{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T02:57:04Z","timestamp":1791341824822,"version":"4.3.1"},"reference-count":49,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi251531-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>The requirement for in-person, often daily, attendance at opioid treatment programs (OTPs) makes travel times a barrier to methadone treatment. Research on methadone accessibility has primarily focused on travel via personal vehicle, and there is uncertainty about public transit travel time to methadone treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi251531-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate travel time via personal vehicle vs public transit to methadone treatment in the state of Connecticut.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi251531-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This cross-sectional study included geospatial analysis of median travel time to nearest OTP via personal vehicle and public transit from all census block groups (CBGs). This study took place in the state of Connecticut in 2023. Participants were all CBGs in Connecticut.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi251531-7\">\n                    <jats:title>Exposures<\/jats:title>\n                    <jats:p>Participants were characterized by racial and ethnic demographics; household income; car ownership; urban, suburban, or rural designations; and per-capita opioid overdose deaths.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi251531-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>\n                      The primary outcome was the median travel time to nearest OTP by via personal vehicle and public transit. Spatial error models using\n                      <jats:italic toggle=\"yes\">k<\/jats:italic>\n                      -nearest neighbor spatial weight matrices were estimated to assess the associations between sociodemographic characteristics and travel times for each transportation mode (personal vehicle vs public transit) at the CBG level.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi251531-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From the centroids of the 2702 CBGs in Connecticut, the median (IQR) travel time to the closest OTP was 11.0 (7.5-16.3) minutes by personal vehicle and 41.7 (31.0-49.5) minutes via public transit, with 1431 CBGs (53%) lacking access to public transit or having high public transit times (&amp;amp;gt;60 minutes or no trip available). Travel times via public transit increased along the urban-rural gradient and across CBGs with an increasing percentage of non-Hispanic White residents. Median (IQR) travel times to an OTP from the 489 CBGs with the highest per-capita overdose death rates were 8.2 (5.9-11.7) minutes by personal vehicle and 37.6 (27.8-48.5) minutes by public transit, with 166 (34%) lacking public transit access.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi251531-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>The findings of this cross-sectional study of barriers to access to methadone treatment suggest that areas with high overdose death rates, low car ownership, and high public transit travel times should be targets for interventions (eg, mobile services or greater use of take-home doses for patients) to lower travel-based barriers to methadone. Current federal statutes and regulations governing methadone provision are the greatest barrier, as they directly require often daily transit to opioid treatment clinics. Reducing this barrier requires policy changes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.57361","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T16:00:23Z","timestamp":1770134423000},"page":"e2557361","source":"Crossref","is-referenced-by-count":2,"title":["Travel Time to Methadone Treatment Via Personal Vehicle vs Public Transit"],"prefix":"10.1001","volume":"9","author":[{"given":"Benjamin A.","family":"Howell","sequence":"first","affiliation":[{"name":"Section of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut"},{"name":"Program in Addiction Medicine, Yale School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junghwan","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Geography, College of Natural Resources and Environment, Virginia Tech, Blacksburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas A.","family":"Thornhill","sequence":"additional","affiliation":[{"name":"Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut"},{"name":"Public Health Modeling Unit, Yale School of Public Health, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinhyung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Geography and Environment, Faculty of Social Science, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma T.","family":"Biegacki","sequence":"additional","affiliation":[{"name":"Program in Addiction Medicine, Yale School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauretta E.","family":"Grau","sequence":"additional","affiliation":[{"name":"Program in Addiction Medicine, Yale School of Medicine, New Haven, Connecticut"},{"name":"Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Fiellin","sequence":"additional","affiliation":[{"name":"Section of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut"},{"name":"Program in Addiction Medicine, Yale School of Medicine, New