Spatial inequities in access to medications for treatment of opioid use disorder highlight scarcity of methadone providers under counterfactual scenarios.

Autor: Tatara E; Consortium for Advanced Science and Engineering, University of Chicago, Chicago, Illinois, United States of America.; Decision and Infrastructure Sciences, Argonne National Laboratory, Lemont, Illinois, United States of America., Lin Q; Center for Spatial Data Science, University of Chicago, Chicago, Illinois, United States of America., Ozik J; Consortium for Advanced Science and Engineering, University of Chicago, Chicago, Illinois, United States of America.; Decision and Infrastructure Sciences, Argonne National Laboratory, Lemont, Illinois, United States of America., Kolak M; Center for Spatial Data Science, University of Chicago, Chicago, Illinois, United States of America., Collier N; Consortium for Advanced Science and Engineering, University of Chicago, Chicago, Illinois, United States of America.; Decision and Infrastructure Sciences, Argonne National Laboratory, Lemont, Illinois, United States of America., Halpern D; Center for Spatial Data Science, University of Chicago, Chicago, Illinois, United States of America., Anselin L; Center for Spatial Data Science, University of Chicago, Chicago, Illinois, United States of America., Dahari H; The Program for Experimental & Theoretical Modeling, Division of Hepatology, Department of Medicine, Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois, United States of America., Boodram B; Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, United States of America., Schneider J; Departments of Medicine and Public Health Sciences, University of Chicago, Chicago, Illinois, United States of America.
Jazyk: angličtina
Zdroj: PLoS computational biology [PLoS Comput Biol] 2024 Jul 26; Vol. 20 (7), pp. e1012307. Date of Electronic Publication: 2024 Jul 26 (Print Publication: 2024).
DOI: 10.1371/journal.pcbi.1012307
Abstrakt: Access to treatment and medication for opioid use disorder (MOUD) is essential in reducing opioid use and associated behavioral risks, such as syringe sharing among persons who inject drugs (PWID). Syringe sharing among PWID carries high risk of transmission of serious infections such as hepatitis C and HIV. MOUD resources, such as methadone provider clinics, however, are often unavailable to PWID due to barriers like long travel distance to the nearest methadone provider and the required frequency of clinic visits. The goal of this study is to examine the uncertainty in the effects of travel distance in initiating and continuing methadone treatment and how these interact with different spatial distributions of methadone providers to impact co-injection (syringe sharing) risks. A baseline scenario of spatial access was established using the existing locations of methadone providers in a geographical area of metropolitan Chicago, Illinois, USA. Next, different counterfactual scenarios redistributed the locations of methadone providers in this geographic area according to the densities of both the general adult population and according to the PWID population per zip code. We define different reasonable methadone access assumptions as the combinations of short, medium, and long travel distance preferences combined with three urban/suburban travel distance preference. Our modeling results show that when there is a low travel distance preference for accessing methadone providers, distributing providers near areas that have the greatest need (defined by density of PWID) is best at reducing syringe sharing behaviors. However, this strategy also decreases access across suburban locales, posing even greater difficulty in regions with fewer transit options and providers. As such, without an adequate number of providers to give equitable coverage across the region, spatial distribution cannot be optimized to provide equitable access to all PWID. Our study has important implications for increasing interest in methadone as a resurgent treatment for MOUD in the United States and for guiding policy toward improving access to MOUD among PWID.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Tatara et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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