Opioid Use Disorder Treatment Facilities With Programs for Special Populations [2020]

Introduction
Special populations, including veterans, pregnant and postpartum women, and adolescents, benefit from opioid use disorder treatment tailored to their specific needs, but access to such services is poorly described. This study identifies the availability of opioid use disorder treatment facilities that use medications and have special programming and contextualizes facilities amid counties’ opioid-related overdose mortality.

Methods
Data were compiled on 15,945 U.S. treatment facilities using medications for opioid use disorder listed in the Behavioral Health Services Treatment Locator in 2018. Facilities with programs tailored to special populations (veterans, pregnant and postpartum women, and adolescents) were identified and geocoded. Counties with such facilities were characterized. Cold spots (county clusters with poor treatment availability) were identified using Getis–Ord Gi* statistics. Data were extracted in October 2018 and analyzed from October 2018 to May 2019.

Results
Of all 3,142 U.S. counties, 1,889 (60.1%) had opioid use disorder treatment facilities. Facilities with tailored programs for veterans, pregnant and postpartum women, and adolescents were located in 701 (22.3%), 918 (29.2%), and 1,062 (33.8%) of the counties, respectively. Specific medications provided for opioid use disorder varied, with only a minority of facilities offering methadone (among facilities with tailored programs for veterans, 6.0%; pregnant and postpartum women, 13.2%; adolescents, 1.3%). Many counties reporting opioid-related overdose deaths lacked programs for special populations (veterans, 72.6%; pregnant and postpartum women, 54.8%; adolescents, 30.6%). Cold spots were located throughout the Midwest, U.S. Southeast, and portions of Texas.

Conclusions
Facilities using medications for opioid use disorder with tailored programs for veterans, pregnant and postpartum women, and adolescents are limited. There is a need for improved access to evidence-based programs that address the unique treatment needs of special populations.

Scott E. Hadland MD, MPH, MS, Victoria A. Jent MAS, Rachel H. Alinsky MD, MPH, Brandon D. L. Marshall PhD, Pia M. Mauro PhD, Magdalena Cerdá DrPH, MPH
American Journal of Preventive Medicine, Volume 59, Issue 3, September 2020
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