Pub Date : 2025-11-14DOI: 10.1016/j.lana.2025.101301
Merike Blofield , Andrea L. Wirtz , Magaly Pedraza , Rafael Olarte , Doris Parada
Background
Syphilis incidence is increasing globally; however, cost and time are significant barriers to treatment completion rates among vulnerable populations, including displaced populations and host communities. To inform public health strategies, we aimed to test whether conditional cash transfers (CCT) increased completion of syphilis treatment among a community sample in a border city of Colombia.
Methods
We embedded a quasi-experimental trial of a CCT intervention in a community sexual health program serving participants aged 14 years and older in low-income settlements around Cúcuta, Colombia in 2023. The program included workshops and syphilis screening. Individuals with laboratory-confirmed syphilis were eligible for inclusion in the trial. Both control and CCT arms provided syphilis diagnostics, counseling and free treatment. CCT consisted of cash payments of USD$12.69 for completion of each of two follow-up treatments. We used generalized linear models to estimate the effect of CCT on treatment completion, defined as three doses of penicillin.
Findings
Of 1751 workshop participants, 114 had laboratory-confirmed syphilis and were enrolled in the trial. Participants were 56% female (64/114) and 44% male (50/114), with 6 participants (5.3%) identifying as transgender, regardless of sex at birth. Participants included 47% Venezuelan migrants staying in Cúcuta (53/114), 26% Colombian returnees (30/114), and 19% Colombians from the host community (22/114). Data on ethnicity was not collected. Median age was 34.5 years (IQR: 25.0–46.0). More than three-quarters (78%, 39/50) of CCT participants completed the three-dose treatment regimen compared to 45% (29/64) of control participants, a risk difference of 33% (p < 0.001). In adjusted models, CCT-assigned participants had a 36% higher treatment completion rate compared to control-assigned participants (adjusted risk difference: aRD: 0.36, 95% CI: 0.19–0.53).
{"title":"Conditional cash transfer interventions to support syphilis treatment in vulnerable populations: a quasi-experimental study among displaced and host communities in a border city of Colombia","authors":"Merike Blofield , Andrea L. Wirtz , Magaly Pedraza , Rafael Olarte , Doris Parada","doi":"10.1016/j.lana.2025.101301","DOIUrl":"10.1016/j.lana.2025.101301","url":null,"abstract":"<div><h3>Background</h3><div>Syphilis incidence is increasing globally; however, cost and time are significant barriers to treatment completion rates among vulnerable populations, including displaced populations and host communities. To inform public health strategies, we aimed to test whether conditional cash transfers (CCT) increased completion of syphilis treatment among a community sample in a border city of Colombia.</div></div><div><h3>Methods</h3><div>We embedded a quasi-experimental trial of a CCT intervention in a community sexual health program serving participants aged 14 years and older in low-income settlements around Cúcuta, Colombia in 2023. The program included workshops and syphilis screening. Individuals with laboratory-confirmed syphilis were eligible for inclusion in the trial. Both control and CCT arms provided syphilis diagnostics, counseling and free treatment. CCT consisted of cash payments of USD$12.69 for completion of each of two follow-up treatments. We used generalized linear models to estimate the effect of CCT on treatment completion, defined as three doses of penicillin.</div></div><div><h3>Findings</h3><div>Of 1751 workshop participants, 114 had laboratory-confirmed syphilis and were enrolled in the trial. Participants were 56% female (64/114) and 44% male (50/114), with 6 participants (5.3%) identifying as transgender, regardless of sex at birth. Participants included 47% Venezuelan migrants staying in Cúcuta (53/114), 26% Colombian returnees (30/114), and 19% Colombians from the host community (22/114). Data on ethnicity was not collected. Median age was 34.5 years (IQR: 25.0–46.0). More than three-quarters (78%, 39/50) of CCT participants completed the three-dose treatment regimen compared to 45% (29/64) of control participants, a risk difference of 33% (p < 0.001). In adjusted models, CCT-assigned participants had a 36% higher treatment completion rate compared to control-assigned participants (adjusted risk difference: aRD: 0.36, 95% CI: 0.19–0.53).</div></div><div><h3>Interpretation</h3><div>Conditional cash transfers might enhance syphilis treatment adherence among populations facing socioeconomic challenges.</div></div><div><h3>Funding</h3><div><span>German Development Cooperation Agency</span>, <span>Deutsche Gesellschaft für Internationale Zusammenarbeit</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"53 ","pages":"Article 101301"},"PeriodicalIF":7.0,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-14DOI: 10.1016/j.lana.2025.101300
