Spatial accessibility of drug treatment facilities and the effects on locus of control, drug use, and service use among heroin-injecting Mexican American men

Abstract

Background This study explores the spatial accessibility of outpatient drug treatment facilities and the potential relationship with drug abuse-related outcomes among Mexican American heroin users. Methods Secondary data on 219 current and former heroin-injecting Mexican American men aged 45 and older were drawn from a research study in Houston, Texas. We used geographic information systems (GIS) to derive two spatial accessibility measures: distance from one’s place of residence to the closest drug treatment facility (in minutes); and the number of facilities within a 10-minute driving distance from one’s place of residence. Exploratory logistic regression analyses examined the association between the spatial accessibility of drug treatment facilities and several drug abuse-related outcomes: internal locus of control (LOC); perceived chances and worries of injecting in the next six months; treatment utilization; and location of last heroin purchase. Results Participants with greater spatial access to treatment programs were more likely to report a higher chance of injecting in the near future. However, while current heroin users were more worried about injecting in the next six months, greater spatial access to treatment programs seemed to have a buffering effect. Finally, those who lived closer to a treatment programs were more likely to have last purchased heroin inside the neighborhood versus outside the neighborhood. Spatial accessibility was not associated with internal LOC or treatment utilization. Conclusion The findings showed that the presence of outpatient treatment facilities—particularly services in Spanish—may influence perceived risk of future heroin use and purchasing behaviors among Mexican American men. Implications for future spatially-informed drug abuse research and the planning of culturally and linguistically responsive drug treatment programs are discussed.

HIV risk and the association with accessibility coverage to medical facilities and socioeconomic status among heroin users in Kaohsiung, Taiwan (2011‐2015): A GIS approach

“…Inconvenient access to medical facilities would also influence adolescents' drug use behaviors to have higher probability to initiate drug use . Therefore, in order to have maximum effectiveness, the locations of medical treatment facilities should meet with the needs of drug users …”

“…It was found that the distance was an obvious impediment to access to health services in regions with fewer populations . However, access to medical or social services was a multidimensional issue between patients and the service delivery system . The locations and distributions of treatment facilities in geography could affect individuals’ willingness to participate in treatment programs and their retention rate .…”

“…14 However, access to medical or social services was a multidimensional issue between patients and the service delivery system. 15 The locations and distributions of treatment facilities in geography could affect individuals' willingness to participate in treatment programs and their retention rate. 16 A 2004 study identified four factors that could influence individuals' willingness to retain in treatment, namely, availability of drugs, neighborhood disadvantage, availability of community resources, and the influence of a particular location on individual's mental state or behavior.…”

Integrating place into research on drug use, drug users’ health, and drug policy

“…Tobin and colleagues explored complex relationships among place, social networks, and substance misuse among African-American men who have sex with men in Baltimore, Maryland (USA). Kao et al (2014) applied geospatial methods to study the relationship of spatial access to outpatient drug treatment facilities to drug use and treatment utilization among Mexican Americans in Houston, Texas (USA) who are current or former heroin users. McNeil and colleagues (2014) expanded research on gender-based violence in drug scenes to include “marginal men” – that is, men who occupy a marginal position in the drug scene because of their income-generation strategies, age, disability, health status, social isolation, or drug use practices.…”

A review on the potential role and application of GIS in the management of substance abuse

“…For example, Kao et al (2014) explored the spatial accessibility of drug treatment outpatients. In a study by Pang and Lee (2008) to identify the coverage of methadone maintenance clinic to heroin users, GIS was used for the measurement of districtbased geographic coverage in which methadone clinic should be located at the location needed by heroin users.…”