Quantifying the impact of a large-scale opioid agonist treatment program on suicide prevention in New South Wales, Australia: A data-modeling study.

IF 5.2 1区医学 Q1 PSYCHIATRY

Addiction Pub Date : 2025-02-25 DOI:10.1111/add.70018

Thomas James Santo, Antoine Chaillon, Natasha Martin, Matthew Hickman, Nicola Jones, Michael Farrell, Chrianna Bharat, Louisa Degenhardt, Annick Borquez

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引用次数: 0

Abstract

Aims: This study aimed to quantify the population-level impact of a large-scale opioid agonist treatment (OAT) program on suicide-related mortality among people with opioid use disorder (OUD) in New South Wales (NSW), Australia.

Design: This is the first study to use dynamic mathematical modeling to explore the population-level impact of OAT on suicide mortality. The study used a two-part approach. First, we analyzed cohort data (2001-2017) to calculate incidence rate ratios (IRRs) and other model parameters related to OAT and suicide risk. Second, findings were applied to model outputs to estimate suicides averted by the NSW OAT program (2001-2020).

Setting and participants: A cohort of 46 845 individuals who received OAT between 2001 and 2017 in community and prison settings in New South Wales, Australia.

Measurements: IRRs for suicide and other model parameters were calculated for individuals on versus off OAT in community and prison settings (2001-2017). These estimates, along with model outputs, were used to determine the number and proportion of suicides averted by the OAT program (2001-2020).

Findings: Receiving OAT was associated with an IRR for suicide of 0.32 [95% confidence interval (CI) = 0.25-0.40] in the community and 0.34 (95% CI = 0.10-1.10) in prison for cohort data analyses (2001-2017). Between 2001 and 2020, the OAT program in NSW averted an estimated 338 suicides [95% credible interval (CrI) = 213-492), with 325 (95% CrI = 202-476) averted in the community and 13 (95% CrI = 0-46) in prison, corresponding to a 35% (95% CrI = 27%-43%) reduction in suicides among those accessing OAT.

Conclusions: The opioid agonist treatment program in New South Wales, Australia, was associated with a 35% reduction in suicide mortality among individuals with opioid use disorder receiving treatment between 2001 and 2020, providing novel evidence of its population-level impact on suicide prevention.

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量化大规模阿片类激动剂治疗计划对澳大利亚新南威尔士州预防自杀的影响：数据建模研究。

目的：本研究旨在量化澳大利亚新南威尔士州（NSW）大规模阿片类药物激动剂治疗（OAT）计划对阿片类药物使用障碍（OUD）患者自杀相关死亡率的人口水平影响。设计：这是第一个使用动态数学模型来探讨OAT对自杀死亡率的人口水平影响的研究。这项研究采用了两部分的方法。首先，我们分析了2001-2017年的队列数据，以计算OAT和自杀风险相关的发病率比（IRRs）和其他模型参数。其次，将研究结果应用于模型输出，以估计新南威尔士州OAT计划（2001-2020）避免的自杀事件。环境和参与者：在2001年至2017年期间，在澳大利亚新南威尔士州的社区和监狱环境中接受OAT的46845人。测量方法：计算了社区和监狱环境中使用OAT与关闭OAT的个体的自杀率和其他模型参数（2001-2017）。这些估计值，连同模型输出，被用来确定OAT项目（2001-2020）避免自杀的数量和比例。研究结果：队列数据分析（2001-2017）显示，社区接受OAT与自杀的IRR为0.32[95%可信区间(CI) = 0.25-0.40]，监狱接受OAT与自杀的IRR为0.34 （95% CI = 0.10-1.10）相关。2001年至2020年间，新南威尔士州的OAT项目估计避免了338起自杀事件[95%可信区间(CrI) = 213-492]，其中325起（95%可信区间(CrI) = 202-476）发生在社区，13起（95%可信区间= 0-46）发生在监狱，相当于接受OAT治疗的人自杀率降低了35% （95% CrI = 27%-43%）。结论：在澳大利亚新南威尔士州，阿片类药物激动剂治疗项目与2001年至2020年间接受阿片类药物使用障碍治疗的个体自杀死亡率降低35%有关，为其在人群层面上对自杀预防的影响提供了新的证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Addiction 医学-精神病学

CiteScore

10.80

自引率

6.70%

发文量

319

审稿时长

3 months

期刊介绍： Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines. Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries. Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.