Table 2. Outcomes for Each Treatment Option, Modeled on a General US Cohort of Individuals With OUD.
| Treatment option | Over 5 y, per 100 000 individuals with OUD, mean (95% CrI) | Lifetime, per person discounted, mean (95% CrI) | ||||||
|---|---|---|---|---|---|---|---|---|
| Overdose | Deathsb | QALYs | Cost in $1000a | |||||
| Fatal | Nonfatal | Total | Health care | Criminal justice | Total | |||
| No treatment | 4132 (3171-5275) | 38 585 (15 642-87 416) | 42 717 (19 406-91 833) | 12 660 (10 936-14 666) | 11.58 (10.06-12.93) | 256 (239-274) | 357 (279-452) | 613 (529-714) |
| OEND | 3399 (1882-4827) | 39 496 (16 374-88 555) | 42 895 (19 482-92 199) | 11 963 (10 012-14 115) | 11.80 (10.25-13.18) | 261 (242-281) | 363 (283-462) | 624 (537-732) |
| MAT with methadone | ||||||||
| Methadone only | 3690 (2502-6473) | 34 451 (12 849-85 051) | 38 141 (15 839-90 293) | 11 905 (9583-17 631) | 12.60 (10.95-13.77) | 272 (236-302) | 244 (189-307) | 516 (442-588) |
| Methadone + CM | 3318 (2224-5935) | 30 970 (11 463-77 093) | 34 287 (14 122-81 921) | 11 176 (9028-16 570) | 13.03 (11.47-14.13) | 292 (254-325) | 216 (167-274) | 508 (440-574) |
| Methadone + PT | 3675 (2478-6463) | 34 304 (12 800-84 848) | 37 979 (15 766-89 971) | 11 874 (9537-17 594) | 12.62 (10.96-13.80) | 285 (247-317) | 243 (187-307) | 528 (453-600) |
| Methadone + OEND | 3118 (1643-5808) | 36 457 (13 601-91 523) | 39 575 (16 115-95 878) | 11 285 (8904-16 673) | 12.80 (11.19-13.98) | 277 (241-307) | 247 (192-313) | 524 (450-599) |
| Methadone + CM + OEND | 2805 (1465-5317) | 32 803 (12 120-83 131) | 35 608 (14 363-87 290) | 10 617 (8428-15 665) | 13.22 (11.70-14.32) | 296 (258-330) | 219 (169-279) | 515 (447-583) |
| Methadone + CM + PT | 3263 (2183-5853) | 30 457 (11 269-75 976) | 33 720 (13 859-80 650) | 11 069 (8941-16 388) | 13.10 (11.55-14.18) | 309 (269-345) | 212 (164-269) | 521 (454-587) |
| Methadone + OEND + PT | 3105 (1634-5794) | 36 302 (13 519-91 220) | 39 407 (16 031-95 695) | 11 257 (8872-16 648) | 12.82 (11.20-14.00) | 290 (252-323) | 246 (190-313) | 536 (461-612) |
| Methadone + CM + OEND + PT | 2759 (1441-5245) | 32 264 (11 905-81 822) | 35 023 (14 102-85 996) | 10 519 (8357-15 498) | 13.28 (11.78-14.37) | 314 (274-350) | 215 (166-274) | 529 (461-596) |
| MAT with buprenorphine | ||||||||
| Buprenorphine only | 3227 (2508-4081) | 30 136 (12 273-68 084) | 33 363 (15 229-71 522) | 10 894 (9588-12 410) | 12.65 (11.54-13.67) | 274 (253-297) | 275 (218-342) | 549 (486-621) |
| Buprenorphine + CM | 2893 (2235-3683) | 27 012 (10 987-61 210) | 29 905 (13 624-64 314) | 10 249 (9042-11 668) | 13.07 (12.04-14.02) | 291 (266-318) | 245 (193-307) | 536 (477-603) |
| Buprenorphine + PT | 3213 (2487-4080) | 30 005 (12 212-67 906) | 33 218 (15 130-71 327) | 10 866 (9545-12 408) | 12.66 (11.55-13.70) | 285 (262-310) | 274 (216-342) | 559 (495-632) |
