{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T08:05:25Z","timestamp":1767773125031,"version":"3.37.3"},"reference-count":15,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,10,12]],"date-time":"2018-10-12T00:00:00Z","timestamp":1539302400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Addict"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Outcome intervention data from Medicare, veteran, prison, and United States\u2019 public populations can identify best practices to decrease opioid misuse. Prescription policies for treating pain in the United States and other countries are relevant to preventing overdose.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Three strategies are considered: (1) <jats:italic>Demand Reduction<\/jats:italic> counsels and educates patients and current or potential opioid users about risks and treatment options to reduce motivation to consume opioids. (2) <jats:italic>Supply Reduction<\/jats:italic> limits access and dosage of opioids and co\u2010drugs such as benzodiazepines. It encourages use of safest prescribing practices for treating pain. (3) <jats:italic>Harm Reduction<\/jats:italic> reduces opioid deaths through medication\u2010assisted treatment (MAT) combining opioid substitution therapy (OST), provision of opioid antagonists like Naltrexone, and behavioral health services.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:italic>Demand Reduction<\/jats:italic> is often inadequate to treat severe pain or in the presence of major psychopathology like opioid abuse disorder (OUD). Among veterans, lower opioid doses for pain treatment were associated with diminished death rates. <jats:italic>Supply Reduction<\/jats:italic> interventions have disadvantages. Banning drugs has poor long\u2010term success with prison inmates, because abstinence is difficult to enforce after discharge. Limiting opioid supplies does not increase survival rates for Medicare patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusions<\/jats:title><jats:p>Sharp opioid dose restriction in outpatient treatment increases heroin and fentanyl use, explaining why recent years\u2019 decrease in United States opioid prescriptions has not reduced national mortality rates. Although <jats:italic>Harm Reduction<\/jats:italic> is the safest, most effective single approach, combining three interventions while improving pain and addiction prescribing practices is optimal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Scientific Significance<\/jats:title><jats:p>Scientific research needs to inform choice of opioid overuse interventions. (Am J Addict 2018;XX:1\u20133)<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajad.12823","type":"journal-article","created":{"date-parts":[[2018,10,12]],"date-time":"2018-10-12T13:19:10Z","timestamp":1539350350000},"page":"605-607","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Commentary: The opioid overdose epidemic: Evidence\u2010based interventions"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6266-8629","authenticated-orcid":false,"given":"Peter","family":"Barglow","sequence":"first","affiliation":[{"name":"Former Professor of Psychiatry Northwestern Medical School Chicago Illinois"},{"name":"Former Professor in Residence and Chief of Addiction Medicine UC Davis Medical School Sacramento California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,10,12]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Centers for Disease Control and Prevention.Drug Overdose Death Data 2016. Atlanta GA: Centers for Disease Control and Prevention;2016."},{"key":"e_1_2_6_3_1","unstructured":"HedegaardH WarnerM MininoAM.Drug overdose deaths in the United States 1999\u20132016. NCHS Data Brief # 294. Atlanta GA: National Center for Health Statistics. Atlanta GA: Centers for Disease Control and Prevention;2017."},{"key":"e_1_2_6_4_1","first-page":"1","volume-title":"Long\u2010term opioid use in patients with non\u2010cancer pain","author":"Campbell G","year":"2017"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.0899"},{"key":"e_1_2_6_6_1","unstructured":"Opioid use in Medicare part D remains concerning. 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