TABLE 3.

Number of substance use disorder treatment programs in the county and distance to the nearest substance use disorder treatment program as a function of severity of the county’s opioid problem and year, by type of program^a

	All programs (N=18,001)b			Methadone, buprenorphine. or both (N=7,030)c			Medicaid (N=15,880)d			Methadone, buprenorphine. or both and Medicaid (N=5.332)e
Variable	b	SE	P	b	SE	P	b	SE	P	b	SE	P
				N of substance use disorder treatment programsf
Opioid problem severity
(reference: low)
Moderate	−.08**	.03	<.01	−.15**	.05	<.01	−.13**	.03	<.01	−.18**	.06	<.01
High	−.07*	.03	.03	−.06	.06	.26	−.13**	.03	<.01	−.11	.07	.11
Year fixed effects
(reference: 2009)
2010	−.03**	.01	<.01	.10**	.02	<.01	−.01	.01	.52	.12**	.03	<.01
2011	−.18**	.03	<.01	−.01	.05	.79	−.08*	.03	.02	.05	.05	.34
2012	−.18**	.03	<.01	.01	.05	.79	−.08*	.04	.04	.09	.06	.13
2013	−.17**	.03	<.01	.08	.05	.14	−.04	.04	.32	.13*	.07	.05
2014	−25**	.04	<.01	.11	.07	.10	−.07	.05	.13	.20*	.08	.02
2015	−27**	.05	<.01	.13†	.08	.08	−.06	.05	.27	.23*	.10	.02
2016	−29**	.05	<.01	.17†	.09	.05	−.03	.06	.67	.32**	.11	<.01
2017	−.34**	.06	<.01	.08	.09	.40	−.08	.07	.24	.25*	.11	.03
	All programs (N=10,269) g			Methadone, buprenorphine, or both (N=21240)h			Medicaid (N= 12.390)i			Methadone, buprenorphine, or both and Medicaid (N=22938)j
	b	SE	P	b	SE	P	b	SE	P	b	SE	P
				Distance to nearest substance use disorder treatment programk
Opioid problem severity
(reference: low)
Moderate	−.00	.01	.92	−.00	.01	.87	.01	.01	.42	−.02	.01	.12
High	.03†	.02	.09	.01	.02	.51	.03	.02	.11	−.01	.02	.72
Year fixed effects
(reference: 2009)
2010	−.00	.01	.66	−.04**	.01	<.01	−.02*	.01	.03	−.08**	.01	<.01
2011	−04†	.02	.08	−.10**	.02	<.01	−.10**	.02	<.01	−.16**	.02	<.01
2012	−.05*	.02	.04	−.16**	.02	<.01	−.13**	.02	<.01	−.24**	.02	<.01
2013	−.01	.03	.62	−.16**	.02	<.01	−.09**	.03	<.01	−.24**	.03	<.01
2014	−.07*	.03	.03	−24**	.03	<.01	−.19**	.03	<.01	−.37**	.03	<.01
2015	−.02	.04	.56	−25**	.03	<.01	−.14**	.04	<.01	−.40**	.03	<.01
2016	.01	.04	.81	−.22**	.04	<.01	−.11**	.04	<.01	−.41**	.04	<.01
2017	−.08*	.04	.05	−39**	.04	<.01	−.21**	.04	<.01	−.57**	.04	<.01

^aSource: authors’ analysis of all substance use disorder treatment programs listed in the National Directory of Drug and Alcohol Abuse Treatment Facilities (2009–2017) (derived from the National Survey of Substance Abuse Treatment Services), Substance Abuse and Mental Health Services Administration. All models conducted in Stata 15 by using the margins command following logistic regression, with standard errors clustered at the county level and control for Medicaid expansion; optional and mandatory prescription drug monitoring program; pain clinic laws; mental health parity laws; substance abuse prevention and treatment block grant funds per capita (2017 $); county population; percentage of rural population; county percentage of whites, blacks, Hispanics, Asians, and members of other race-ethnicity; county educational attainment (percentage of residents with less than high school, high school graduate/GED, some college/associate degree, and bachelor’s degree or higher); median income (2017 $); unemployment rate; poverty rate; and physicians per 1,000 residents.

^bR²=.31, F=38.17, df=30 and 2,369.

^cR²=.44, F=43.74, df=30 and 1,128.

^dR²=.44, F=63.32, df=30 and 2,218.

^eR²=.55, F=49.12, df=30 and 955.

^fLog number of programs per 100,000 population (conditional on having at least one program).

^gR²=.37, F=32.46, df=30 and 1,597.

^hR²=.37, F=69.43, df=30 and 2,649.

ⁱR²=.33, F=38.82, df=30 and 1,910.

^jR²=.33, F=88.35, df=30 and 2,824.

^kLog distance in miles (conditional on having no programs).

^*p<.05,

^**p<.01.

^†p<.1.