Public transit and methadone - Spatial analyses of opioid treatment program access in Greater Boston, 2020-2022.

OBJECTIVE

Methadone, an FDA-approved medication, can effectively treat opioid use disorder (OUD). However, long travel times to opioid treatment programs (OTPs) commonly present barriers to initiating and continuing methadone treatment. We utilized geographic information systems to identify areas with unmet OTP access needs via public transportation and walking in Boston, Massachusetts.

METHODS

We created public transit-time and walk-time catchment areas around OTPs. We assessed spatial overlap between the catchment areas and locations of opioid-related overdose decedent residences from 2020 to 2022 in Boston, and inequities in OTP access by decedent race/ethnicity using logistic regression.

RESULTS

In Greater Boston, 50.1% of fatal opioid-related overdose decedent residences were within 30 min of an OTP via public transit at the time of death. In Boston, 80.4% of fatal opioid-related overdose decedent residences were within 30-min transit times of an OTP. In the early morning, access to OTPs on public transit is limited. Differences in OTP access based on decedent race/ethnicity were inconsistent.

CONCLUSION

Many areas in Greater Boston have unmet OTP access needs on public transit. Our results can inform decision-making to improve OTP access in Boston, such as increased early-morning transit service, expanding access to methadone beyond existing OTPs, or broadening non-emergent medical transit.