Andrés F. Cardona , Natalia Sánchez , Liliana Gutiérrez-Babativ , Leonardo Rojas , Jairo Zuluaga , Stella Martínez , Lucia Viola , Carlos Carvajal , Juliana Bogoya , Laura Prieto-Pinto , Daniel Samacá-Samacá , Antonio Robles , Joshua Kock , Claudio Martín , Luis Corrales , Luis E. Raez , Vladmir Cordeiro de Lima , Suraj Samtani , Oscar Arrieta
{"title":"Corrigendum to “Clinical and economic impact of the availability of innovative therapies for advanced lung cancer in men in Latin America: a population-based secondary data study”- the Lancet Regional Health—Americas 2025; Volume 49: 101172; DOI: 10.1016/j.lana.2025.101172","authors":"Andrés F. Cardona , Natalia Sánchez , Liliana Gutiérrez-Babativ , Leonardo Rojas , Jairo Zuluaga , Stella Martínez , Lucia Viola , Carlos Carvajal , Juliana Bogoya , Laura Prieto-Pinto , Daniel Samacá-Samacá , Antonio Robles , Joshua Kock , Claudio Martín , Luis Corrales , Luis E. Raez , Vladmir Cordeiro de Lima , Suraj Samtani , Oscar Arrieta","doi":"10.1016/j.lana.2025.101300","DOIUrl":"10.1016/j.lana.2025.101300","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"52 ","pages":"Article 101300"},"PeriodicalIF":7.0,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-13DOI: 10.1016/j.lana.2025.101299
Sarah E. Anthony , Manali A. Phadke , Richard B. Lipton , Daniel G. Rogers , Lisa A. Brenner , John P. Ney , Hamada H. Altalib , X. Michelle Androulakis , Amy S. Grinberg , Melissa Skanderson , Hung-Mo Lin , Joel D. Scholten , Brenda T. Fenton , Elizabeth K. Seng , Jason J. Sico
Background
Post-traumatic headache (PTH) is a common sequela of traumatic brain injury (TBI). Although there is a known association between TBI and suicide risk in veterans, the association between PTH and suicide-related outcomes in veterans with TBI is relatively unknown. We aimed to evaluate the association between PTH and suicide-related outcomes in veterans compared to matched controls diagnosed with TBI but no history of headaches.
Methods
This retrospective cohort study was conducted with Veterans Health Administration and Department of Defense electronic health record data from fiscal years 2008 through 2020. Veterans with PTH were matched to a control group who had TBI and no headache disorders. Relative risk was estimated using propensity score-weighted log-binomial models that evaluated differences in suicidal ideation, suicide attempts, and suicide death.
Findings
Of the 95,224 veterans included in the total sample, 85,730 were male (90.0%) and 9,949 were female (10.0%). The average age of the sample was 45.9 years (SD = 16.6). 73,500 (77.2%) were White, Non-Hispanic, 17,256 (18.1%) were Black, Non-Hispanic, and 4,468 (4.7%) were classified as other or mixed race. Of the 47,612 veterans diagnosed with PTH, 4,618 (9.7%) reported suicidal ideation or suicide attempts compared to 3,162 (6.6%) in the control group. Veterans with PTH had increased risk of suicidal ideation (RR, 1.45; 95% CI, 1.39–1.51) and suicide attempts (RR, 1.66; 95% CI, 1.50–1.83) compared to matched controls. Using inverse probability weighting to adjust for confounding, these results remained significant. When adjusting for potential confounders, as well as prior suicidal ideation or suicide attempts, there was no significant difference in risk of suicide death in veterans with PTH (RR, 0.83; 95% CI, 0.67–1.02) compared to those with TBI without headache.
Interpretation
Veterans with PTH have an increased risk of suicidal ideation and suicide attempts compared to veterans with TBI and without headache. There was no difference in suicide mortality between the two groups. Clinicians should be aware of heightened suicide risk among veterans with PTH and be especially diligent in terms of screening for suicide risk and related medical and mental health comorbidities that contribute to increased risk.
