Comparing Projected Fatal Overdose Outcomes and Costs of Strategies to Expand Community-Based Distribution of Naloxone in Rhode Island

In this decision analytical model study evaluating the distribution of 10 000 additional naloxone kits annually in Rhode Island, the strategy focusing on distribution of naloxone according to geographic need to people who inject drugs resulted in the best outcomes at the lowest cost, averting an estimated 25.3% of opioid overdose deaths at an incremental cost of $27 312 per opioid overdose death averted. This study suggests that expanding naloxone distribution to people at highest risk for opioid overdose should be prioritized and that redirecting spatial distribution of naloxone to areas with the greatest need will improve both effectiveness and efficiency and reduce geospatial health inequality.