Identifying Priority Areas for Increasing the Supply of Medication-Assisted Treatments for Opioid Use Disorder: A Geospatial Approach

BACKGROUND: The opioid epidemic has disproportionately affected several areas across the United States (US), with research indicating that these areas may be underserved and lack access to sufficient medication-assisted treatment (MAT) options. The objective of this study was to introduce a geospatial analytical framework for identifying sub-state priority areas to target federal allocation of MAT training and resources. METHODS: We used a geospatial analytical framework, which integrated multiple substance use measures and layers of geographic information. Measures included estimates of illicit drug dependence and unmet treatment need from the National Survey on Drug Use and Health (NSDUH), opioid-related admissions from the Treatment Episode Data Set: Admissions (TEDs-A), and Drug Enforcement Agency (DEA) waiver practitioner data from the Substance Abuse and Mental Health Services Administration (SAMHSA). Analyses included standard deviation outlier mapping, local indicators of spatial autocorrelation (LISA), and map overlays. RESULTS: We identified twenty-nine opioid dependence priority areas, eleven unmet treatment need priority areas, and seven low MAT capacity priority areas, located across the US, including southeastern Ohio, western Indiana, the District of Columbia, New England, and northern and southern California. CONCLUSIONS: This study identified several areas across the US that have unmet need for MAT. Targeting these areas will allow for the most effective deployment of cost-effective MAT resources to aid the greatest number of patients with opioid use disorders.