Funding
This study was supported by the United States Department of Veterans Affairs special purpose medical service funding (SP80DPE.1-0160).
{"title":"Suicide-related outcomes in veterans with post-traumatic headache: a retrospective cohort study","authors":"Sarah E. Anthony , Manali A. Phadke , Richard B. Lipton , Daniel G. Rogers , Lisa A. Brenner , John P. Ney , Hamada H. Altalib , X. Michelle Androulakis , Amy S. Grinberg , Melissa Skanderson , Hung-Mo Lin , Joel D. Scholten , Brenda T. Fenton , Elizabeth K. Seng , Jason J. Sico","doi":"10.1016/j.lana.2025.101299","DOIUrl":"10.1016/j.lana.2025.101299","url":null,"abstract":"<div><h3>Background</h3><div>Post-traumatic headache (PTH) is a common sequela of traumatic brain injury (TBI). Although there is a known association between TBI and suicide risk in veterans, the association between PTH and suicide-related outcomes in veterans with TBI is relatively unknown. We aimed to evaluate the association between PTH and suicide-related outcomes in veterans compared to matched controls diagnosed with TBI but no history of headaches.</div></div><div><h3>Methods</h3><div>This retrospective cohort study was conducted with Veterans Health Administration and Department of Defense electronic health record data from fiscal years 2008 through 2020. Veterans with PTH were matched to a control group who had TBI and no headache disorders. Relative risk was estimated using propensity score-weighted log-binomial models that evaluated differences in suicidal ideation, suicide attempts, and suicide death.</div></div><div><h3>Findings</h3><div>Of the 95,224 veterans included in the total sample, 85,730 were male (90.0%) and 9,949 were female (10.0%). The average age of the sample was 45.9 years (SD = 16.6). 73,500 (77.2%) were White, Non-Hispanic, 17,256 (18.1%) were Black, Non-Hispanic, and 4,468 (4.7%) were classified as other or mixed race. Of the 47,612 veterans diagnosed with PTH, 4,618 (9.7%) reported suicidal ideation or suicide attempts compared to 3,162 (6.6%) in the control group. Veterans with PTH had increased risk of suicidal ideation (RR, 1.45; 95% CI, 1.39–1.51) and suicide attempts (RR, 1.66; 95% CI, 1.50–1.83) compared to matched controls. Using inverse probability weighting to adjust for confounding, these results remained significant. When adjusting for potential confounders, as well as prior suicidal ideation or suicide attempts, there was no significant difference in risk of suicide death in veterans with PTH (RR, 0.83; 95% CI, 0.67–1.02) compared to those with TBI without headache.</div></div><div><h3>Interpretation</h3><div>Veterans with PTH have an increased risk of suicidal ideation and suicide attempts compared to veterans with TBI and without headache. There was no difference in suicide mortality between the two groups. Clinicians should be aware of heightened suicide risk among veterans with PTH and be especially diligent in terms of screening for suicide risk and related medical and mental health comorbidities that contribute to increased risk.</div></div><div><h3>Funding</h3><div>This study was supported by the United States <span>Department of Veterans Affairs</span> special purpose medical service funding (SP80DPE.1-0160).</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"53 ","pages":"Article 101299"},"PeriodicalIF":7.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reconceptualizing access: advancing pharmaceutical equity for health system resilience in Central and South America","authors":"Esteban Zavaleta-Monestel, Sebastián Arguedas-Chacón","doi":"10.1016/j.lana.2025.101302","DOIUrl":"10.1016/j.lana.2025.101302","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"53 ","pages":"Article 101302"},"PeriodicalIF":7.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-07DOI: 10.1016/j.lana.2025.101297
