Geographic and Racial/Ethnic Differences in Access to Methamphetamine Detoxification Services, United States, 2021

Med Care. 2024 Jul 1;62(7):464-472. doi: 10.1097/MLR.0000000000002013. Epub 2024 May 15.

Abstract

Introduction: 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.

MeSH terms

  • Amphetamine-Related Disorders* / ethnology
  • Amphetamine-Related Disorders* / therapy
  • Black or African American / statistics & numerical data
  • Ethnicity / statistics & numerical data
  • Female
  • Health Services Accessibility* / statistics & numerical data
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Male
  • Methamphetamine*
  • Racial Groups / statistics & numerical data
  • Substance Abuse Treatment Centers / statistics & numerical data
  • United States
  • White People / statistics & numerical data

Substances

  • Methamphetamine