美国各社区阿片类药物治疗项目的可用性存在地域差异。

IF 1.6 4区 医学 Q3 SUBSTANCE ABUSE Journal of Addictive Diseases Pub Date : 2024-04-01 Epub Date: 2023-01-16 DOI:10.1080/10550887.2023.2165869
Sadia Jehan, Whitney E Zahnd, Nikki R Wooten, Kristen D Seay
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引用次数: 0

摘要

用于阿片类药物使用障碍 (OUD) 治疗的美沙酮仅在阿片类药物治疗计划 (OTP) 中配发。为了:(1)描述 OTP 的地理分布情况;(2)根据美国毗邻地区的邮政编码区制表(ZCTA)水平,按社区特征检查 OTP 的可用性,我们对 OTP 可用性的地理差异以及与美国较小地理社区可用性相关的社区特征知之甚少。我们使用逻辑回归法来研究与OTP可用性相关的社区特征(N = 30,367)。采用卡方检验(Chi-square)和 t 检验(t-tests)来检验 OTP 可用性在统计上的显著差异。使用地图和描述性统计来检查 OTP 可得性的地理差异。只有 5%(1,417 个)的 ZCTAs 至少有一个 OTP,总共有 1,682 个 OTP。与城市地区相比,农村地区拥有 OTP 的几率要低 50%[AOR 0.5;(95% CI:0.41-0.60)]。与收入最高的四分位数地区相比,收入最低的四分位数地区拥有 OTP 的几率更高[AOR 3.4;(95% CI:2.71-4.18)]。此外,拥有 OTP 的 ZCTA 少数族裔居民比例较高 [黑人:17.5% 对 7.2%;西班牙裔:19.2% 对 9%],白人居民比例较低 [55.1% 对 78.2%]。在全国范围内,开放式治疗方案非常稀缺,地区和城乡差距明显。本文讨论了解决这些差异的潜在方案。
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Geographic variation in availability of opioid treatment programs across U.S. communities.

Methadone for Opioid Use Disorder (OUD) treatment is only dispensed at Opioid Treatment Programs (OTPs). Little is known about the geographic variation in OTP availability and community characteristics associated with the availability across smaller geographic communities in the U.S. To (1) describe geographic distribution of OTPs and (2) examine OTP availability by community characteristics in the contiguous U.S. at Zip Code Area Tabulation (ZCTA) level. Logistic regression was used to examine community characteristics associated with OTP availability (N = 30,367). Chi-square and t-tests were conducted to examine statistically significant differences in OTP availability. Maps and descriptive statistics were used to examine geographic variation in OTP availability. Only 5% (1,417) of ZCTAs had at least one OTP for a total of 1,682 OTPs. Rural ZCTAs had 50% lower odds of having an OTP compared to urban ZCTAs [AOR 0.5; (95% CI: 0.41-0.60)]. ZCTAs in the lowest income quartile had higher odds of having an OTP compared to ZCTAs in the highest income quartile [AOR 3.4; (95% CI: 2.71-4.18)]. Further, ZCTAs with OTPs had a higher proportion of minority residents [Black: 17.5% vs. 7.2%; Hispanic: 19.2% vs. 9%] and a lower proportion of White residents [55.1% vs. 78.2%]. Nationally, OTPs are extremely scarce with notable regional and urban-rural disparities. Potential solutions to address these disparities are discussed.

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来源期刊
CiteScore
4.30
自引率
4.30%
发文量
69
期刊介绍: The Journal of Addictive Diseases is an essential, comprehensive resource covering the full range of addictions for today"s addiction professional. This in-depth, practical journal helps you stay on top of the vital issues and the clinical skills necessary to ensure effective practice. The latest research, treatments, and public policy issues in addiction medicine are presented in a fully integrated, multi-specialty perspective. Top researchers and respected leaders in addiction issues share their knowledge and insights to keep you up-to-date on the most important research and practical applications.
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