Availability of Outpatient Substance Use Disorder Treatment Programs in the United States

Abstract

The purpose of this study was to examine the availability of outpatient substance use disorder (SUD) treatment programs in the United States. A geographic information system (GIS) was used to spatially locate outpatient SUD treatment programs, calculate areas, and determine population density within specific areas. Urban areas were mapped using data from the US Census (2000). Addresses of outpatient SUD treatment programs were obtained from the Facility Locator Web site of the Substance Abuse and Mental Health Services Administration. A 15-mile service catchment around each outpatient SUD treatment program was drawn. The amount of urban area not covered by the service catchment represents the underserved. Total underserved urban area and population without access was computed for each state. Significant variability of underserved urban area and population was observed across the states. Moderate correlations among area and population suggest that some states are more effective in locating SUD treatment programs than other states.

RÉSUMÉ

L’objectif de cette étude était d’évaluer la disponibilité des programmes de traitement externes des patients toxicomanes aux Etats-Unis. Un système d’information géographique était utilisé pour situer les programmes de traitement, pour établir les zones et pour déterminer la densité de la population dans les zones spécifiques. Les zones urbaines étaient schématisées avec les données du Recensement des Etats-Unis (2000). Les adresses des programmes de traitement ont été obtenues du site web de la «Substance Abuse and Mental Health Services Administration ». Un bassin de population avec un rayon de 24.14 kilomètres (15 miles) a été établi autour de chaque site des programmes de traitement. La superficie exclue de ces bassins représente les régions insuffisamment desservies. Le territoire complet et la population totale avec ce manque de service ont été identifiés dans chaque état. Une variance importante a été observée entre les états en ce qui concerne les régions et populations totales qui sont insuffisamment desservies. Les corrélations modérées parmi les régions et les populations suggèrent que certains états sont plus efficaces que d’autres à situer les programmes de traitement pour les patients toxicomanes.

Mots-clefs : Disponibilité des services; le traitement des personnes toxicomanes; les systèmes d’information géographiques

RESUMEN

El objetivo de este estudio fue examinar la disponibilidad de programas de tratamiento del abuso de sustancias para pacientes externos en los Estados Unidos. Un sistema geográfico informativo estuvo empleado para localizar los programas para pacientes externos, calcular su zona y establecer la densidad de población dentro de las regiones especificas. Se trazó regiones urbanas con los datos del Censo de los Estado Unidos (2000). Las direcciones de los programas de tratamiento se consiguieron a través del sitio web de la Administración de Salud Mental y Abuso de Sustancias, en la pagina de localización de instalaciones. Una zona de captación de 24.14 kilómetros (15 millas) alrededor de cada programa de tratamiento fue identificado. La cantidad de territorio urbano que se ubicó fuera de las zonas de captación constituye las zonas con una carencia de servicios. Las zonas y personas con una carencia de servicios fueron calculadas por cada estado. Se descubrió una gran variabilidad en las zonas y poblaciones urbanas con carencias de servicios entre estados. Correlaciones moderadas entre las zonas y poblaciones indican que algunos estados son más efectivos en localizar los programas de tratamiento que otros.

Palabras claves: disponibilidad de servicio; tratamiento del abuso de sustancias; los sistemas geográficos informativos

Keywords :

• service availability
• substance use disorder treatment
• geographic information systems
• GIS

THE AUTHORS

Brian E. Perron, After completing his PhD at Washington University in 2007, Dr. Perron joined the faculty at the University of Michigan, School of Social Work. Previously, he worked as a clinical social worker in community mental health, providing services to persons with serious mental illnesses and substance use disorders. His research focuses on issues related to the quality of care for persons with mental illnesses and substance use disorders. He is involved in a variety of research activities, including analysis of nationally representative data and clinic-based surveys, and collaborating on field-based interventions. Dr. Perron is also interested in innovative research methodologies and provides statistical consultation for a number of projects.

David F. Gillespie, Professor Gillespie is a national expert in the area of disaster preparedness and mitigation, specifically the integration of social work and social services with emergency management. Professor Gillespie teaches social measurement and structural equation modeling at the doctoral level and organizational dynamics and disaster preparedness at the master's level. Professor Gillespie is a member of the FOCUS St. Louis Regional Disaster Preparedness Task Force, a cross-section of 30 citizen leaders representing a range of perspective and skills charged with assessing the region's readiness for a major disaster.

Ben Alexander-Eitzman, Ben Alexander-Eitzman is an assistant professor of social work at Appalachian State University in Boone, NC. He continues his research on adult homelessness and substance abuse that was initially funded through a NIDA dissertation grant at the George Warren Brown School of Social Work at Washington University. He also is engaged in several research projects focused on improvements in mental health services and innovative crisis intervention programs throughout North Carolina.

Jorge Delva, Jorge Delva, a native of Chile, is the co-director of the Vivian A. and James L. Curtis School of Social Work Research and Training Center. The main aim of the Curtis Center is to create a multidisciplinary environment that will facilitate collaboration among investigators to increase their competitiveness in securing funding and advancing their research agendas. With funding from NIH, RWJF, and other sources, his research has focused on studying trends and effects of individual risk and protective factors on substance use and childhood obesity while taking into account neighborhood and other contextual level factors. He is particularly interested in how these factors manifest themselves among racial and ethnic minority populations and between cultures in the United States and internationally. He is also a faculty associate with the Center for Social Epidemiology and Population Health in the School of Public Health, and the Institute for Social Research at the University of Michigan.