Affordable transportation access to treatment for opioid use disorder

Abstract

Transportation is a key barrier for accessing healthcare services. This is particularly concerning for the millions suffering from opioid use disorder (OUD) since treatment for OUD can require in-person visits daily or a few times a week. To better understand how public transit influences access to treatment for OUD, we observe distances among opioid treatment programs (OTPs), buprenorphine providers, and public transit stops in the U.S. We also investigate the possible role of micromoblity, specifically bikesharing and e-scooters, in filling these transportation gaps. Results show that in urban counties, 48 to 91% of buprenorphine providers and OTPs are within possible walking distance (i.e., 0.4 to 1.4 km) of public transit stops, suggesting a high degree of heterogeneity in public transit access even among urban counties. In rural counties, only 5 to 40% of buprenorphine providers and OTPs are within possible walking distance of public transit stops. Given that many micromobility programs are in urban areas, they could complement public transit in urban counties where public transit runs less frequently, but not in rural counties. We also find that, on average, the odds an OTP or a buprenorphine provider is within walking distance of a public transit stop decreases outside the large central metro counties, as well as in counties that have a greater percentage of people with lower educational attainment. Affordable transportation options will continue to limit treatment options for people suffering from OUD, especially outside major metropolitan areas, unless public transit or other transportation innovations are expanded or telemedicine becomes more accessible.