Substance Abuse and Mental Health Services Administration. Key Substance Use and Mental Health Indicators in the United States: Results from the 2023 National Survey on Drug Use and Health. 2024; https://www.samhsa.gov/data/sites/default/files/reports/rpt47095/National%20Report/National%20Report/2023-nsduh-annual-national.pdf. Accessed 28 June 2025.

Substance Abuse and Mental Health Services Administration. Interactive NSDUH State Estimates. 2024; https://datatools.samhsa.gov/saes/state. Accessed 7 Oct 2024.

Spencer MR, Garnett MF, Miniño AM. Drug overdose deaths in the United States, 2002–2022. NCHS Data Brief, no 491. National Center for Health Statistics; 2024; https://doi.org/10.15620/cdc:135849.

National Vital Statistics System. Provisional Drug Overdose Death Counts. 2024; https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm. Accessed 13 Nov 2024.

Haffajee RL, Lin LA, Bohnert ASB, Goldstick JE. Characteristics of US counties with high opioid overdose mortality and low capacity to deliver medications for opioid use disorder. JAMA Netw Open. 2019;2(6): e196373. https://doi.org/10.1001/jamanetworkopen.2019.6373.

Article  PubMed  PubMed Central  Google Scholar 

Irvine MA, Kuo M, Buxton JA, et al. Modelling the combined impact of interventions in averting deaths during a synthetic-opioid overdose epidemic. Addiction. 2019;114(9):1602–13. https://doi.org/10.1111/add.14664.

Article  PubMed  PubMed Central  Google Scholar 

Swensen ID. Substance-abuse treatment and mortality. J Public Econ. 2015;122:13–30. https://doi.org/10.1016/j.jpubeco.2014.12.008.

Article  Google Scholar 

Guagliardo MF. Spatial accessibility of primary care: concepts, methods and challenges. Int J Health Geogr. 2004;3(1):3. https://doi.org/10.1186/1476-072x-3-3.

Article  PubMed  PubMed Central  Google Scholar 

Penchansky R, Thomas JW. The concept of access: definition and relationship to consumer satisfaction. Med Care. 1981;19(2):127–40. https://doi.org/10.1097/00005650-198102000-00001.

Article  CAS  PubMed  Google Scholar 

Muthulingam D, Bia J, Madden LM, Farnum SO, Barry DT, Altice FL. Using nominal group technique to identify barriers, facilitators, and preferences among patients seeking treatment for opioid use disorder: a needs assessment for decision making support. J Subst Abuse Treat. 2019;100:18–28. https://doi.org/10.1016/j.jsat.2019.01.019.

Article  PubMed  PubMed Central  Google Scholar 

Andraka-Christou B, Randall-Kosich O, Totaram R. Designing an “Ideal” substance use disorder treatment center: perspectives of people who have utilized medications for opioid use disorder. Qual Health Res. 2021;31(3):512–22. https://doi.org/10.1177/1049732320971231.

Article  PubMed  Google Scholar 

Ferguson L, Ries R, Russo J. Barriers to identification and treatment of hazardous drinkers as assessed by urban/rural primary care doctors. J Addict Dis. 2003;22(2):79–90. https://doi.org/10.1300/J069v22n02_07.

Article  PubMed  Google Scholar 

Hewell VM, Vasquez AR, Rivkin ID. Systemic and individual factors in the buprenorphine treatment-seeking process: a qualitative study. Subst Abuse Treat Prev Policy. 2017;12(1):3. https://doi.org/10.1186/s13011-016-0085-y.

Article  PubMed  PubMed Central  Google Scholar 

McLean K, Kavanaugh PR. “They’re making it so hard for people to get help:” Motivations for non-prescribed buprenorphine use in a time of treatment expansion. Int J Drug Policy. 2019;71:118–24. https://doi.org/10.1016/j.drugpo.2019.06.019.

Article  PubMed  Google Scholar 

Beardsley K, Wish ED, Fitzelle DB, O’Grady K, Arria AM. Distance traveled to outpatient drug treatment and client retention. J Subst Abuse Treat. 2003;25(4):279–85. https://doi.org/10.1016/s0740-5472(03)00188-0.

Article  PubMed  Google Scholar 

Alibrahim A, Marsh JC, Amaro H, Kong Y, Khachikian T, Guerrero E. Disparities in expected driving time to opioid treatment and treatment completion: findings from an exploratory study. BMC Health Serv Res. 2022;22(1):478. https://doi.org/10.1186/s12913-022-07886-7.

Article  PubMed  PubMed Central  Google Scholar 

Amiri S, Lutz R, Socías ME, McDonell MG, Roll JM, Amram O. Increased distance was associated with lower daily attendance to an opioid treatment program in Spokane County Washington. J Subst Abuse Treat. 2018;93:26–30. https://doi.org/10.1016/j.jsat.2018.07.006.