| Buprenorphine + OEND | 2653 (1474-3737) | 30 826 (12 836-68 927) | 33 479 (15 275-71 784) | 10 345 (8841-11 987) | 12.84 (11.72-13.88) | 279 (256-303) | 279 (221-348) | 558 (492-634) |
| Buprenorphine + CM + OEND | 2378 (1318-3368) | 27 624 (11 481-61 910) | 30 001 (13 665-64 522) | 9755 (8376-11 279) | 13.24 (12.20-14.21) | 295 (269-323) | 249 (195-312) | 544 (482-614) |
| Buprenorphine + CM + PT | 2841 (2189-3621) | 26 530 (10 768-60 134) | 29 371 (13 367-63 185) | 10 149 (8949-11 551) | 13.13 (12.10-14.08) | 306 (279-337) | 241 (189-302) | 547 (488-613) |
| Buprenorphine + OEND + PT | 2642 (1467-3731) | 30 691 (12 752-68 760) | 33 333 (15 185-71 578) | 10 320 (8808-11 979) | 12.85 (11.71-13.90) | 289 (265-316) | 278 (219-348) | 567 (500-644) |
| Buprenorphine + CM + OEND + PT | 2335 (1292-3310) | 27 129 (11 256-60 855) | 29 464 (13 406-63 367) | 9664 (8301-11 169) | 13.31 (12.27-14.27) | 311 (282-342) | 244 (191-307) | 555 (493-623) |
| MAT with naltrexone | ||||||||
| Naltrexone only | 3226 (2523-4059) | 30 131 (12 298-68 135) | 33 357 (15 275-71 581) | 10 892 (9617-12 367) | 12.65 (11.58-13.65) | 295 (271-321) | 275 (220-339) | 570 (506-642) |
| Naltrexone + CM | 2890 (2250-3655) | 26 991 (11 017-61 068) | 29 881 (13 660-64 122) | 10 244 (9075-11 616) | 13.07 (12.08-14.01) | 319 (290-350) | 245 (195-304) | 564 (504-630) |
| Naltrexone + PT | 3212 (2502-4056) | 29 998 (12 236-67 832) | 33 210 (15 184-71 233) | 10 865 (9574-12 365) | 12.67 (11.58-13.68) | 306 (280-335) | 274 (218-339) | 580 (515-652) |
| Naltrexone + OEND | 2653 (1480-3720) | 30 820 (12 862-68 956) | 33 473 (15 324-71 826) | 10 344 (8863-11 945) | 12.84 (11.75-13.87) | 300 (274-327) | 279 (223-345) | 579 (512-654) |
| Naltrexone + CM + OEND | 2376 (1322-3347) | 27 601 (11 525-61 729) | 29 977 (13 706-64 306) | 9751 (8401-11 230) | 13.25 (12.24-14.20) | 322 (293-355) | 249 (197-309) | 571 (509-641) |
| Naltrexone + CM + PT | 2839 (2202-3593) | 26 506 (10 798-60 048) | 29 345 (13 404-63 072) | 10 144 (8981-11 498) | 13.13 (12.15-14.07) | 335 (304-370) | 241 (190-299) | 576 (516-641) |
| Naltrexone + OEND + PT | 2641 (1471-3715) | 30 684 (12 777-68 698) | 33 325 (15 236-71 465) | 10 319 (8827-11 941) | 12.86 (11.75-13.89) | 310 (283-341) | 278 (221-345) | 588 (521-665) |
| Naltrexone + CM + OEND + PT | 2333 (1297-3289) | 27 105 (11 288-60 686) | 29 438 (13 441-63 271) | 9660 (8322-11 121) | 13.31 (12.31-14.25) | 339 (307-376) | 244 (192-304) | 583 (521-652) |
Abbreviations: CM, contingency management; CrI, credible interval; MAT, medication-assisted treatment; OEND, overdose education and naloxone distribution; OUD, opioid use disorder; PT, psychotherapy; QALY, quality-adjusted life-year.
a
Currency is reported in 2019 values.
b
From all causes.