There goes the neighborhood? The public safety enhancing effects of a mobile harm reduction intervention

Abstract

BackgroundBuprenorphine is a gold-standard treatment for opioid use disorders, but most people with these disorders do not access it. Barriers to treatment access may be diminished by low-threshold mobile treatment programs but concern regarding their impact on local public safety challenges their adoption. MethodsThis quasi-experimental study uses difference-in-differences analyses to measure the impact of four mobile buprenorphine clinics in Pittsburgh on neighborhood arrest rates. The study period spans 2018 to 2022, with a pre-intervention period of 11 to 12 quarters and a post-intervention period of 7 to 8 quarters (dependent on neighborhood). A treatment group of 84 census block groups in the areas surrounding clinics during the time period after their establishment were compared to a control group of city census blocks not within one mile of a clinic plus treated block groups in the two years prior to clinic establishment. Outcome variables include drug, non-drug, and total arrests, measured quarterly per 100 in population. ResultsCompared to block groups further than 1 mile from a clinic, arrests fell by 34.13 % (b = −0.358, 95 % CI = −0.557, −0.158), drug arrests by 33.85 % (b = −0.087, 95 % CI = −0.151, −0.023), and non-drug related arrests by 22.29 % (b = −0.179, 95 % CI = −0.302, −0.057). Drug arrests declined significantly on days when the clinics were not present (b = −0.015, 95 % CI = −0.025, −0.006), with no significant change on clinic operational days (b = −0.002, 95 % CI = −0.016, −0.013). Total arrests declined significantly on days when clinics were and were not present (b = −0.045, 95 % CI = −0.078, −0.012; and b = −0.052, CI = −0.082, −0.023, respectively). ConclusionsMobile clinics providing medication for opioid use disorders were associated with reduced neighborhood arrest rates. Expansion of mobile services could promote health equity and public safety.