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Projected Effects of Naloxone and Buprenorphine Scale-Up on Opioid Overdose Mortality in Six Pennsylvania Counties

  • Abdulrahman A. Ahmed
  • M. Amin Rahimian
  • Qiushi Chen
  • Praveen Kumar
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Abstract

Opioid overdose deaths remain a severe public health crisis in the US, with heterogeneous burden across counties that differ in epidemic trajectory, baseline resources, and local context. While harm reduction through naloxone distribution and buprenorphine treatment are both evidence-based strategies, limited information on county-level effects hinders the ability of policymakers to prioritize resources across counties. We developed a simulation model of opioid use disorder (OUD), calibrated separately to six Pennsylvania counties spanning large urban (Allegheny, Philadelphia), intermediate-sized (Erie, Dauphin), and rural (Clearfield, Columbia) settings. We projected county-specific overdose mortality trajectories under three levels of increase in buprenorphine dispensing and naloxone distribution (10%, 20%, and 30% above each county's baseline), over a five-year horizon from 2025 to 2029. A 30% increase in naloxone distribution above projected county baseline levels was projected to reduce 2029 overdose deaths by approximately 70% (95% uncertainty interval, UI: 55-81%) in Allegheny County, 11% (95% UI: 4-17%) in Erie County, and 28% (95% UI: 2-64%) in Clearfield County. The relative projected benefits of naloxone and buprenorphine varied by county; buprenorphine produced larger reductions in Erie and Dauphin. The same proportional increase in naloxone distribution produced substantially different projected mortality reductions across the six Pennsylvania counties. County-level context is important for informing harm reduction and treatment prioritization at the county level.

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Cite

BibTeXRIS
BibTeX
@misc{ahmed2026projected,
  title = {{Projected Effects of Naloxone and Buprenorphine Scale-Up on Opioid Overdose Mortality in Six Pennsylvania Counties}},
  author = {Abdulrahman A. Ahmed and M. Amin Rahimian and Qiushi Chen and Praveen Kumar},
  howpublished = {arXiv},
  year = {2026},
  month = oct,
  doi = {10.48550/arxiv.2609.22419},
  eprint = {2609.22419},
  archivePrefix = {arXiv},
  url = {https://arxiv.org/abs/2609.22419},
}
RIS
TY  - UNPB
TI  - Projected Effects of Naloxone and Buprenorphine Scale-Up on Opioid Overdose Mortality in Six Pennsylvania Counties
AU  - Abdulrahman A. Ahmed
AU  - M. Amin Rahimian
AU  - Qiushi Chen
AU  - Praveen Kumar
PY  - 2026
DA  - 2026/10/23
PB  - arXiv
DO  - 10.48550/arxiv.2609.22419
UR  - https://arxiv.org/abs/2609.22419
AB  - Opioid overdose deaths remain a severe public health crisis in the US, with heterogeneous burden across counties that differ in epidemic trajectory, baseline resources, and local context. While harm reduction through naloxone distribution and buprenorphine treatment are both evidence-based strategies, limited information on county-level effects hinders the ability of policymakers to prioritize resources across counties. We developed a simulation model of opioid use disorder (OUD), calibrated separately to six Pennsylvania counties spanning large urban (Allegheny, Philadelphia), intermediate-sized (Erie, Dauphin), and rural (Clearfield, Columbia) settings. We projected county-specific overdose mortality trajectories under three levels of increase in buprenorphine dispensing and naloxone distribution (10%, 20%, and 30% above each county's baseline), over a five-year horizon from 2025 to 2029. A 30% increase in naloxone distribution above projected county baseline levels was projected to reduce 2029 overdose deaths by approximately 70% (95% uncertainty interval, UI: 55-81%) in Allegheny County, 11% (95% UI: 4-17%) in Erie County, and 28% (95% UI: 2-64%) in Clearfield County. The relative projected benefits of naloxone and buprenorphine varied by county; buprenorphine produced larger reductions in Erie and Dauphin. The same proportional increase in naloxone distribution produced substantially different projected mortality reductions across the six Pennsylvania counties. County-level context is important for informing harm reduction and treatment prioritization at the county level.
ER  -