Article  PubMed  Google Scholar 

Amiri S, Lutz RB, McDonell MG, Roll JM, Amram O. Spatial access to opioid treatment program and alcohol and cannabis outlets: analysis of missed doses of methadone during the first, second, and third 90 days of treatment. Am J Drug Alcohol Abuse. 2020;46(1):78–87. https://doi.org/10.1080/00952990.2019.1620261.

Article  PubMed  Google Scholar 

Mennis J, Stahler GJ, Baron DA. Geographic barriers to community-based psychiatric treatment for drug-dependent patients. Ann Assoc Am Geogr. 2012;102(5):1093–103. https://doi.org/10.1080/00045608.2012.657142.

Article  Google Scholar 

Cole ES, DiDomenico E, Cochran G, et al. The role of primary care in improving access to medication-assisted treatment for rural medicaid enrollees with opioid use disorder. J Gen Intern Med. 2019;34(6):936–43. https://doi.org/10.1007/s11606-019-04943-6.

Article  PubMed  PubMed Central  Google Scholar 

Saloner B, Landis RK, Jayakrishnan R, Stein BD, Barry CL. A bridge too far? Distance to waivered physicians and utilization of buprenorphine treatment for opioid use disorder in West Virginia Medicaid. Subst Abus. 2022;43(1):682–90. https://doi.org/10.1080/08897077.2021.1986882.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Fortney JC, Booth BM, Blow FC, Bunn JY. The effects of travel barriers and age on the utilization of alcoholism treatment aftercare. Am J Drug Alcohol Abuse. 1995;21(3):391–406. https://doi.org/10.3109/00952999509002705.

Article  CAS  PubMed  Google Scholar 

Schmitt SK, Phibbs CS, Piette JD. The influence of distance on utilization of outpatient mental health aftercare following inpatient substance abuse treatment. Addict Behav. 2003;28(6):1183–92. https://doi.org/10.1016/s0306-4603(02)00218-6.

Article  PubMed  Google Scholar 

Klinger JL, Karriker-Jaffe KJ, Witbrodt J, Kaskutas LA. Effects of distance to treatment on subsequent alcohol consumption. Drugs (Abingdon Engl). 2018;25(2):173–80. https://doi.org/10.1080/09687637.2016.1189875.

Article  PubMed  Google Scholar 

Garnick DW, Horgan CM, Acevedo A, et al. Rural clients’ continuity into follow-up substance use disorder treatment: impacts of travel time, incentives, and alerts. J Rural Health. 2020;36(2):196–207. https://doi.org/10.1111/jrh.12375.

Article  PubMed  Google Scholar 

Substance Abuse and Mental Health Services Administration. Federal Guidelines for Opioid Treatment Programs (2024). 2024; https://library.samhsa.gov/product/federal-guidelines-opioid-treatment-programs-2024/pep24-02-011. Accessed 28 June 2025.

Drake C, Donohue JM, Nagy D, Mair C, Kraemer KL, Wallace DJ. Geographic access to buprenorphine prescribers for patients who use public transit. J Subst Abuse Treat. 2020;117: 108093. https://doi.org/10.1016/j.jsat.2020.108093.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Kiang MV, Barnett ML, Wakeman SE, Humphreys K, Tsai AC. Robustness of estimated access to opioid use disorder treatment providers in rural vs urban areas of the United States. Drug Alcohol Depend. 2021. https://doi.org/10.1016/j.drugalcdep.2021.109081.

Article  PubMed  PubMed Central  Google Scholar 

Spencer MR, Garnett MF, Miniño AM. Urban-Rural differences in drug overdose death rates, 2020. NCHS Data Brief. 2022;440:1–8.

Google Scholar 

Davis CN, O’Neill SE. Treatment of alcohol use problems among rural populations: a review of barriers and considerations for increasing access to quality care. Curr Addict Rep. 2022;9(4):432–44. https://doi.org/10.1007/s40429-022-00454-3.

Article  PubMed  PubMed Central  Google Scholar 

Bommersbach T, Justen M, Bunting AM, Funaro MC, Winstanley EL, Joudrey PJ. Multidimensional assessment of access to medications for opioid use disorder across urban and rural communities: a scoping review. Int J Drug Policy. 2023;112: 103931. https://doi.org/10.1016/j.drugpo.2022.103931.

Article  PubMed  Google Scholar 

Pullen E, Oser C. Barriers to substance abuse treatment in rural and urban communities: counselor perspectives. Subst Use Misuse. 2014;49(7):891–901. https://doi.org/10.3109/10826084.2014.891615.

Article  PubMed  PubMed Central  Google Scholar 

New York State Department of Health. Economic Development Regions. 2022; https://www.health.ny.gov/health_care/medicaid/regulations/global_cap/regional/regions.htm. Accessed 10 April 2024.

Bachhuber MA, Cunningham CO, Jordan AE. Potential improvement in spatial accessibility of methadone treatment with integration into other outpatient substance use disorder treatment programs, New York City, 2024. PLoS ONE. 2025;20(2): e0317967.