Rural and urban differences in treatment on demand for substance use treatment involving medications for opioid use disorder

IF 2.7 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Journal of Rural Health Pub Date : 2025-08-25 DOI:10.1111/jrh.70076

Ryan J. Lofaro PhD, Robert M. Bohler PhD, Robert Spurgeon BA, William A. Mase DrPH

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引用次数: 0

Abstract

Purpose

Research has found that the use of medications for opioid use disorder (MOUD) varies across the rural-urban divide; however, relationships between rurality, MOUD, and substance use treatment wait times remain underexplored. This study analyzes associations between rurality, MOUD usage, and immediate access to outpatient treatment—that is, “treatment on demand”—in the United States.

Methods

Using 2021-2022 Treatment Episode Data Set Admissions (TEDS-A) data on outpatient treatment centers, we employ logistic regression to analyze treatment on demand (0-day wait time) as the outcome and rurality as the key predictor in models disaggregated into patients who utilized MOUD at intake and those who did not. Analyses are also disaggregated by Census region and division of the country.

Findings

Results show that rurality reduces the odds of treatment on demand in both MOUD (OR = .513, P <.001) and non-MOUD (OR = .593, P <.001) models, with slightly stronger effects in the former. Associations with rurality vary substantially by region of the country. MOUD models in the Midwest, West, and South show rurality has a significant negative effect; these negative associations held for non-MOUD models only in the South. Further, differences across Census divisions highlight rurality's spatial disparities at a more granular level.

Conclusions

Understanding barriers to treatment on demand for evidence-based treatments is a crucial aspect of ensuring people who have opioid use disorder in rural regions receive the care they need. Policies should focus on increasing access to treatment to avoid delays while considering regional differences.

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城乡在涉及阿片类药物使用障碍药物的物质使用治疗需求方面的差异

研究发现，阿片类药物使用障碍（mod）的药物使用在农村和城市之间存在差异；然而，农村、mod和药物使用治疗等待时间之间的关系仍未得到充分探讨。本研究分析了在美国农村地区、mod使用情况和立即获得门诊治疗（即“按需治疗”）之间的关系。方法使用门诊治疗中心的2021-2022年治疗事件数据集入院（TEDS-A）数据，我们采用logistic回归分析按需治疗（0天等待时间）作为结果，农村性作为模型的关键预测因素，并将模型分解为在入院时使用mod和未使用mod的患者。分析还按人口普查地区和国家划分进行了分类。结果显示，乡村性降低了mode （OR = .513, P <.001）和非mode （OR = .593, P <.001）模型中按需治疗的几率，前者的影响略强。与乡村性的联系在全国各地差别很大。中西部、西部和南部的模型显示乡村性具有显著的负向影响；这些负面关联仅在南方的非mod模式中成立。此外，人口普查部门之间的差异在更细粒度的层面上突出了农村的空间差异。了解循证治疗需求治疗的障碍是确保农村地区阿片类药物使用障碍患者获得所需护理的一个关键方面。政策应侧重于增加获得治疗的机会，以避免延误，同时考虑到区域差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Rural Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.60

自引率

6.10%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of Rural Health, a quarterly journal published by the NRHA, offers a variety of original research relevant and important to rural health. Some examples include evaluations, case studies, and analyses related to health status and behavior, as well as to health work force, policy and access issues. Quantitative, qualitative and mixed methods studies are welcome. Highest priority is given to manuscripts that reflect scholarly quality, demonstrate methodological rigor, and emphasize practical implications. The journal also publishes articles with an international rural health perspective, commentaries, book reviews and letters.