Haven, Connecticut"},{"name":"Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Heimer","sequence":"additional","affiliation":[{"name":"Program in Addiction Medicine, Yale School of Medicine, New Haven, Connecticut"},{"name":"Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregg S.","family":"Gonsalves","sequence":"additional","affiliation":[{"name":"Program in Addiction Medicine, Yale School of Medicine, New Haven, Connecticut"},{"name":"Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut"},{"name":"Public Health Modeling Unit, Yale School of Public Health, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"issue":"S1","key":"zoi251531r2","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1111\/1468-0009.12602","article-title":"The future of the United States overdose crisis: challenges and opportunities.","volume":"101","author":"Cerd\u00e1","year":"2023","journal-title":"Milbank Q"},{"key":"zoi251531r3","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108329","article-title":"Addressing opioid overdose deaths: the vision for the HEALing communities study.","volume":"217","author":"Chandler","year":"2020","journal-title":"Drug Alcohol Depend"},{"issue":"25","key":"zoi251531r4","doi-asserted-by":"publisher","first-page":"567","DOI":"10.15585\/mmwr.mm7325a1","article-title":"Treatment for opioid use disorder: population estimates\u2014United States, 2022.","volume":"73","author":"Dowell","year":"2024","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"2","key":"zoi251531r5","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.37385","article-title":"Interventions to address the opioid crisis-modeling predictions and consequences of inaction.","volume":"4","author":"Volkow","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"25","key":"zoi251531r6","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.abm8147","article-title":"Reducing opioid use disorder and overdose deaths in the United States: a dynamic modeling analysis.","volume":"8","author":"Stringfellow","year":"2022","journal-title":"Sci Adv"},{"issue":"2","key":"zoi251531r7","doi-asserted-by":"publisher","first-page":"217","DOI":"10.2165\/11597520-000000000-00000","article-title":"Current and potential pharmacological treatment options for maintenance therapy in opioid-dependent individuals.","volume":"72","author":"Tetrault","year":"2012","journal-title":"Drugs"},{"issue":"11","key":"zoi251531r8","doi-asserted-by":"publisher","first-page":"1105","DOI":"10.1001\/jamapsychiatry.2020.1511","article-title":"Methadone for opioid use disorder-decades of effectiveness but still miles away in the US.","volume":"77","author":"Joudrey","year":"2020","journal-title":"JAMA Psychiatry"},{"issue":"6","key":"zoi251531r9","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1007\/s11606-018-4801-3","article-title":"Methadone matters: what the United States can learn from the global effort to treat opioid addiction.","volume":"34","author":"Calcaterra","year":"2019","journal-title":"J Gen Intern Med"},{"issue":"1","key":"zoi251531r10","doi-asserted-by":"publisher","first-page":"191","DOI":"10.2139\/ssrn.4189693","article-title":"Methadone\u2019s regulatory thicket.","volume":"32","author":"Stanley","year":"2022","journal-title":"Ann Health Law"},{"issue":"1","key":"zoi251531r14","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1186\/s12913-022-07886-7","article-title":"Disparities in expected driving time to opioid treatment and treatment completion: findings from an exploratory study.","volume":"22","author":"Alibrahim","year":"2022","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"zoi251531r16","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/s13722-022-00316-3","article-title":"Cumulative barriers to retention in methadone treatment among adults from rural and small urban communities.","volume":"17","author":"Pasman","year":"2022","journal-title":"Addict Sci Clin Pract"},{"issue":"4","key":"zoi251531r17","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.3099","article-title":"Medicare beneficiary receipt of methadone by drive time to opioid treatment programs.","volume":"8","author":"Cantor","year":"2025","journal-title":"JAMA Netw Open"},{"issue":"11","key":"zoi251531r18","doi-asserted-by":"publisher","first-page":"1163","DOI":"10.1001\/jamapsychiatry.2020.1624","article-title":"Comparison of driving times to opioid treatment programs and pharmacies in the US.","volume":"77","author":"Kleinman","year":"2020","journal-title":"JAMA Psychiatry"},{"key":"zoi251531r19","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.108534","article-title":"Expanding access to methadone treatment in Ohio through federally qualified health centers and a chain pharmacy: a geospatial modeling analysis.","volume":"220","author":"Iloglu","year":"2021","journal-title":"Drug Alcohol Depend"},{"key":"zoi251531r20","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.107968","article-title":"Pharmacy-based methadone dispensing and drive time to methadone treatment in five states within the United States: A cross-sectional study.","volume":"211","author":"Joudrey","year":"2020","journal-title":"Drug Alcohol Depend"},{"key":"zoi251531r21","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2022.109565","article-title":"Access to methadone clinics and opioid overdose deaths in Georgia: a geospatial analysis.","volume":"238","author":"Anwar","year":"2022","journal-title":"Drug Alcohol