International Journal of Drug Policy - 2014

Volume 25 Issue 3 May 2014

Issue link: http://digitalreprints.elsevier.com/i/364061

Contents of this Issue

Navigation

Page 97 of 153

International Journal of Drug Policy 25 (2014) 598–607 Contents lists available at ScienceDirect International Journal of Drug Policy j o u r n a l h o m e p a g e : w w w . e l s e v i e r . c o m / l o c a t e / d r u g p o Research paper Spatial accessibility of drug treatment facilities and the effects on locus of control, drug use, and service use among heroin-injecting Mexican American men q Dennis Kao a,b,∗ , Luis R. Torres a,b , Erick G. Guerrero c , Rebecca L. Mauldin a , Patrick S. Bordnick a,b,1 a Graduate College of Social Work, University of Houston, Houston, TX, United States b Center for Drug and Social Policy Research, University of Houston, Houston, TX, United States c School of Social Work, University of Southern California, Los Angeles, CA, United States a r t i c l e i n f o Article history: Received 18 April 2013 Received in revised form 11 September 2013 Accepted 6 December 2013 Keywords: Mexican Americans Injection heroin users Spatial accessibility Geography of drug treatment programs Treatment utilization a b s t r a c t Background: This study explores the spatial accessibility of outpatient drug treatment facilities and the potential relationship with drug use-related outcomes among Mexican American heroin users. Methods: Secondary data on 219 current and former heroin-injecting Mexican American men aged 45 and older were drawn from a research study in Houston, Texas. We used geographic information systems (GIS) to derive two spatial accessibility measures: distance from one's place of residence to the closest drug treatment facility (in minutes); and the number of facilities within a 10-minute driving distance from one's place of residence. Exploratory logistic regression analyses examined the association between the spatial accessibility of drug treatment facilities and several drug use-related outcomes: internal locus of control (LOC); perceived chances and worries of injecting in the next six months; treatment utilization; and location of last heroin purchase. Results: Participants with greater spatial access to treatment programs were more likely to report a higher chance of injecting in the near future. However, while current heroin users were more worried about injecting in the next six months, greater spatial access to treatment programs seemed to have a buffering effect. Finally, those who lived closer to a treatment programs were more likely to have last purchased heroin inside the neighborhood versus outside the neighborhood. Spatial accessibility was not associated with internal LOC or treatment utilization. Conclusion: The findings showed that the presence of outpatient treatment facilities—particularly services in Spanish—may influence perceived risk of future heroin use and purchasing behaviors among Mexican American men. Implications for future spatially-informed drug use research and the planning of culturally and linguistically responsive drug treatment programs are discussed. © 2014 Elsevier B.V. All rights reserved. Introduction Racial and ethnic minority groups—especially Hispanics—continue to face significant disparities in access to drug use treatment and other related services. Compared to non-Hispanic Whites, Hispanics tend to utilize fewer services, be q Research supported by the National Institute on Drug Abuse (5R24DA019798-06). ∗ Corresponding author at: Graduate College of Social Work, University of Hous- ton, 110HA Social Work Building, Houston, TX 77204, United States. Tel.: +1 713 743 6392. E-mail address: dtkao@uh.edu (D. Kao). 1 Principal investigator. less satisfied with the treatment they do receive, be more likely to prematurely terminate treatment, and exhibit poorer treatment outcomes (Alegria et al., 2006; Alvarez, Jason, Olson, Ferrari, & Davis, 2007; Hser, Huang, Teruya, & Anglin, 2004; Substance Abuse and Mental Health Services Administration, 2009a). While access to care has been generally studied based on wait time to enter treatment or as a service barrier to care, limited research has explored the geographic accessibility of treatment for Hispanic communities with great need for services (Guerrero, Kao, & Perron, 2013; Guerrero, Pan, Curtis, & Lizano, 2011). The environmental context of illicit drug use is a complex phe- nomenon that requires an ecological or multilevel perspective (Galea, Nandi, & Vlahov, 2004). With the advent of increasingly accessible Geographic Information Systems (GIS) and other tech- nologies, researchers have a broad range of spatial tools to analyze 0955-3959/$ – see front matter © 2014 Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.drugpo.2013.12.012

Articles in this issue

Links on this page

view archives of International Journal of Drug Policy - 2014 - Volume 25 Issue 3 May 2014