Bachhuber Marcus A, Cunningham Chinazo O, Jordan Ashly E
New York State Office of Addiction Services and Supports, New York, New York, United States of America.
Department of Medicine, Oregon Health & Science University, Portland, Oregon, United States of America.
PLoS One. 2025 Feb 5;20(2):e0317967. doi: 10.1371/journal.pone.0317967. eCollection 2025.
Methadone is an effective treatment for opioid use disorder; however, its provision in the US is limited to federally-regulated opioid treatment programs (OTP). Expansion of methadone treatment into non-OTP substance use disorder (SUD) treatment programs ('expanded methadone treatment access') is a promising intervention to increase access.
We performed a cross-sectional geospatial analysis of public transit times to OTPs, expanded methadone treatment access, and other healthcare facilities as of March, 2024 in New York City (NYC). We estimated one-way public transit travel time and compared travel times using population weighted paired t-tests.
For OTPs, 38.2% (95% CI: 38.0, 38.4) of the NYC population was within 15 minutes and 79.7% (95% CI: 79.5, 79.9) was within 30 minutes. For expanded methadone treatment access, 72.1% (95% CI: 71.9, 72.2) of the NYC population was within 15 minutes and 97.5% (95% CI: 97.5, 97.6) was within 30 minutes. The mean travel time was 20.4 minutes (SD: 10.9) for OTPs and 12.1 minutes (SD: 7.1) for expanded methadone treatment access (difference: -8.3 minutes [95% CI: -8.5, -8.1]; P < 0.001). The mean travel time for expanded methadone treatment access was slightly longer than the mean travel time for dialysis facilities (difference: 0.22 minutes [95% CI: 0.06, 0.39]; P = 0.009]), not significantly different than Federally Qualified Health Centers (difference: -0.06 minutes [95% CI: -0.22, 0.11]; P = 0.51), and significantly shorter than the mean travel time to ambulatory surgical centers (difference: -6.3 [95% CI: -6.5, -6.0]; P < 0.001) and hospitals (difference: -8.1 [95% CI: -8.3, -7.9]; P < 0.001).
Efforts to increase access to methadone treatment in the US should promote expansion to additional non-OTP outpatient SUD treatment programs. Such integration is anticipated to increase spatial accessibility of methadone treatment substantially, greatly enhancing the potential for patient access.
美沙酮是治疗阿片类物质使用障碍的有效药物；然而，在美国，其供应仅限于联邦监管的阿片类物质治疗项目（OTP）。将美沙酮治疗扩展到非OTP物质使用障碍（SUD）治疗项目（“扩大美沙酮治疗可及性”）是一种有望增加可及性的干预措施。
我们对截至2024年3月纽约市（NYC）前往OTP、扩大美沙酮治疗可及性场所及其他医疗设施的公共交通时间进行了横断面地理空间分析。我们估算了单程公共交通出行时间，并使用人口加权配对t检验比较出行时间。
对于OTP，纽约市38.2%（95%置信区间：38.0, 38.4）的人口在15分钟内可到达，79.7%（95%置信区间：79.5, 79.9）的人口在30分钟内可到达。对于扩大美沙酮治疗可及性场所，纽约市72.1%（95%置信区间：71.9, 72.2）的人口在15分钟内可到达，97.5%（95%置信区间：97.5, 97.6）的人口在30分钟内可到达。OTP的平均出行时间为20.4分钟（标准差：10.9），扩大美沙酮治疗可及性场所的平均出行时间为12.1分钟（标准差：7.1）（差值：-8.3分钟[95%置信区间：-8.5, -8.1]；P < 0.001）。扩大美沙酮治疗可及性场所的平均出行时间略长于透析设施的平均出行时间（差值：0.22分钟[95%置信区间：0.06, 0.39]；P = 为0.009），与联邦合格健康中心的平均出行时间无显著差异（差值：-0.06分钟[95%置信区间：-0.22, 0.11]；P = 0.51），且显著短于前往门诊手术中心的平均出行时间（差值：-6.3[95%置信区间：-6.5, -6.0]；P < 0.001）和医院的平均出行时间（差值：-8.1[95%置信区间：-8.3, -
