Are Delaware Opioid Treatment Programs (OTPs) Ready for Disasters?

Researcher(s)

  • Joshua Hall, Biological Sciences, West Virginia University

Faculty Mentor(s)

  • Jennifer Horney, Epidemiology, University of Delaware

Abstract

Background: Flooding has a wide range of negative health impacts including worsening many chronic diseases outcomes. Due in part to limited resources and stigma, the impact of disasters on access to care for substance use disorder has been understudied. Understanding the impacts of flooding on OTPs is critical since an opioid public health emergency was declared in 2017 and the frequency and intensity of flooding is expected to increase.

Methods: The location of OTPs in Delaware was downloaded from the U.S. Department of Health & Human Services and confirmed by the Division of Substance Abuse and Mental Health. Maps were generated in ArcGIS using the 100-year flood plain, transportation networks, and OTP locations to show flood risk. The number of flooded and isolated OTPs were estimated. Contact information for each OTP was collected and key informant interviews were conducted to identify challenges related to disaster preparedness.

Results: The loss of access to opioid treatment programs will increase over time in Delaware, especially OTPs that will be isolated and unreachable by patients, if no additional flood mitigation is implemented. Poorer and more rural communities at greater risk of access loss. According to key informants, although OTPs are now required to have a comprehensive emergency plan, there are still critical unmet gaps.

Conclusion: Opioid overdose deaths in the US doubled between 2015 and 2022. Ensuring access to treatment during disasters is an important dimension of disaster preparedness and response that has not been adequately addressed. While the growing risk of flood-related access loss to OTPs may be partly addressed by new rules required preparedness planning for OTP accreditation and certification, a better understanding of the health impacts of disasters on this population are needed.