{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T03:41:53Z","timestamp":1784346113679,"version":"3.55.0"},"reference-count":47,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UM1DA049394"],"award-info":[{"award-number":["UM1DA049394"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UM1DA049406"],"award-info":[{"award-number":["UM1DA049406"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UM1DA049412"],"award-info":[{"award-number":["UM1DA049412"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UM1DA049415"],"award-info":[{"award-number":["UM1DA049415"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000058","name":"Substance Abuse and Mental Health Services Administration","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000058","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>The opioid crisis is still a public health emergency in the United States, despite recent declines in opioid overdose deaths (OODs) and increased availability of evidence\u2010based practices (EBPs) for opioid use disorder (OUD). The geographic variability in OODs drives the need for localized decision\u2010making, where interventions are tailored to the unique needs of communities. This study aimed to develop and calibrate a simulation model that evaluates the impact of enhanced implementation of EBP on OODs at the community\u2010level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We developed OPSiM (Opioid Policy Simulation Model), a community\u2010level microsimulation model that simulates the course of opioid use, OUD, treatment, recovery and overdose\u2010related events. The model was parameterized with data from the HEALing Communities Study and looked at six scenarios of EBPs implemented in 2025 with sustainment through 2030: (1) maintain 2024 EBP levels (status quo); (2) increase initiation of medications for opioid use disorder (MOUD); (3) increase MOUD retention; (4) increase MOUD initiation and retention; (5) increase distribution of naloxone; and (6) both scenarios 4 and 5.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Twenty\u2010nine communities in Massachusetts, New York, and Ohio, USA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Simulated community residents with non\u2010prescribed opioid use or OUD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Estimated number of OODs per 100\u2009000 individuals between 2025 and 2030 in each community, averaged across the 26 communities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Under the status quo, the model projected 158 OODs (range across communities: 39\u2013468) per 100\u2009000 individuals between 2025 and 2030. Increasing medications for the treatment of OUD (MOUD) retention alone reduced OODs by 6% (range: 3\u201315%), while increasing MOUD initiation alone reduced OODs by 9% (range: 8\u201312%). Increasing both MOUD initiation and retention had a synergistic effect, reducing OODs by 21% (range: 15\u201331%). Reduction in OODs in response to increased MOUD initiation and\/or retention was similar across urban and rural communities. The effect of increasing naloxone distribution varied substantially across communities due to differing saturation levels; in some communities, additional naloxone kits provided only marginal benefits. Rural communities were further from saturation whereas most urban communities were at or close to saturation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A tailored, multi\u2010pronged approach that scales up medications for opioid use disorder alongside widespread naloxone distribution, and that addresses community\u2010specific needs and capacities, will be most effective at reducing opioid overdose deaths in the United States.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.70367","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T10:20:39Z","timestamp":1772965239000},"page":"1747-1760","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of enhanced practices on opioid overdose deaths: A community\u2010based modeling approach"],"prefix":"10.1111","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7535-9443","authenticated-orcid":false,"given":"Carolina","family":"Barbosa","sequence":"first","affiliation":[{"name":"RTI International, Research Triangle Park  Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4031-2669","authenticated-orcid":false,"given":"Qiushi","family":"Chen","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital  Boston MA USA"},{"name":"The Pennsylvania State University, University Park  State College PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mert","family":"Sahinkoc","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3331-0788","authenticated-orcid":false,"given":"Gary A.","family":"Zarkin","sequence":"additional","affiliation":[{"name":"RTI International, Research Triangle Park  Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6331-060X","authenticated-orcid":false,"given":"William","family":"Dowd","sequence":"additional","affiliation":[{"name":"RTI International, Research Triangle Park  Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2337-2504","authenticated-orcid":false,"given":"Jennifer","family":"Villani","sequence":"additional","affiliation":[{"name":"National Institute on Drug Abuse  Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4155-4697","authenticated-orcid":false,"given":"Joshua A.","family":"Barocas","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine  Aurora CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8441-7046","authenticated-orcid":false,"given":"Magdalena","family":"Cerd\u00e1","sequence":"additional","affiliation":[{"name":"NYU Grossman School of Medicine  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avik","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"University School of Medicine  Boston MA USA"},{"name":"Boston Medical Center  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naleef","family":"Fareed","sequence":"additional","affiliation":[{"name":"The Ohio State University  Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayaz","family":"Hyder","sequence":"additional","affiliation":[{"name":"The Ohio State University  Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5624-021X","authenticated-orcid":false,"given":"Katherine M.","family":"Keyes","sequence":"additional","affiliation":[{"name":"Columbia University  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc R.","family":"Larochelle","sequence":"additional","affiliation":[{"name":"Boston Medical Center  Boston MA USA"},{"name":"Boston University School of Medicine  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9574-7075","authenticated-orcid":false,"given":"Benjamin P.","family":"Linas","sequence":"additional","affiliation":[{"name":"Boston University School of Medicine  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara M.