs of distributed THN kits were less than $15\u202f000 per averted death in all 27 scenarios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241367-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>This study found that THN distribution at jail release is an economical and feasible approach to substantially reducing opioid-related overdose mortality. Training and preparation of proficient and willing bystanders are central factors in reaching the full potential of this intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.48732","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T11:25:59Z","timestamp":1733829959000},"page":"e2448732","source":"Crossref","is-referenced-by-count":12,"title":["Agent-Based Model of Combined Community- and Jail-Based Take-Home Naloxone Distribution"],"prefix":"10.1001","volume":"7","author":[{"given":"Eric","family":"Tatara","sequence":"first","affiliation":[{"name":"Decision and Infrastructure Sciences Division, Argonne National Laboratory, Lemont, Illinois"},{"name":"Consortium for Advanced Science and Engineering, The University of Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Ozik","sequence":"additional","affiliation":[{"name":"Decision and Infrastructure Sciences Division, Argonne National Laboratory, Lemont, Illinois"},{"name":"Consortium for Advanced Science and Engineering, The University of Chicago, Chicago, Illinois"},{"name":"Department of Public Health Sciences, The University of Chicago, Chicago, Illinois"},{"name":"Northwestern-Argonne Institute for Science and Engineering, Evanston, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harold A.","family":"Pollack","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, The University of Chicago, Chicago, Illinois"},{"name":"Crown Family School of Social Work, Policy, and Practice, The University of Chicago, Chicago, Illinois"},{"name":"Urban Health Lab, The University of Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, The University of Chicago, Chicago, Illinois"},{"name":"Crown Family School of Social Work, Policy, and Practice, The University of Chicago, Chicago, Illinois"},{"name":"Department of Medicine, The University of Chicago, Chicago, Illinois"},{"name":"Chicago Center for HIV Elimination, Department of Medicine, The University of Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel R.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Center for Opioid Epidemiology and Policy, Department of Population Health, New York University (NYU) Grossman School of Medicine, New York"},{"name":"Center for Drug Use and HIV Research, NYU School of Global Public Health, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina T.","family":"Harawa","sequence":"additional","affiliation":[{"name":"Fielding School of Public Health, UCLA (University of California, Los Angeles)"},{"name":"David Geffen School of Medicine at UCLA"},{"name":"College of Medicine, Charles R. 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