Conigrave James H, Dobbins Timothy, Buckley Nicholas A, Lee K S Kylie, Morley Kirsten C, Doyle Michael, Al-Ansari Basma, Wilson Scott, Loggins Summer, Conigrave Katherine
Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.
Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, Australia.
Drug Alcohol Rev. 2025 May;44(4):975-982. doi: 10.1111/dar.14069. Epub 2025 May 9.
Opioid agonist treatment (OAT) is effective for managing opioid dependence; however, it can be hard to access in some regions. We investigated OAT access for priority populations living in New South Wales, Australia: Aboriginal and Torres Strait Islander peoples, Culturally and Linguistically Diverse (CALD) peoples, and youth (18-24 years).
Using a linked database, we analysed distances between residential postcodes and OAT dosing points for 29,935 individuals from July 2015 to June 2020. We used multi-level models with random intercepts for clients to assess the relative distance lived from dosing points for members of each priority population.
The median distance to dosing points was 9.80 km. Multi-level regression predicting log-transformed distance (ln) showed, relative to others, Aboriginal and Torres Strait Islander clients lived 89.98% (95% confidence interval [CI] 82.25%, 98.04%) further, and youth lived 15.09% (95% CI 4.70%, 26.52%) further from dosing points. In contrast, CALD individuals lived 35.32% (95% CI 31.88%, 38.58%) closer than others. Multi-level logistic regression showed Aboriginal and Torres Strait Islander clients were 3.39 (95% CI 2.82, 4.07) times more likely to live 50 km or more from their chosen dosing point.
Aboriginal and Torres Strait Islander Australians and youth have poorer access to OAT dosing points than others in New South Wales. CALD individuals live closer to dosing points, which could suggest better access, or reticence to travel far for care. Targeted interventions are needed to improve OAT accessibility in regional and remote areas.
阿片类激动剂治疗（OAT）对管理阿片类药物依赖有效；然而，在某些地区可能难以获得。我们调查了居住在澳大利亚新南威尔士州的优先人群的阿片类激动剂治疗可及性：原住民和托雷斯海峡岛民、文化和语言多元（CALD）人群以及青年（18 - 24岁）。
利用一个关联数据库，我们分析了2015年7月至2020年6月期间29935名个体的居住邮政编码与阿片类激动剂治疗给药点之间的距离。我们使用带有随机截距的多层次模型来评估每个优先人群成员离给药点的相对居住距离。
到给药点的中位距离为9.80千米。预测对数转换距离（ln）的多层次回归显示，与其他人相比，原住民和托雷斯海峡岛民离给药点的距离远89.98%（95%置信区间[CI] 82.25%，98.04%），青年离给药点的距离远15.09%（95% CI 4.70%，26.52%）。相比之下，文化和语言多元人群比其他人离给药点近35.32%（95% CI 31.88%，38.58%）。多层次逻辑回归显示，原住民和托雷斯海峡岛民离其选择的给药点50千米或更远的可能性是其他人的3.39倍（95% CI 2.82，4.07）。
在新南威尔士州，澳大利亚原住民和托雷斯海峡岛民以及青年比其他人更难获得阿片类激动剂治疗给药点。文化和语言多元人群居住得离给药点更近，这可能表明可及性更好，或者不愿远行就医。需要有针对性的干预措施来改善区域和偏远地区的阿片类激动剂治疗可及性。
