Effects of distance to treatment on subsequent alcohol consumption

Background:

Several studies have identified increasing distance and travel time as barriers to attending and completing mental health and substance abuse treatment; however, few studies have examined proximity to treatment in relation to post-treatment outcomes. The current study examines this relationship among a heterogeneous sample of residential/inpatient, detoxification and outpatient treatment program clients. We expected distance to treatment to matter more for outpatient clients than for inpatient or detox clients.

Methods:

Participants (n=604) were part of a longitudinal study of clients recruited from 10 public and private substance abuse treatment programs in one Northern California county. Each individual’s distance to treatment from their recorded home address was calculated using a Geographic Information System. Linear regression analyses assessed whether effects of distance to treatment on total drink volume one year after treatment was moderated by treatment program type, controlling for problem severity, AA attendance after treatment, neighborhood disadvantage, and client demographic characteristics.

Results:

Results partially supported our hypothesis. Clients entering residential/inpatient or detox programs farther than 10 miles from home reported higher drink volumes at follow-up than those entering residential programs closer to home. Counter expectations, this relationship was not found for individuals entering outpatient programs.

Conclusion

For residential and detox treatment clients, a greater benefit derived from closer proximity to a program suggests staying within one’s cultural domain, being in a social environment with others who share similar beliefs and experiences, or being near family and other adjunctive community resources, may enhance recovery efforts.