Proximity Increases the Likelihood of Adherence to Medication Assisted Treatment with Methadone in Spokane, Washington

Authors: Ofer Amram*, Simon Fraser University
Topics: Geography and Urban Health
Keywords: Access to care, Opioid treatment
Session Type: Paper
Day: 4/5/2019
Start / End Time: 9:55 AM / 11:35 AM
Room: Truman, Marriott, Mezzanine Level
Presentation File: No File Uploaded


Drug overdose has become the leading cause of accidental death in the United States with opioids driving this crisis. Medication assisted treatment (MAT) combines medication and behavioral therapy for the treatment of opioid use disorders. MAT with methadone is associated with improved clinical and community outcomes such as reductions in drug use, criminal behavior, and high-risk sexual behavior. The main drawback of methadone is that newly enrolled patients are required to attend treatment on a daily basis for supervised dosing of methadone during the first 90 days of treatment. Using data from the Spokane Regional Health District Treatment Services database, we examined the association between access to the treatment program in Spokane, Washington and treatment adherence during the first 90 days, second 90 days, and third 90 days of treatment. Distance was measured as the number of miles (continuous) traveled between client’s self-reported home address and the treatment program using ArcGIS. Additional explanatory variables were distance to the closest cannabis retail, distance to the closest on-premise and off-premise alcohol outlets, and client’s age, sex, race, and dosage of methadone. The results of generalized linear models showed that the number of missed doses of methadone during the first 30 days of treatment increased as clients lived farther away from the treatment facility. Findings also showed that the number of missed doses of methadone declined as distance to the closest cannabis facility increased. Findings suggest the need to improve the spatial availability of treatment programs to optimize opioid use disorder treatment outcomes.

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