Jesús Endara-Mina , Damary S. Jaramillo-Aguilar , Katherine Simbaña-Rivera
{"title":"Oil spill in Esmeraldas: a public health emergency in the context of environmental racism","authors":"Jesús Endara-Mina , Damary S. Jaramillo-Aguilar , Katherine Simbaña-Rivera","doi":"10.1016/j.lana.2025.101297","DOIUrl":"10.1016/j.lana.2025.101297","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"53 ","pages":"Article 101297"},"PeriodicalIF":7.0,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145468229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-06DOI: 10.1016/j.lana.2025.101294
Vitoria Borges Spinola , Lucas Porto Santos , Hamilton Roschel , Bruno Gualano , Megan E. Roberts
{"title":"Weak enforcement of Brazil's E-cigarette ban and the expansion of a dangerous illicit market","authors":"Vitoria Borges Spinola , Lucas Porto Santos , Hamilton Roschel , Bruno Gualano , Megan E. Roberts","doi":"10.1016/j.lana.2025.101294","DOIUrl":"10.1016/j.lana.2025.101294","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"52 ","pages":"Article 101294"},"PeriodicalIF":7.0,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Thirty-five years of Brazil's Unified Health System (SUS): from Alma-ata to the climate challenge","authors":"Alexandre Padilha , Adriano Massuda , Florentino Leônidas , Andreza Davidian","doi":"10.1016/j.lana.2025.101295","DOIUrl":"10.1016/j.lana.2025.101295","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"51 ","pages":"Article 101295"},"PeriodicalIF":7.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.lana.2025.101223
Kevin Hu , Roshni Desai , Shania Au , Bin Zhao , Skye Barbic , Kirsten Marchand , Tonia Nicholls , Christian Schütz , Hasina Samji , Jia Hu , Geoff McKee , Alexis Crabtree , Heather Palis
Background
Emerging evidence indicates a potential rise in attention-deficit/hyperactivity disorder (ADHD) incidence worldwide and in British Columbia (BC) since the pandemic. Given the high comorbidity of ADHD with substance use disorder (SUD) and other mental disorders, understanding changes in ADHD diagnosis among adults is crucial for healthcare planning amid BC's drug poisoning (overdose) crisis. We aimed to report how rates of newly diagnosed adult ADHD changed before, during and after the pandemic by demographic variables and histories of SUD or mental disorders.
Methods
We conducted interrupted time series analyses on overall and stratified monthly incidence rates of ADHD diagnosis between Jan, 2013, and Nov, 2023 in BC, using data from linked population-based administrative databases.
Findings
The pre-pandemic average of newly diagnosed adult ADHD was 8.8 cases per 100,000 population monthly. During the pandemic (Mar, 2020–Jun, 2021), this rose to 19.2 driven by a 4.9% (95% confidence interval: [3.7, 6.2]) month-over-month increase. When the pandemic ended, the monthly rate jumped by 107.3% [68.5, 155.0] in Jul, 2021 and grew 1.5% [0.4, 2.7] per month thereafter, averaging 34.8 cases per 100,000 post-pandemic. Substantial differences in trends emerged when stratified by sex and SUD histories.
Interpretation
This exponential rise in adult ADHD may be explained by pandemic-related sociocultural changes and the broader societal evolution in mental health awareness in recent years and decades. This rise could foreshadow a potential increase in the population at risk of SUD, underscoring the urgent need for bidirectional integration of ADHD and SUD services.
Funding
We acknowledge the UBC Psychiatry Stimulus Grants Initiative.
