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Availability of timely methadone treatment in the United States and Canada during COVID-19: A census tract-level analysis.
Amram, Ofer; Rosenkrantz, Leah; DDes, Solmaz Amiri; Schuurman, Nadine; Panwala, Victoria J; Joudrey, Paul J.
  • Amram O; Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA; Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA 99164, USA. Electronic address: ofer.amram@wsu.edu.
  • Rosenkrantz L; Department of Geography, Simon Fraser University, British Columbia, Canada.
  • DDes SA; Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA.
  • Schuurman N; Department of Geography, Simon Fraser University, British Columbia, Canada.
  • Panwala VJ; Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA.
  • Joudrey PJ; Division of General Internal Medicine, University of Pittsburgh School of Medicine, USA.
Drug Alcohol Depend ; 245: 109801, 2023 04 01.
Article in English | MEDLINE | ID: covidwho-2227482
ABSTRACT

OBJECTIVES:

We sought to compare timely access to methadone treatment in the United States (US) and Canada during the COVID-19 pandemic.

METHODS:

We conducted a cross-sectional study of census tracts and aggregated dissemination areas (used for rural Canada) within 14 US and 3 Canadian jurisdictions in 2020. We excluded census tracts or areas with a population density of less than one person per square km. Data from a 2020 audit of timely medication access was used to determine clinics accepting new patients within 48 h. Unadjusted and adjusted linear regressions were performed to examine the relationship between area population density and sociodemographic covariates and three outcome variables 1) driving distance to the nearest methadone clinic accepting new patients, 2) driving distance to the nearest methadone clinic accepting new patients for medication initiation within 48 h, and 3) the difference in the driving distance between the first and second outcome.

RESULTS:

We included 17,611 census tracts and areas with a population density greater than one person per square kilometer. After adjusting for area covariates, US jurisdictions were a median of 11.6 miles (p value <0.001) further from a methadone clinic accepting new patients and 25.1 miles (p value <0.001) further from a clinic accepting new patients within 48 h than Canadian jurisdictions.

CONCLUSIONS:

These results suggest that the more flexible Canadian regulatory approach to methadone treatment is associated with a greater availability of timely methadone treatment and reduced urban-rural disparity in availability, compared to the US.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: North America Language: English Journal: Drug Alcohol Depend Year: 2023 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: North America Language: English Journal: Drug Alcohol Depend Year: 2023 Document Type: Article