Examining associations between community drug-related exposure and receiving treatment among individuals with opioid use disorder (OUD) in the U.S.

Background: The opioid crisis in the U.S. remains a critical issue, with many individuals not receiving necessary treatment. This study investigates the relationship between community context–specifically exposure to drug-related activities–and treatment receipt among individuals with opioid use disorder (OUD) from 2015 to 2019, examining variations by sociodemographic factors. Methods: Data from the 2015–2019 National Survey on Drug Use and Health (NSDUH) were analyzed using logistic regression with inverse probability weighting (IPW) to address selection bias and estimate the effects of exposure to drug-related activities on treatment receipt. Stratified analyses were conducted by race/ethnicity, gender, sexual identity, educational attainment, and urbanicity. Results: Among 2,048 respondents with OUD, 47% reported exposure to drug-related activities in their community. This exposure increased the odds of receiving treatment by 9% compared to those with less exposure. The association was stronger for non-Hispanic whites, females, heterosexuals, individuals without a college degree, and residents of large metro or rural areas. Conclusions: Exposure to drug-related activities in communities is linked to a higher likelihood of treatment among individuals with OUD, possibly due to reduced stigma and greater access to resources. Interventions targeting community contexts, tailored to sociodemographic differences, could enhance treatment accessibility and reduce gaps in OUD care.