Opioid Crisis Made Worse for People Living in Rural Counties

New research from Yale finds people living in rural counties have a tough time reaching methadone clinics.
Donna Fuscaldo

The opioid epidemic has devastated the country, with more than 42,000 Americans dying because of an opioid overdose in 2016 alone. The problem is widespread plaguing cities and rural areas alike. 

But those living in more rural regions have another barrier in getting help: the distance to a clinic that can administer methadone, a treatment to help opioid addicts.  


Residents of rural counties prevented from getting help 

According to researchers at Yale University, long drive times in rural counties is preventing people from getting help and that making methadone more accessible at primary care clinics can help. The study was published in the Journal of the American Medical Association.

"In the United States, methadone for opioid addiction can only be dispensed by clinics certified by the federal government as Opioid Treatment Programs or OTPs. This requirement, combined with state and local laws, limits the number of clinics offering methadone for opioid addiction despite a need for methadone in all communities," wrote the Yale researchers in a press release highlighting the study results. 

The Yale team looked at the drive times in rural and urban counties in Indiana, Kentucky, Ohio, Virginia and West Virginia using a mapping tool they calculated the minimum drive times from the center of the county to an opioid treatment facility, methadone clinic, and Federally Qualified Health Care Centers, which are community-based primary care clinics.

They used the latter to determine how feasible it would be to dispense methadone from the community based primary care clinics. They also calculated the drive times to dialysis centers. The researchers found that the mean drive times to the OTPs compared to other centers were longer in all the counties except the ones that were home to the biggest cities.

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Drive time to get methadone can be as long as two hours in some cases

The mean drive time to a methadone clinic was 37 minutes while it was 16 and 15 minutes for a community based primary care clinic and dialysis centers, respectively. In rural areas, the drive time to a methadone clinic was the longest, with it taking some people as much as two hours. This is problematic since six visits per week are required to get the medicine administered. 

This study makes clear how poorly accessible methadone is for rural communities harmed by the opioid epidemic,” corresponding author Paul Joudrey, M.D said in the press release. People who live in rural counties face long drive times to access methadone, and this barrier to treatment could be reduced if methadone prescribing occurred at Federally Qualified Health Centers."

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