Exploring Community and the Spatial Accessibility of Drug Treatment Programs for Aging Mexican American Heroin Users

Background: Limited research exists on the role of community on drug abuse, and the potential impact that the physical presence of drug treatment programs may have on the drug abuse behaviors among those living in the surrounding community. Spatial accessibility focuses on the geographic location of services and spatial dimensions of access, e.g., proximity or density of service providers in one’s community. Using Geographic Information Systems (GIS), this study explores the impact of treatment programs in the communities of aging Mexican American heroin users, focusing on the spatial accessibility of outpatient substance abuse treatment facilities and the potential relationship with drug abuse-related outcomes.

Methods: Secondary data on 219 current and former heroin-injecting Mexican American men aged 45 and older were drawn from a research study based in in Houston, Texas. We used GIS to derive two spatial accessibility measures to represent the availability of drug treatment programs in one’s community: distance from one’s place of residence to the closest drug treatment facility (in minutes); and the number of facilities within one’s potential “activity space,” as defined by a 10-minute service area around one’s place of residence. Exploratory logistic regression analyses were then used to explore the association between the spatial accessibility of drug treatment facilities and several drug abuse-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.

Findings: Although current heroin users were more worried about injecting in the next six months, living in communities with greater access to treatment programs seemed to have a buffering effect. In contrast, participants with more access to community treatment programs were more likely to report a greater chance of injecting in the near future. Participants who lived closer to a treatment programs were more likely to have last purchased heroin inside the neighborhood, versus outside the neighborhood. Neither spatial accessibility measure was associated with internal LOC or treatment utilization.

Conclusions and Implications: The findings showed that the community 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 abuse research and the planning of culturally and linguistically responsive drug treatment programs are discussed.