Community social deprivation and availability of substance use treatment and mutual aid recovery groups

Cory M Morton

doi:10.1186/s13011-019-0221-6

Abstract

BackgroundThe spatial distribution of substance use services impacts their use, with greater access to services associated with more positive outcomes. Findings from availability of primary healthcare indicate service shortages exist in areas characterized by social deprivation. This study investigated whether community social deprivation was associated with a lack of availability of substance use treatment or mutual aid recovery support services.MethodsThis is an ecological analysis investigating the availability of substance use services at a community level in the state of New Hampshire. Several public data sources were combined to represent community social deprivation and availability of substance treatment of mutual aid recovery support groups. Principal components analysis and negative binomial regression were used to test the relationship between community structure and the availability of substance use services.ResultsCommunity social deprivation was characterized by high rates of poverty, no access to motor vehicles, renter-occupied housing, less than a high school degree, and nonemployment. Communities high in measures of social deprivation were associated with increased availability of both substance use treatment and recovery support services.ConclusionsContrary to findings in access to primary healthcare services, social disadvantage was positively related to availability for both types of substance use services. This relationship may reflect the stigma associated with substance use where services associated with stigmatized conditions locate in areas with the least resistance to their presence or be a function of affordability of space. Future research could investigate the relationship between access to services and individual client outcomes.

Highlights

The spatial distribution of substance use services impacts their use, with greater access to services associated with more positive outcomes
While shorter physical distance to services is associated with positive outcomes, availability of some forms of health care resources has been cited as an issue in socially disadvantaged communities [9,10,11]
This study explores the link between measures of social deprivation and the availability of two forms of substance use services: formal treatment and mutual aid recovery support groups

Summary

Introduction

The spatial distribution of substance use services impacts their use, with greater access to services associated with more positive outcomes. Treatment for alcohol and substance use disorders is predicated upon keeping individuals engaged and present during an intervention [3, 4]. Positive outcomes such as abstinence from substance use, increased self-efficacy, and decreased criminal justice involvement are related to longer time spent in treatment [5, 6]. While shorter physical distance to services is associated with positive outcomes, availability of some forms of health care resources has been cited as an issue in socially disadvantaged communities [9,10,11]. Some research has shown treatment rich communities have higher rates of substance use disorders and drug market activity than areas with little resources for formal substance use treatment [10, 12]

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Conclusion