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Improving geographic access to methadone clinics.

Anthony Bonifonte1, Erin Garcia2

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Journal of Substance Abuse Treatment
|July 23, 2022
PubMed
Summary

Millions lack access to methadone treatment due to geographic barriers. Opening new clinics can significantly improve access for new and existing patients, addressing critical public health needs in opioid use disorder treatment.

Keywords:
Access to careHeroin useMethadone maintenance treatmentOpioid use disorder

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Area of Science:

  • Public Health
  • Health Services Research
  • Health Geography

Background:

  • Opioid misuse is a significant public health crisis in the United States.
  • Methadone treatment is a proven, effective intervention for opioid use disorder (OUD).
  • Geographic accessibility to methadone clinics is critical for treatment initiation and adherence.

Purpose of the Study:

  • To estimate the unmet demand for methadone treatment resulting from geographic access limitations.
  • To model the optimal placement of new methadone clinics to serve underserved populations.
  • To assess the impact of new clinics on both new patient access and existing patient travel times.

Main Methods:

  • Utilized 2019 Substance Abuse and Mental Health Services Administration (SAMHSA) data on methadone clinics and demand.
  • Estimated unsatisfied methadone demand at the census tract level using linear regression.
  • Developed an optimization model to identify new clinic locations, balancing unmet demand and travel time improvements.

Main Results:

  • 18.2% of the U.S. population lacks geographic access to a methadone clinic, representing an estimated 77,973 individuals.
  • Opening new clinics can serve 180-804 additional clients per state in a Midwestern case study.
  • New clinics can reduce travel distances for existing clients by 6.3-11.9 miles per person per day.

Conclusions:

  • Significant unmet demand for methadone treatment exists nationwide due to geographic barriers.
  • Strategic placement of new methadone clinics can substantially improve access for underserved populations.
  • State-specific geographic factors play a crucial role in optimizing the impact of new clinic locations.