Variation in Spatial Access to Substance Use Disorder Treatment Programs for Older Adults in the United States

Introduction.The number of adults aged 65 and older is increasing across the United States, and substance use disorder is an important health concern for this population.Treatment programs specifically designed for older adults can improve recovery outcomes.This study examines spatial access to substance use treatment (SUT) programs tailored for older adults.Methods.Data on SUT facilities were obtained from the 2022 National Directory of Drug and Alcohol Abuse Treatment Facilities.Distances between census tracts and facility locations were measured, and spatial accessibility was assessed using the two-step floating catchment area method to generate a spatial access index (SPAI).Results are displayed as descriptive statistics overall and by rurality, including the number of census tracts, number of affected populations, average distance, and average SPAI.A map also illustrates spatial patterns of access. Results.Of 12,102 identified SUT facilities, 3,614 (29.9%) offered programs for older adults.Among 84,120 census tracts, 4,323 had no such facility within 50 miles, affecting 2,589,240 adults aged 65 and older.On average, the nearest older adult program was 13 miles away (SD = 19), with small rural tracts averaging 34 miles farther than urban tracts (p <0.001).SPAI values further highlighted disparities in rural areas, even after accounting for service demand.Conclusions.Few SUT facilities provide specialized programs for older adults.For millions, particularly in rural areas, distance poses a significant barrier to care.Expanding these programs in underserved areas could improve treatment availability and promote healthier aging.