Abstract：
BACKGROUND: Methamphetamine detoxification before entering formal and longer term treatment may have a positive impact on treatment retention and success. Understanding geographic distribution of methamphetamine specialty detox services and differential access by race/ethnicity is critical for establishing policies that ensure equitable access across populations.
METHODS: We used the Mental health and Addiction Treatment Tracking Repository to identify treatment facilities that offered any substance use detoxification in 2021 (N=2346) as well as the census block group in which they were located. We sourced data from the US Census Bureau to identify the percentage of a census block group that was White, Black, and Hispanic. We used logistic regression to model the availability of methamphetamine-specific detox, predicted by the percentage of a block group that was Black and Hispanic. We adjusted for relevant covariates and defined state as a random effect. We calculated model-based predicted probabilities.
RESULTS: Over half (60%) of detox facilities offered additional detox services specifically for methamphetamine. Sixteen states had <10 methamphetamine-specific detox facilities. The predicted probability of methamphetamine-specific detox availability was 60% in census block groups with 0%-9% Black residents versus only 46% in census block groups with 90%-100% Black residents, and was 61% in census block groups with 0%-9% Hispanic residents versus 30% in census block groups with 90%-100% Hispanic residents.
CONCLUSIONS: During an unprecedented national methamphetamine crisis, access to a critical health care service was disproportionately lower in communities that were predominately Black and Hispanic. We orient our findings around a discussion of health disparities, residential segregation, and the upstream causes of the systematic exclusion of minoritized communities from health care.
METHODS: We used the Mental health and Addiction Treatment Tracking Repository to identify treatment facilities that offered any substance use detoxification in 2021 (N=2346) as well as the census block group in which they were located. We sourced data from the US Census Bureau to identify the percentage of a census block group that was White, Black, and Hispanic. We used logistic regression to model the availability of methamphetamine-specific detox, predicted by the percentage of a block group that was Black and Hispanic. We adjusted for relevant covariates and defined state as a random effect. We calculated model-based predicted probabilities.
RESULTS: Over half (60%) of detox facilities offered additional detox services specifically for methamphetamine. Sixteen states had <10 methamphetamine-specific detox facilities. The predicted probability of methamphetamine-specific detox availability was 60% in census block groups with 0%-9% Black residents versus only 46% in census block groups with 90%-100% Black residents, and was 61% in census block groups with 0%-9% Hispanic residents versus 30% in census block groups with 90%-100% Hispanic residents.
CONCLUSIONS: During an unprecedented national methamphetamine crisis, access to a critical health care service was disproportionately lower in communities that were predominately Black and Hispanic. We orient our findings around a discussion of health disparities, residential segregation, and the upstream causes of the systematic exclusion of minoritized communities from health care.
摘要：
背景：进入正式和长期治疗之前的甲基苯丙胺解毒可能对治疗保留和成功产生积极影响。了解甲基苯丙胺专业排毒服务的地理分布和种族/族裔的差异获取对于制定确保跨人群公平获取的政策至关重要。
方法：我们使用心理健康和成瘾治疗追踪资料库来确定2021年提供任何物质使用解毒的治疗设施（N=2346）以及它们所在的人口普查区块组。我们从美国人口普查局获得了数据，以确定白人人口普查组的百分比，黑色,和西班牙裔。我们使用逻辑回归对甲基苯丙胺特异性排毒的可用性进行建模，由黑人和西班牙裔群体的百分比预测。我们调整了相关协变量，并将状态定义为随机效应。我们计算了基于模型的预测概率。
结果：超过一半（60％）的排毒设施提供了专门针对甲基苯丙胺的额外排毒服务。16个州拥有<10个甲基苯丙胺专用排毒设施。在具有0％-9％黑人居民的人口普查区块组中，甲基苯丙胺特定排毒的预测概率为60％，而在具有90％-100％黑人居民的人口普查区块组中，只有46％，在西班牙裔居民为0％-9％的人口普查区块组中为61％，在西班牙裔居民为90％-100％的人口普查区块组中为30％。
结论：在前所未有的全国性甲基苯丙胺危机期间，在主要是黑人和西班牙裔的社区中，获得关键医疗保健服务的比例要低得多。我们围绕健康差异的讨论，住宅隔离,以及将少数民族社区系统地排除在医疗保健之外的上游原因。
方法：我们使用心理健康和成瘾治疗追踪资料库来确定2021年提供任何物质使用解毒的治疗设施（N=2346）以及它们所在的人口普查区块组。我们从美国人口普查局获得了数据，以确定白人人口普查组的百分比，黑色,和西班牙裔。我们使用逻辑回归对甲基苯丙胺特异性排毒的可用性进行建模，由黑人和西班牙裔群体的百分比预测。我们调整了相关协变量，并将状态定义为随机效应。我们计算了基于模型的预测概率。
结果：超过一半（60％）的排毒设施提供了专门针对甲基苯丙胺的额外排毒服务。16个州拥有<10个甲基苯丙胺专用排毒设施。在具有0％-9％黑人居民的人口普查区块组中，甲基苯丙胺特定排毒的预测概率为60％，而在具有90％-100％黑人居民的人口普查区块组中，只有46％，在西班牙裔居民为0％-9％的人口普查区块组中为61％，在西班牙裔居民为90％-100％的人口普查区块组中为30％。
结论：在前所未有的全国性甲基苯丙胺危机期间，在主要是黑人和西班牙裔的社区中，获得关键医疗保健服务的比例要低得多。我们围绕健康差异的讨论，住宅隔离,以及将少数民族社区系统地排除在医疗保健之外的上游原因。
