Exploring the reciprocal effects of substance abuse treatment provision and area substance abuse

Abstract

This study examines the relationship between substance abuse treatment provision and substance abuse. Several questions serve as the basis for testing substance abuse reduction, treatment need-demand, and diffusion hypotheses: Does treatment provision reduce area rates of substance abuse; do area rates of substance abuse (i.e., treatment need-demand) foster increases in treatment provision; and, does spatial and temporal diffusion drive changes in both substance abuse and treatment provision? Analyses of spatial and panel data from 159 counties in Georgia revealed that provision of treatment services did not reduce area rates of substance abuse, in fact, greater density of service providers was related to increases in prevalence. Moreover, demand did not foster changes in service provision; only greater service provision at an earlier period. While temporal diffusion of substance abuse and treatment provision took place, there was little evidence of spatial clustering. Strategies to uncover mechanisms underlying these relationships and their implications for treatment policy are discussed. © 2008 Springer Science+Business Media B.V.