@article{TEXTUAL,
      recid = {11202},
      author = {Joudrey, Paul J. and Kolak, Marynia and Lin, Qinyun and  Paykin, Susan and Anguiano, Vidal and Wang, Emily A.},
      title = {Assessment of Community-Level Vulnerability and Access to  Medications for Opioid Use Disorder},
      journal = {JAMA Network Open},
      address = {2022-04-19},
      number = {TEXTUAL},
      abstract = {&lt;p&gt;Importance: Given that COVID-19 and recent natural  disasters exacerbated the shortage of medication for opioid  use disorder (MOUD) services and were associated with  increased opioid overdose mortality, it is important to  examine how a community's ability to respond to natural  disasters and infectious disease outbreaks is associated  with MOUD access.&lt;/p&gt;&lt;p&gt;Objective: To examine the  association of community vulnerability to disasters and  pandemics with geographic access to each of the 3 MOUDs and  whether this association differs by urban, suburban, or  rural classification.&lt;/p&gt;&lt;p&gt;Design, Setting, and  Participants: This cross-sectional study of zip code  tabulation areas (ZCTAs) in the continental United States  excluding Washington, DC, conducted a geospatial analysis  of 2020 treatment location data. Exposures: Social  vulnerability index (US Centers for Disease Control and  Prevention measure of vulnerability to disasters or  pandemics).&lt;/p&gt;&lt;p&gt;Main Outcomes and Measures: Drive time in  minutes from the population-weighted center of the ZCTA to  the ZCTA of the nearest treatment location for each  treatment type (buprenorphine, methadone, and  extended-release naltrexone).&lt;/p&gt;&lt;p&gt;Results: Among 32604  ZCTAs within the continental US, 170 within Washington, DC,  and 20 without an urban-rural classification were excluded,  resulting in a final sample of 32434 ZCTAs. Greater social  vulnerability was correlated with longer drive times for  methadone (correlation, 0.10; 95% CI, 0.09 to 0.11), but it  was not correlated with access to other MOUDs. Among rural  ZCTAs, increasing social vulnerability was correlated with  shorter drive times to buprenorphine (correlation,-0.10;  95% CI,-0.12 to-0.08) but vulnerability was not correlated  with other measures of access. Among suburban ZCTAs,  greater vulnerability was correlated with both longer drive  times to methadone (correlation, 0.22; 95% CI, 0.20 to  0.24) and extended-release naltrexone (correlation, 0.15;  95% CI, 0.13 to 0.17).&lt;/p&gt;&lt;p&gt;Conclusions and Relevance: In  this study, communities with greater vulnerability did not  have greater geographic access to MOUD, and the mismatch  between vulnerability and medication access was greatest in  suburban communities. Rural communities had poor geographic  access regardless of vulnerability status. Future disaster  preparedness planning should match the location of services  to communities with greater vulnerability to prevent  inequities in overdose deaths.&lt;/p&gt;},
      url = {http://knowledge.uchicago.edu/record/11202},
}