Horney Jennifer A, Scales Sarah Elizabeth, Gangwal Urkarsh, Dong Shangjia
Professor, Epidemiology Program, University of Delaware.
Graduate Research Assistant, Epidemiology Program, University of Delaware.
Dela J Public Health. 2023 Jun 12;9(2):130-132. doi: 10.32481/djph.2023.06.024. eCollection 2023 Jun.
To quantify potential flood-related access disruptions to medication-assisted treatment for opioid use disorder (OUD) among Delawareans.
Spatial flood risk maps and infrastructure, services, and hazard risk, transportation networks, opioid treatment programs (OTPs) for the State of Delaware were integrated to visually display the relationship between these layers. A complex network theory-based simulation model was used to assess both direct (e.g., inundation with flood water) and indirect (e.g., isolation) impacts of floods.
Delaware is at increasing risk from flooding associated with storms and sea-level rise, which can lead to sunny day flooding during high tides. Of the 18 OTPs in Delaware, 4 are expected to be flooded in a 100-year flood and 7 are expected to be severely disrupted, increasing to 9 by 2035 and to 10 by 2050, with service reachability less than 15 square miles due to flood-induced isolation.
Individuals utilizing OTPs for OUDs must be able to access treatment programs regardless of external disruptors like floods. Because these programs require consistent treatment adherence and in-person oversight by clinicians, timely restoration of services and continuity of operations for treatment facilities in post-disaster settings is critical for treatment compliance.
The State of Delaware has the third highest rate of drug overdose mortality in the U.S., with three-quarters of all drug-related deaths involving opioids. Impeded access to opioid treatment during a flood disaster can lead to relapse, overdose, and death. Hazard planning must develop policies and practices to address these risks.
量化特拉华州居民在阿片类药物使用障碍（OUD）药物辅助治疗方面因洪水可能导致的就医中断情况。
整合特拉华州的空间洪水风险地图、基础设施、服务、灾害风险、交通网络以及阿片类药物治疗项目（OTP），以直观展示这些图层之间的关系。使用基于复杂网络理论的模拟模型来评估洪水的直接影响（如被洪水淹没）和间接影响（如隔离）。
特拉华州因风暴和海平面上升引发洪水的风险不断增加，这可能导致涨潮时出现晴天洪水。在特拉华州的18个OTP中，预计有4个在百年一遇的洪水中会被淹没，7个预计会受到严重干扰，到2035年将增至9个，到2050年将增至10个，由于洪水导致的隔离，服务可达范围小于15平方英里。
使用OTP治疗OUD的个人必须能够在不考虑洪水等外部干扰因素的情况下获得治疗项目。由于这些项目需要持续的治疗依从性和临床医生的亲自监督，灾后及时恢复服务以及治疗设施运营的连续性对于治疗依从性至关重要。
特拉华州的药物过量死亡率在美国排名第三，所有与药物相关的死亡中有四分之三涉及阿片类药物。在洪水灾害期间，阿片类药物治疗的就医受阻可能导致复发、过量用药和死亡。灾害规划必须制定政策和措施来应对这些风险。
