A curated, source-verified library of the strongest available research on harm reduction, treatment outcomes, overdose prevention, and the comparative effectiveness of voluntary versus coercive addictions care. Every entry links to a peer-reviewed journal, government report, university source, or major public-health agency.
Studies, systematic reviews, and meta-analyses published in major medical and public-health journals.
Showing 36 of 36 entries
The Lancet · Marshall BDL, Milloy MJ, Wood E, Montaner JSG, Kerr T
Population-level analysis comparing overdose mortality in the 500 m around Vancouver's Insite supervised injection facility before and after opening.
35% drop in fatal overdoses in the immediate vicinity of Insite (vs. 9.3% in the rest of the city).
Drug and Alcohol Dependence · Potier C, Laprévote V, Dubois-Arber F, Cottencin O, Rolland B
Reviews 75 studies of SCS worldwide. Finds consistent evidence of reduced overdose mortality, fewer unsafe injections, increased treatment uptake, and no increase in drug use or crime.
International Journal of Drug Policy · MacArthur GJ, van Velzen E, Palmateer N, et al.
Umbrella review of needle/syringe programs and opioid substitution therapy. Strong evidence that NSPs reduce HIV transmission; combined NSP+OST is most effective.
Cochrane Database of Systematic Reviews · Platt L, Minozzi S, Reed J, et al.
Cochrane meta-analysis: OST reduces HCV acquisition risk by 50%; combining OST with high-coverage NSP reduces risk by 74%.
OST + high-coverage NSP → 74% reduction in HCV acquisition.
BMJ · Sordo L, Barrio G, Bravo MJ, et al.
Pooled cohort analysis of 122,885 people. All-cause mortality is roughly one-third to one-half lower during methadone or buprenorphine treatment than out of treatment.
Methadone reduces all-cause mortality risk ~3x compared to no treatment.
JAMA Psychiatry · Santo T Jr, Clark B, Hickman M, et al.
Meta-analysis of 15 cohort studies (n=2.8 million person-years) confirming OAT roughly halves all-cause mortality and reduces overdose deaths by ~50%.
BMJ · Walley AY, Xuan Z, Hackman HH, et al.
Interrupted time-series across 19 Massachusetts communities. Opioid-overdose death rates dropped significantly in communities implementing community naloxone distribution.
Up to 46% lower overdose death rates in high-implementation communities.
Addiction · McDonald R, Strang J
Reviews 22 studies. Take-home naloxone programs increase survival after witnessed overdose with low rates of adverse effects.
The Lancet · Strang J, Volkow ND, Degenhardt L, et al.
Comprehensive Lancet seminar on opioid use disorder synthesizing evidence on OAT, naloxone, psychosocial care, and the harms of forced abstinence.
International Journal of Drug Policy · Werb D, Kamarulzaman A, Meacham MC, et al.
Systematic review of compulsory drug-treatment outcomes. Of 9 evaluated studies, only 2 reported any positive outcomes; the majority reported null or worse outcomes vs. voluntary care.
78% of evaluated studies showed null or negative outcomes from compulsory treatment.
Addiction · Merrall ELC, Kariminia A, Binswanger IA, et al.
Pooled analysis showing dramatically elevated overdose mortality in the first weeks after release from incarceration — the same risk profile follows forced-abstinence detention.
Overdose mortality is 3–8× higher in the 2 weeks following release.
New England Journal of Medicine · Binswanger IA, Stern MF, Deyo RA, et al.
Washington State cohort: in the 2 weeks after release, overdose was the leading cause of death; mortality was 12.7× the general population.
Addiction · Rafful C, Orozco R, Rangel G, et al.
Tijuana longitudinal cohort. People who were involuntarily detained for drug treatment had significantly higher odds of subsequent non-fatal overdose.
Adjusted odds ratio for overdose after forced treatment: 1.76.
Harm Reduction Journal · Karamouzian M, Dohoo C, Forsting S, et al.
Insite fentanyl-strip pilot: clients whose drugs tested positive were 10× more likely to reduce their dose.
Current HIV/AIDS Reports · Kennedy MC, Karamouzian M, Kerr T
Updated systematic review confirming SCS reduce overdose mortality, ambulance call-outs, and public injecting without increasing crime or drug initiation.
CMAJ · Fairbairn N, Ross J, Trew M, et al.
Canadian Research Initiative in Substance Misuse (CRISM) national guideline for injectable hydromorphone and diacetylmorphine.
New England Journal of Medicine · Oviedo-Joekes E, Brissette S, Marsh DC, et al.
Canadian RCT of prescription heroin vs. methadone for long-term refractory opioid dependence. Diacetylmorphine had superior retention and reduced illicit drug use.
JAMA Psychiatry · Oviedo-Joekes E, Guh D, Brissette S, et al.
SALOME RCT shows hydromorphone is non-inferior to diacetylmorphine for retention and outcomes — opening the door to prescribed safer supply in Canada.
Annals of Internal Medicine · Larochelle MR, Bernson D, Land T, et al.
