Population-based estimates of geographic accessibility of medication for opioid use disorder by substance use disorder treatment facilities from 2014 to 2020

Abstract

Background: Understanding whether individuals have geographic accessibility to a substance use disorder treatment facility and a treatment facility that offers medication treatment for opioid use disorder (MOUD) can inform efforts to address the ongoing opioid crisis.

Methods: We used data from the National Directory of Drug and Alcohol Abuse Treatment Programs. First, we calculate the national share of treatment facilities that offer one type of MOUD or all forms of MOUD using a novel dataset of providers. Second, we quantify the share of counties with a treatment facility offering at least one type of MOUD. Finally, we calculate the share of the national population residing within a 10-mile radius of a treatment facility.

Results: The share of counties with a treatment facility offering a MOUD as a form of treatment rose from 30% to 45% from 2014 to 2020 while the share of counties with facilities offering all three forms of MOUD increased from 4% to 9%. Over 83% of the population lives within 10 miles of a facility offering MOUD treatment, and 42% of the population have a treatment facility that offers all three forms of MOUD within a 10-mile radius. Much of the difference between the county- and population-based measures is explained by more population dense areas having higher rates of facilities providing MOUD.

Conclusions: While the share of facilities within a county offering a MOUD is relatively small, the share of the population within 10 miles of such a facility is higher.

Keywords: Access to care; Medications for opioid use disorder.

Figure A1:

Percent of population by Census Block Group with a Treatment Facility within 10-miles Notes: This map studies access to facilities offering all three types of MOUD. The shaded areas in the map above represent counties and areas that do not have facilities in or near them that offer all three forms of MOUD. The gray areas are areas where there are no facilities present within a given county and there are no facilities present within a 10-mile radius of a Census Block Group. The areas in blue have a facility offering all three forms of MOUD within a 10-mile radius but not within its county. The areas in green have facilities offering all forms of MOUD within the same county as well as facilities within a 10-mile radius.

Figure A2:

Percent of population by Census Block Group with a Treatment Facility within 25-miles Notes: Each bar represents the percentage of the population within 25 miles of 0, 1–4, or 5+ treatment facilities meeting criteria listed at base.

Figure A3:

Map of Differences in County and Population Geographic Access to Treatment Centers Offering All Three Forms of MOUD in 2020 Note: This map studies access to facilities offering all three types of MOUD. The shaded areas in the map above represent counties and areas that do not have facilities in or near them that offer all three forms of MOUD. The gray areas are areas where there are no facilities present within a given county and there are no facilities present within a 25-mile radius of a Census Block Group. The areas in blue have a facility offering all three forms of MOUD within a 25-mile radius but not within its county. The areas in green have facilities offering all forms of MOUD within the same county as well as facilities within a 25-mile radius.

Figure A4:

Percent of population by Census Block Group with a Treatment Facility within 50-miles Notes: Each bar represents the percentage of the population within 50 miles of 0, 1–4, or 5+ treatment facilities meeting criteria listed at base.

Figure A5:

Map of Differences in County and Population Geographic Access to Treatment Centers Offering All Three Forms of MOUD in 2020 Note: This map studies access to facilities offering all three types of MOUD. The shaded areas in the map above represent counties and areas that do not have facilities in or near them that offer all three forms of MOUD. The gray areas are areas where there are no facilities present within a given county and there are no facilities present within a 50-mile radius of a Census Block Group. The areas in blue have a facility offering all three forms of MOUD within a 50-mile radius but not within its county. The areas in green have facilities offering all forms of MOUD within the same county as well as facilities within a 50-mile radius.

Figure 1

1a: Share of facilities offering types of MOUD (2014–2020) 1b: Share of counties offering types of MOUD (2014–2020) Notes: MOUD includes buprenorphine, methadone and naltrexone. In Panel A, the yellow line indicates the share of facilities that report offering at least one form of MOUD in each year. The grey line indicates the share of facilities that report offering two or more forms of MOUD treatment. The orange line indicates the share of facilities that offer all three forms of MOUD over time. In Panel B, each line corresponds to the share of counties with a facility providing access to MOUD treatment.

Figure 1

1a: Share of facilities offering types of MOUD (2014–2020) 1b: Share of counties offering types of MOUD (2014–2020) Notes: MOUD includes buprenorphine, methadone and naltrexone. In Panel A, the yellow line indicates the share of facilities that report offering at least one form of MOUD in each year. The grey line indicates the share of facilities that report offering two or more forms of MOUD treatment. The orange line indicates the share of facilities that offer all three forms of MOUD over time. In Panel B, each line corresponds to the share of counties with a facility providing access to MOUD treatment.

Figure 2:

County-Level Measures for Facilities and MOUD Notes: Each bar represents the percentage of counties with 0, 1–4, or 5+ treatment facilities meeting criteria listed at base.

Figure 3:

Percent of population by Census Block Group with a Treatment Facility within 10-miles Notes: Each bar represents the percentage of the population within 10 miles of 0, 1–4, or 5+ treatment facilities meeting criteria listed at base.

Figure 4:

Share of the country that does not have a facility in the county but within 10-, 25-, and 50-miles in 2020 Notes: Denominator is the total population of counties that do not have a treatment facility in the county. The numerator is the total population that does not have a facility in their county but does have a facility within 10-, 25- and 50-miles from the centroid of their census tract.