Ensuring Access to Opioid Treatment Program Services Among Delawareans Vulnerable to Flooding

Area of Science:

• Environmental Health
• Public Health Preparedness
• Addiction Medicine

Background:

• Delaware faces increasing flood risks from storms and sea-level rise, impacting critical infrastructure.
• Opioid Use Disorder (OUD) is a significant public health crisis in Delaware, with high overdose mortality rates.
• Access to consistent medication-assisted treatment (MAT) is vital for OUD management and relapse prevention.

Purpose of the Study:

• To quantify the potential disruption of flood events on access to MAT for OUD in Delaware.
• To assess the vulnerability of Opioid Treatment Programs (OTPs) to various flood scenarios.

Main Methods:

• Integrated spatial flood risk maps with data on infrastructure, transportation networks, and OTP locations.
• Utilized a complex network theory-based simulation model to evaluate direct and indirect flood impacts on service accessibility.

Main Results:

• In a 100-year flood scenario, 4 out of 18 Delaware OTPs are projected to flood, with 7 severely disrupted.
• Disruptions are expected to increase, affecting 9 OTPs by 2035 and 10 by 2050.
• Flood-induced isolation could reduce OTP service reachability to under 15 square miles.

Conclusions:

• Consistent access to MAT is critical for OUD treatment compliance and patient outcomes.
• Disruptions to OTPs during floods can lead to relapse, overdose, and death.
• Robust hazard planning is necessary to ensure the continuity of OUD treatment services post-disaster.