Geographic disparities in access to Medication for Opioid Use Disorder across US census tracts based on treatment utilization behavior

Mitchell, Penelope; Samsel, Steven; Curtin, Kevin M.; Price, Ashleigh N.; Turner, Daniel; Tramp, Ryan; Hudnall, Matthew; Parton, Jason; Lewis, Dwight

doi:10.1016/j.socscimed.2022.114992

Cited by 27 publications

(9 citation statements)

References 87 publications

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“…In rural areas, additional barriers exist to provide MOUD to people who are incarcerated due in part to geographical distance to services (Mitchell et al, 2022 ) and lack of treatment providers (Bridges et al, 2023 ). Funding was also a barrier to providing MOUD identified in this study, as the rural jails were under-resourced and faced challenges of maintaining adequate staffing.…”

Section: Discussionmentioning

confidence: 99%

Facilitators and barriers to adopting or expanding medications for opioid use disorder provision in rural Colorado jails: a qualitative analysis

McNeely,

Schreiber,

Swann

et al. 2024

Health Justice

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Background Opioid use disorder (OUD) is common among individuals who are incarcerated. However, OUD treatment services are sparse in smaller county jails found in many rural areas, which limits a healthy and supportive jail environment. This study assesses the facilitators of and barriers to medications for opioid use disorder (MOUD) adoption or expansion in rural Colorado jails. A qualitative descriptive design was implemented during the summer of 2022 using semi-structured interviews with jail staff, sheriffs, and contracted personnel. Interview questions focused on facilitators of existing MOUD services and barriers to adopting or expanding services. To identify the facilitators and barriers, data were coded using thematic analysis. Results Seven jails were included in the study. Representatives from each jail participated in the seven interviews, which often included multiple participants per interview. Three of the jails had established routine practices for MOUD administration. Two jails occasionally administered MOUD or had plans in place to be able to administer, while the remaining two did not offer any MOUD. While administrative support, collaborative partnerships, and jail nurses facilitated MOUD use, barriers were more prevalent, including physical space limitations, distance to services, lack of providers in the area, staffing and training issues, funding/budget issues, and perceived risk of diversion. Conclusion Making MOUD available to people who are incarcerated is an important and timely step in enhancing the jail environment, especially in rural areas that often lack access to MOUD. As states look to require MOUD availability for people who are incarcerated, facilitators to MOUD adoption/expansion can be leveraged while strategies are needed to overcome barriers.

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Section: Discussionmentioning

confidence: 99%

Facilitators and barriers to adopting or expanding medications for opioid use disorder provision in rural Colorado jails: a qualitative analysis

McNeely,

Schreiber,

Swann

et al. 2024

Health Justice

View full text Add to dashboard Cite

show abstract

“…Briefly, frontier living is defined as a community of less than 50,000 people and at least one hour away from a metro of over 50,000 people. This metric of rurality was utilized as opposed to other metrics, given distance to receive treatment has historically been noted as a barrier to treatment for opioid use disorder ( Amiri et al, 2018 ; Mitchell et al, 2022 ). All studies were reviewed and approved by the IRB at the University of South Dakota.…”

Section: Methodsmentioning

confidence: 99%

Changes in buprenorphine visits in frontier and remote locations: Effects of the SARS-CoV-2 pandemic

McFadden

2023

Drug and Alcohol Dependence Reports

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“…Since 2019, there have been notable efforts to expand access to OUD treatment, especially in the context of the COVID-19 pandemic, a time where many changes were occurring in both the clinical and policy space (e.g. prescribing buprenorphine via telehealth without an initial in-person exam, take-home doses of methadone to relatively stable patients) [65]. However, we believe our study provides an important overview of the state of care and access needs that predates the COVID-19 pandemic.…”

Section: Limitationsmentioning

confidence: 99%

County-level factors associated with a mismatch between opioid overdose mortality and availability of opioid treatment facilities

Rizk,

Saini,

Kim

et al. 2024

PLoS ONE

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Background Opioid overdose deaths in the United States remain a major public health crisis. Little is known about counties with high rates of opioid overdose mortality but low availability of opioid use disorder (OUD) treatment facilities. We sought to identify characteristics of United States (US) counties with high rates of opioid overdose mortality and low rates of opioid treatment facilities. Methods Rates of overdose mortality from 3,130 US counties were compared with availability of opioid treatment facilities that prescribed or allowed medications for OUD (MOUD), from 2018-2019. The outcome variable, “risk-availability mismatch” county, was a binary indicator of a high rate (above national average) of opioid overdose mortality with a low (below national average) rate of opioid treatment facilities. Covariates of interest included county-level sociodemographics and rates of insurance, unemployment, educational attainment, poverty, urbanicity, opioid prescribing, depression, heart disease, Gini index, and Theil index. Multilevel logistic regression, accounting for the clustering of counties within states, was used to determine associations with being a “risk-availability mismatch” county. Results Of 3,130 counties, 1,203 (38.4%) had high rates of opioid overdose mortality. A total of 1,098 counties (35.1%) lacked a publicly-available opioid treatment facility in 2019. In the adjusted model, counties with an additional 1% of: white residents (odds ratio, OR, 1.02; 95% CI, 1.01-1.03), unemployment (OR, 1.11; 95% CI, 1.05-1.19), and residents without insurance (OR, 1.04; 95% CI, 1.01-1.08) had increased odds of being a mismatch county. Counties that were metropolitan (versus non-metropolitan) had an increased odds of being a mismatch county (OR, 1.85; 95% CI, 1.45-2.38). Conclusion Assessing mismatch between treatment availability and need provides useful information to characterize counties that require greater public health investment. Interventions to reduce overdose mortality are unlikely to be effective if they do not take into account diverse upstream factors, including sociodemographics, disease burden, and geographic context of communities.

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Geographic disparities in access to Medication for Opioid Use Disorder across US census tracts based on treatment utilization behavior

Cited by 27 publications

References 87 publications

Facilitators and barriers to adopting or expanding medications for opioid use disorder provision in rural Colorado jails: a qualitative analysis

Facilitators and barriers to adopting or expanding medications for opioid use disorder provision in rural Colorado jails: a qualitative analysis

Changes in buprenorphine visits in frontier and remote locations: Effects of the SARS-CoV-2 pandemic

County-level factors associated with a mismatch between opioid overdose mortality and availability of opioid treatment facilities

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