{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T14:54:04Z","timestamp":1781016844554,"version":"3.54.1"},"reference-count":33,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2015,6,23]],"date-time":"2015-06-23T00:00:00Z","timestamp":1435017600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002141","name":"Public Health England","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002141","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>A counterfactual model was used to estimate the number of fatal opioid\u2010related poisonings prevented by public treatment services for opioid use disorder (OUD) in England between April 2008 and March 2011.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patient OUD treatment episode data recorded by the English National Drug Treatment Monitoring System were linked to data on opioid deaths recorded by the Office for National Statistics. The source population was the official estimate of non\u2010medical opioid users (aged 15\u201364 years; approximately 260\u2009000 each year). The target population was all individuals (aged 15\u201364 years) treated for OUD in the study period (<jats:italic>n<\/jats:italic>\u2009=\u2009220\u2009665). The outcome measure was fatal opioid\u2010related poisoning (opioid death). The opioid death rate [per 100 person\u2010years (PY)] and mortality rate ratios (MRR) were computed for study year, age group (15\u201324, 25\u201334, 35\u201364 years) and for three treatment\u2010related states: time spent \u2018prior to treatment\u2019, \u2018during treatment\u2019 and \u2018after treatment\u2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between April 2008 and March 2011, there were 3731 opioid deaths in the study: 741 during treatment (0.20 per 100 PY; referent category); 2722 prior to treatment [0.77 per 100 PY; MRR\u2009=\u20093.76, 95% confidence interval (CI)\u2009=\u20093.18\u20134.44]; and 268 after treatment (0.41 per 100 PY; MRR\u2009=\u20091.99, 95% CI\u2009=\u20091.64\u20132.41). By counterfactual estimation, national OUD treatment services prevented an average of 880 opioid deaths each year (95% CI\u2009=\u2009702\u20131084).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Between April 2008 and March 2011, a counterfactual model shows that the English public treatment system for opioid use disorder prevented an average of 880 deaths each year from opioid\u2010related poisoning. Counterfactual models of mortality prevention can be used for outcome and performance monitoring of substance use disorder treatment systems.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.12971","type":"journal-article","created":{"date-parts":[[2015,5,1]],"date-time":"2015-05-01T19:20:50Z","timestamp":1430508050000},"page":"1321-1329","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Fatal opioid poisoning: a counterfactual model to estimate the preventive effect of treatment for opioid use disorder in England"],"prefix":"10.1111","volume":"110","author":[{"given":"Martin","family":"White","sequence":"first","affiliation":[{"name":"Alcohol, Drugs and Tobacco Division, Health and Wellbeing Directorate Public Health England  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn","family":"Burton","sequence":"additional","affiliation":[{"name":"Alcohol, Drugs and Tobacco Division, Health and Wellbeing Directorate Public Health England  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane","family":"Darke","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Eastwood","sequence":"additional","affiliation":[{"name":"Alcohol, Drugs and Tobacco Division, Health and Wellbeing Directorate Public Health England  London UK"},{"name":"Addictions Department Institute of Psychiatry, Psychology and Neuroscience, King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Knight","sequence":"additional","affiliation":[{"name":"Alcohol, Drugs and Tobacco Division, Health and Wellbeing Directorate Public Health England  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Millar","sequence":"additional","affiliation":[{"name":"Centre for Mental Health and Risk, Institute of Brain, Behaviour and Mental Health The University of Manchester, Manchester  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Musto","sequence":"additional","affiliation":[{"name":"Alcohol, Drugs and Tobacco Division, Health and Wellbeing Directorate Public Health England  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Marsden","sequence":"additional","affiliation":[{"name":"Alcohol, Drugs and Tobacco Division, Health and Wellbeing Directorate Public Health England  London UK"},{"name":"Addictions Department Institute of Psychiatry, Psychology and Neuroscience, King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,6,23]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"United Nations Office on Drugs and Crime (UNODC).World Drug Report 2013. 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