Depend"},{"key":"zoi251531r22","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.109081","article-title":"Robustness of estimated access to opioid use disorder treatment providers in rural vs. urban areas of the United States.","volume":"228","author":"Kiang","year":"2021","journal-title":"Drug Alcohol Depend"},{"issue":"13","key":"zoi251531r23","doi-asserted-by":"publisher","first-page":"1310","DOI":"10.1001\/jama.2019.12562","article-title":"Drive times to opioid treatment programs in urban and rural counties in 5 US states.","volume":"322","author":"Joudrey","year":"2019","journal-title":"JAMA"},{"issue":"2","key":"zoi251531r25","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1007\/s11116-014-9547-0","article-title":"Public transportation objectives and rider demographics: are transit\u2019s priorities poor public policy?","volume":"42","author":"Taylor","year":"2015","journal-title":"Transportation"},{"key":"zoi251531r26","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2023.104032","article-title":"Public transport access to drug treatment before and during COVID-19: Implications for the opioid epidemic.","volume":"116","author":"Y\u00fccel","year":"2023","journal-title":"Int J Drug Policy"},{"issue":"2","key":"zoi251531r27","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0317967","article-title":"Potential improvement in spatial accessibility of methadone treatment with integration into other outpatient substance use disorder treatment programs, New York City, 2024.","volume":"20","author":"Bachhuber","year":"2025","journal-title":"PLoS One"},{"key":"zoi251531r29","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2020.108093","article-title":"Geographic access to buprenorphine prescribers for patients who use public transit.","volume":"117","author":"Drake","year":"2020","journal-title":"J Subst Abuse Treat"},{"key":"zoi251531r30","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.jtrangeo.2019.05.008","article-title":"More than travel time: new accessibility index capturing the connectivity of transit services.","volume":"78","author":"Kim","year":"2019","journal-title":"J Transp Geogr"},{"issue":"2","key":"zoi251531r31","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.0209","article-title":"Accessibility of opioid treatment programs based on conventional vs perceived travel time measures.","volume":"7","author":"Kim","year":"2024","journal-title":"JAMA Netw Open"},{"issue":"5","key":"zoi251531r32","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0250324","article-title":"Opioid treatment deserts: concept development and application in a US midwestern urban county.","volume":"16","author":"Hyder","year":"2021","journal-title":"PLoS One"},{"key":"zoi251531r33","doi-asserted-by":"publisher","DOI":"10.1177\/29768357241312554","article-title":"Where do clients receive methadone treatment? exploring bypassing behaviors in methadone treatment clients: temporal, geographic, and demographic factors.","volume":"19","author":"Alibrahim","year":"2025","journal-title":"Subst Use"},{"key":"zoi251531r34","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.drugalcdep.2016.03.028","article-title":"Buprenorphine and methadone treatment for opioid dependence by income, ethnicity and race of neighborhoods in New York City.","volume":"164","author":"Hansen","year":"2016","journal-title":"Drug Alcohol Depend"},{"issue":"3","key":"zoi251531r35","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1007\/s11414-013-9341-3","article-title":"Variation in use of buprenorphine and methadone treatment by racial, ethnic, and income characteristics of residential social areas in New York City.","volume":"40","author":"Hansen","year":"2013","journal-title":"J Behav Health Serv Res"},{"issue":"19","key":"zoi251531r36","doi-asserted-by":"publisher","first-page":"1779","DOI":"10.1056\/NEJMsa2212412","article-title":"Racial inequality in receipt of medications for opioid use disorder.","volume":"388","author":"Barnett","year":"2023","journal-title":"N Engl J Med"},{"issue":"4","key":"zoi251531r37","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1016\/S0740-5472(03)00188-0","article-title":"Distance traveled to outpatient drug treatment and client retention.","volume":"25","author":"Beardsley","year":"2003","journal-title":"J Subst Abuse Treat"},{"issue":"5","key":"zoi251531r38","doi-asserted-by":"publisher","first-page":"131","DOI":"10.3390\/pharmacy11050131","article-title":"Methadone treatment gap in Tennessee and how medication units could bridge the gap: a review.","volume":"11","author":"Risby","year":"2023","journal-title":"Pharmacy (Basel)"},{"key":"zoi251531r39","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2021.108483","article-title":"Mobile methadone medication units: a brief history, scoping review and research opportunity.","volume":"129","author":"Chan","year":"2021","journal-title":"J Subst Abuse Treat"},{"key":"zoi251531r41","doi-asserted-by":"publisher","DOI":"10.1177\/21501319241233198","article-title":"Access to MAT: participants\u2019 experiences with transportation, non-emergency transportation, and telehealth.","volume":"15","author":"Boyd","year":"2024","journal-title":"J Prim Care Community Health"},{"issue":"9","key":"zoi251531r43","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1176\/appi.ajp.2021.20101548","article-title":"Office-based methadone treatment for opioid use disorder and