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Case Western Reserve University, School of Medicine  Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1132-2932","authenticated-orcid":false,"given":"Bruce R.","family":"Schackman","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Seiber","sequence":"additional","affiliation":[{"name":"The Ohio State University  Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E.","family":"Wakeman","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital  Boston MA USA"},{"name":"Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy B.","family":"Knudsen","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital  Boston MA USA"},{"name":"Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jagpreet","family":"Chhatwal","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital  Boston MA USA"},{"name":"Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Secretary Kennedy Renews Public Health Emergency Declaration to Address National Opioid Crisis [press release]","year":"2025"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2021.103435"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2019-212915"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2020.03.015"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.7621"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.14925"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(21)00304-2"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2115714119"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.4617"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2021.100031"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)33078-2"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000001703"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.37259"},{"key":"e_1_2_10_15_1","volume-title":"CDC Reports Nearly 24% Decline in U.S. Drug Overdose Deaths [press release]","year":"2025"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108329"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108335"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2401177"},{"issue":"3","key":"e_1_2_10_19_1","first-page":"235","article-title":"Focus: Addiction: Reducing fatal opioid overdose: Prevention, treatment and harm reduction strategies","volume":"88","author":"Hawk KF","year":"2015","journal-title":"Yale J Biol Med"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.20622"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2018.07.017"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.27488"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/10550887.2016.1100960"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dadr.2022.100126"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2016.08.625"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2017.07.001"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.7326\/M17-0611"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.110669"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2014.07.020"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwp186"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2019.4170"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2021.0976"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j1550"},{"key":"e_1_2_10_34_1","volume-title":"National Survey on Drug Use and Health","author":"Substance Abuse and Mental Health Services Administration (SAMHSA)"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2021.11.1351"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108336"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.70278"},{"key":"e_1_2_10_38_1","volume-title":"Substate Estimates of Substance Use and Mental Illness from the 2016\u20102018 NSDUH: Results and Detailed Tables","author":"Substance Abuse and Mental Health Services Administration; 2016\u20132018"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.41174"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.3109\/10903127.2011.569854"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2019.01.006"},{"key":"e_1_2_10_42_1","volume-title":"IQVIA National Prescription Audit","author":"IQVIA","year":"2023"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.2165\/11314830-000000000-00000"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4733.2008.00484.x"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108338"},{"key":"e_1_2_10_46_1","volume-title":"Improving access to evidence\u2010based medical treatment for opioid use disorder: Strategies to address key barriers within the treatment system. NAM Perspectives","author":"Madras BK","year":"2020"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1093\/haschl\/qxad018"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.3711"}],"container-title":["Addiction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.70367","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/add.70367","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.70367","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T03:37:38Z","timestamp":1782272258000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/add.70367"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,5]]},"references-count":47,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/add.70367"],"URL":"https:\/\/doi.org\/10.1111\/add.70367","archive":["Portico"],"relation":{},"ISSN":["0965-2140","1360-0443"],"issn-type":[{"value":"0965-2140","type":"print"},{"value":"1360-0443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,5]]},"assertion":[{"value":"2025-06-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}