{"title":"Trends of incident adult Attention-deficit/hyperactivity disorder diagnoses before, during and after the pandemic provincial state of emergency in British Columbia (2013–2023): a population-based study","authors":"Kevin Hu , Roshni Desai , Shania Au , Bin Zhao , Skye Barbic , Kirsten Marchand , Tonia Nicholls , Christian Schütz , Hasina Samji , Jia Hu , Geoff McKee , Alexis Crabtree , Heather Palis","doi":"10.1016/j.lana.2025.101223","DOIUrl":"10.1016/j.lana.2025.101223","url":null,"abstract":"<div><h3>Background</h3><div>Emerging evidence indicates a potential rise in attention-deficit/hyperactivity disorder (ADHD) incidence worldwide and in British Columbia (BC) since the pandemic. Given the high comorbidity of ADHD with substance use disorder (SUD) and other mental disorders, understanding changes in ADHD diagnosis among adults is crucial for healthcare planning amid BC's drug poisoning (overdose) crisis. We aimed to report how rates of newly diagnosed adult ADHD changed before, during and after the pandemic by demographic variables and histories of SUD or mental disorders.</div></div><div><h3>Methods</h3><div>We conducted interrupted time series analyses on overall and stratified monthly incidence rates of ADHD diagnosis between Jan, 2013, and Nov, 2023 in BC, using data from linked population-based administrative databases.</div></div><div><h3>Findings</h3><div>The pre-pandemic average of newly diagnosed adult ADHD was 8.8 cases per 100,000 population monthly. During the pandemic (Mar, 2020–Jun, 2021), this rose to 19.2 driven by a 4.9% (95% confidence interval: [3.7, 6.2]) month-over-month increase. When the pandemic ended, the monthly rate jumped by 107.3% [68.5, 155.0] in Jul, 2021 and grew 1.5% [0.4, 2.7] per month thereafter, averaging 34.8 cases per 100,000 post-pandemic. Substantial differences in trends emerged when stratified by sex and SUD histories.</div></div><div><h3>Interpretation</h3><div>This exponential rise in adult ADHD may be explained by pandemic-related sociocultural changes and the broader societal evolution in mental health awareness in recent years and decades. This rise could foreshadow a potential increase in the population at risk of SUD, underscoring the urgent need for bidirectional integration of ADHD and SUD services.</div></div><div><h3>Funding</h3><div>We acknowledge the <span>UBC Psychiatry Stimulus Grants Initiative</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"51 ","pages":"Article 101223"},"PeriodicalIF":7.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.lana.2025.101226
Deborah Dowell, Nisha Nataraj, Michaela Rikard, Joohyun Park, Kun Zhang, Grant Baldwin
While overdose deaths remain high in the United States (U.S.), national data show a 25.0% decline in overdose deaths from the year ending in March 2025 compared to the previous year. Reductions since 2015 in the population exposed to overdose risk through drug use may have until recently been offset by an increased per-person mortality risk, driven by replacement of heroin with fentanyl in the drug supply. We estimated overdose deaths and counterfactual scenarios from 2016 to 2023. An estimated 109,783 additional people would have died from opioid overdose if the population exposed to opioid overdose risk had remained constant rather than declining; an estimated 260,024 fewer people would have died from overdose if probability of fentanyl involvement in opioid overdose deaths had remained constant rather than increasing. Fentanyl's representation in the U.S. drug supply appears to be a key driver of overdose trends. A declining population exposed to overdose risk over the last decade may be related to prior deaths and to evidence-based efforts to prevent substance use and opioid use disorder.
{"title":"Why have overdose deaths decreased? Widespread fentanyl saturation and decreased drug use among key drivers","authors":"Deborah Dowell, Nisha Nataraj, Michaela Rikard, Joohyun Park, Kun Zhang, Grant Baldwin","doi":"10.1016/j.lana.2025.101226","DOIUrl":"10.1016/j.lana.2025.101226","url":null,"abstract":"<div><div>While overdose deaths remain high in the United States (U.S.), national data show a 25.0% decline in overdose deaths from the year ending in March 2025 compared to the previous year. Reductions since 2015 in the population exposed to overdose risk through drug use may have until recently been offset by an increased per-person mortality risk, driven by replacement of heroin with fentanyl in the drug supply. We estimated overdose deaths and counterfactual scenarios from 2016 to 2023. An estimated 109,783 additional people would have died from opioid overdose if the population exposed to opioid overdose risk had remained constant rather than declining; an estimated 260,024 fewer people would have died from overdose if probability of fentanyl involvement in opioid overdose deaths had remained constant rather than increasing. Fentanyl's representation in the U.S. drug supply appears to be a key driver of overdose trends. A declining population exposed to overdose risk over the last decade may be related to prior deaths and to evidence-based efforts to prevent substance use and opioid use disorder.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"51 ","pages":"Article 101226"},"PeriodicalIF":7.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.lana.2025.101293
Rebekah Israel Cross , James Huynh , Taylor B. Rogers , Natalie J. Bradford , Mienah Z. Sharif
{"title":"CBPR is indeed political","authors":"Rebekah Israel Cross , James Huynh , Taylor B. Rogers , Natalie J. Bradford , Mienah Z. Sharif","doi":"10.1016/j.lana.2025.101293","DOIUrl":"10.1016/j.lana.2025.101293","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"51 ","pages":"Article 101293"},"PeriodicalIF":7.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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