Massachusetts cohort of 17,568 survivors of overdose. Methadone and buprenorphine each cut all-cause mortality by more than half.
American Journal of Public Health · Tsemberis S, Gulcur L, Nakae M
Foundational Pathways Housing First RCT in New York: 80% housing retention at 24 months vs. 30% for treatment-first.
Psychiatric Services · Aubry T, Tsemberis S, Adair CE, et al.
At Home/Chez Soi pan-Canadian RCT (n=2,148). Housing First produced rapid, sustained housing stability and reduced shelter and hospital use.
Addiction Science & Clinical Practice · Cheung A, Somers JM, Moniruzzaman A, et al.
Vancouver At Home/Chez Soi cohort analysis documenting heavy acute-care use among people experiencing homelessness with substance dependence and mental disorders.
Substance Abuse Treatment, Prevention, and Policy · Wood E, Tyndall MW, Lai C, Montaner JSG, Kerr T
Insite did not produce measurable increases in drug-related crime, refuting predictions of a public-order spillover.
PLOS ONE · Milloy MJ, Kerr T, Tyndall MW, Montaner J, Wood E
Models 2–12 overdose deaths averted per year at Insite alone using conservative estimates.
PLOS ONE · Ti L, Milloy MJ, Buxton J, et al.
Inadequate in-hospital addiction care drives high rates of leaving against medical advice — a key argument for in-hospital OAT and harm reduction.
The Lancet Public Health (ICES / Unity Health Toronto) · Gomes T, et al.
Population-based matched cohort of 856 safer opioid supply (SOS) recipients vs. matched methadone initiators, tracking overdose, ED use, infections, and retention over multiple years.
Both SOS and methadone groups showed dramatic, statistically significant declines in overdoses, hospitalizations, and aggregate healthcare costs; SOS retained a more medically complex population that frequently drops out of methadone.
JAMA Network Open · Zoorob M, Rouhani S, et al.
Matrix-completion synthetic-control analysis separating Oregon's Measure 110 from the contemporaneous saturation of illicit fentanyl in the unregulated supply.
After adjusting for fentanyl saturation, the association between decriminalization and overdose mortality shrank to zero — supply toxicity, not decriminalization, drove the spike.
Health Promotion and Chronic Disease Prevention in Canada (PHAC) · Garipy G, et al.
Systematic review of six quasi-experimental and observational studies evaluating SCS associations with population-level overdose mortality during the fentanyl era.
Localized analyses consistently show protective effects near sites; province-wide ecological designs are too blunt to detect them. Outcomes are highly sensitive to geographic scale and service coverage.
Canadian Journal of Addiction · Bahji A, et al.
Systematic review of 42 global studies on involuntary and mandatory substance-use treatment, evaluating substance use, retention, and recidivism outcomes.
Only 7 of 42 studies showed improved outcomes vs. voluntary controls, mostly limited to short-term retention. Only one study showed a sustained post-discharge reduction in substance use.
International Review of Psychiatry
Meta-analysis of 36 articles (n = 47,739) identifying epidemiological correlates of admission to compulsory or involuntary substance-use treatment.
Most frequently committed: unmarried males with severe alcohol or opioid use disorders; key triggers were psychosis, aggression, suicidality, legal entanglement, and homelessness.
medRxiv / Swedish national registries
Registry-based analysis of patients discharged from up to six months of civil commitment under Sweden's Care of Abusers Act (LVM), tracking post-discharge mortality.
Massive spike in fatal overdose risk in the first two weeks post-discharge — diminished drug tolerance after forced abstinence collides with a toxic unregulated supply.
Trials (University of Basel Psychiatric Clinics) · Vogel M, et al.
Protocol and early follow-up of a Swiss multi-centre observational cohort offering intranasal diacetylmorphine to patients with severe, treatment-resistant opioid use disorder.
Over 90% of participants retained in intranasal HAT at four weeks.
American Journal of Psychiatry Residents' Journal · Russoniello K, et al.
Clinical retrospective on Measure 110's passage, administrative bottlenecks in funding disbursement, and 2024 repeal.
PMC (peer-reviewed commentary)
Critical medical and ethical review responding to political momentum across Canadian provinces to expand involuntary treatment.
Forced abstinence diminishes opioid tolerance, producing exponentially elevated post-release overdose risk in a toxic supply.
Frontiers in Psychiatry
Review of 45 publications (1988–2023) evaluating reconviction, treatment completion, and substance-use recurrence following court-mandated treatment.
Average 47% failed to complete mandated programs; criminal history — not the mandate — was the strongest predictor of re-offence.
BMJ · Vale de Andrade P, Carapinha L
Authored by Portugal's Institute on Drugs and Drug Addiction; describes the structural healthcare changes and outcomes after the 2001 decriminalisation of personal-use possession.
Drug-related deaths fell from 131 (2001) to 20 (2008); new HIV diagnoses linked to injection use fell from 1,430 to 352.
Curated and maintained by Voluntary Treatment First Saskatchewan. Every entry links to a peer-reviewed journal, government report, university, or major public-health agency. Spot a broken link or missing study? Let us know.