pharmacy dispensing: a scoping review.","volume":"178","author":"McCarty","year":"2021","journal-title":"Am J Psychiatry"},{"issue":"14","key":"zoi251531r44","doi-asserted-by":"publisher","first-page":"1724","DOI":"10.1001\/jama.286.14.1724","article-title":"Methadone maintenance in primary care: a randomized controlled trial.","volume":"286","author":"Fiellin","year":"2001","journal-title":"JAMA"},{"issue":"4","key":"zoi251531r45","doi-asserted-by":"publisher","first-page":"558","DOI":"10.1080\/10826084.2023.2287220","article-title":"Understanding regional patterns of overdose deaths related to opioids and psychostimulants.","volume":"59","author":"Segel","year":"2024","journal-title":"Subst Use Misuse"},{"issue":"1","key":"zoi251531r46","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1080\/24694452.2020.1756208","article-title":"How neighborhood effect averaging might affect assessment of individual exposures to air pollution: a study of ozone exposures in Los Angeles.","volume":"111","author":"Kim","year":"2021","journal-title":"Ann Assoc Am Geogr"},{"issue":"1","key":"zoi251531r47","doi-asserted-by":"publisher","first-page":"89","DOI":"10.3390\/ijerph16010089","article-title":"Beyond commuting: ignoring individuals\u2019 activity-travel patterns may lead to inaccurate assessments of their exposure to traffic congestion.","volume":"16","author":"Kim","year":"2018","journal-title":"Int J Environ Res Public Health"},{"key":"zoi251531r48","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2020.110519","article-title":"Assessment of sociodemographic disparities in environmental exposure might be erroneous due to neighborhood effect averaging: implications for environmental inequality research.","volume":"195","author":"Kim","year":"2021","journal-title":"Environ Res"},{"key":"zoi251531r49","doi-asserted-by":"publisher","DOI":"10.1016\/j.tbs.2023.100588","article-title":"Social equity analysis of public transit accessibility to healthcare might be erroneous when travel time uncertainty impacts are overlooked.","volume":"32","author":"Lee","year":"2023","journal-title":"Travel Behav Soc"},{"key":"zoi251531r11","volume-title":"Federal Administrative Pathways to Promote Access to Quality Methadone Treatment. Methadone Treatment for Opioid Use Disorder: Improving Access through Regulatory and Legal Change: Proceedings of a Workshop","author":"Lawrence","year":"2022"},{"key":"zoi251531r1","unstructured":"United States Center for Disease Control and Prevention: National Center for Health Statistics. U.S. overdose deaths decrease in 2023, first time since 2018. 2024. Accessed October 29, 2024. https:\/\/www.cdc.gov\/nchs\/pressroom\/releases\/20240515.html?CDC_AAref_Val=https:\/\/www.cdc.gov\/nchs\/pressroom\/nchs_press_releases\/2024\/20240515.htm"},{"key":"zoi251531r12","unstructured":"Adams? Z, Krawczyk? N, Simon? R, Sue? K, Suen? L, Joudrey? P. To save lives from opioid overdose deaths, bring methadone into mainstream medicine. Health Affairs Forefront. May 27, 2022. Accessed December 17, 2025. https:\/\/www.healthaffairs.org\/content\/forefront\/save-lives-opioid-overdose-deaths-bring-methadone-into-mainstream-medicine"},{"key":"zoi251531r13","unstructured":"Volkow? N. To address the fentanyl crisis, greater access to methadone is needed. National Institute on Drug Abuse. 2024. Accessed October 31, 2024. https:\/\/nida.nih.gov\/about-nida\/noras-blog\/2024\/07\/to-address-the-fentanyl-crisis-greater-access-to-methadone-is-needed"},{"key":"zoi251531r15","unstructured":"McBournie? A, Duncan? A, Connolly? E, Rising? J. Methadone barriers persist, despite decades of evidence. Health Affairs Forefront. September 23, 2019. Accessed December 17, 2025. https:\/\/www.healthaffairs.org\/content\/forefront\/methadone-barriers-persist-despite-decades-evidence"},{"key":"zoi251531r24","unstructured":"McGuckin? N, Fucci? A. Summary of travel trends: 2017 national household travel survey. US Department of Transportation: Federal Highway Administration. 2018. Accessed December 15, 2025. https:\/\/rosap.ntl.bts.gov\/view\/dot\/68751"},{"key":"zoi251531r28","doi-asserted-by":"crossref","unstructured":"Plesons? M, Malecki? E, Ciraldo? K, . Accessibility of methadone treatment via public transit for syringe services program participants in Miami-Dade County, Florida.? Res Sq. Preprint posted online August 27, 2024. doi:10.21203\/rs.3.rs-4791074\/v1","DOI":"10.21203\/rs.3.rs-4791074\/v1"},{"key":"zoi251531r40","unstructured":"Substance Abuse and Mental Health Services Administration. Methadone take-home flexibilities extension guidance. 2024. Accessed October 7, 2025. https:\/\/www.samhsa.gov\/substance-use\/treatment\/opioid-treatment-program\/methadone-guidance"},{"key":"zoi251531r42","unstructured":"118th Congress. Modernizing opioid treatment access act. 2024. Accessed October 7, 2025. https:\/\/www.congress.gov\/bill\/118th-congress\/senate-bill\/644"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2844613\/howell_2026_oi_251531_1769460398.15457.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T16:00:27Z","timestamp":1770134427000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2844613"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,3]]},"references-count":49,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2,2]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.57361","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,3]]}}}