It would stand to reason that the closer a drug treatment facility is to a person needing those services, the more likely he is to access it, complete treatment plans and maintain his recovery. A new study from the University of Houston Graduate College of Social Work suggests, however, the opposite may be true.
The study, funded by the National Institute on Drug Abuse (NIDA), examined how the proximity to and density of drug treatment facilities influenced the desire to use drugs among Hispanic, male, injecting and non-injecting heroin users. Researchers looked at 219 men, aged 45 years old and older. Using geographic information systems (GIS), researchers looked at the influence of “spatial accessibility,” that is, the geographical location of services and its effects on a person’s risk of future drug use and ability or willingness to access those services. The results illustrate the complex nature of addiction.
“We found that individuals who lived closer to services were less worried about injecting in the future,” said Patrick Bordnick, professor and co-investigator of the study. “But at the same time, those living closer to services and in areas with greater density of services reported a higher chance of injecting in the future.”
Heroin use has increased steadily since 2007 according to NIDA, as users shift from prescription pain medication abuse to the cheaper and more available opioid.
The study also found that those having more access to facilities were more likely to buy heroin inside the neighborhood, as opposed to outside the neighborhood.
Bordnick says the contradictions speak to the stigma associated with having an addiction or seeking treatment. The effects of that stigma on accessing treatment may be even more dramatic for Hispanic and other minority populations where seeking treatment, such as methadone to wean off of heroin, is viewed as a weakness. Treatment facilities may further exacerbate the stigma—and consequently, the drug abuse behaviors—in the very neighborhoods they seek to serve.
“It is possible that participants do not perceive the existing facilities placed near them as culturally relevant, but our findings suggest that drug treatment programs may play an important role in fostering a change in one’s perception and potentially one’s behaviors,” said co-investigator Luis Torres, associate professor at the college.
While calling for additional research on the relationship between the geographic location of drug treatment facilities and their use, the study advises those designing and planning facilities to be mindful of cultural and linguistic needs of at-risk communities and to promote treatment plans that consider all aspects of a patient’s recovery. This would decrease the stigma of seeking out structured treatment plans and increase health among ethnic minorities.
Bordnick also leads the college’s Virtual Reality Clinical Research Lab which pursues innovative ways to assess and treat addiction. The lab’s research on injecting and non-injecting heroin users also is supported by NIDA.