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SAMHSA News - March/April 2008, Volume 16, Number 2

Study Helps Dispel Substance Use Myth

Rural Communities at Risk

By Erin Bryant

Is substance abuse among adolescents predominantly an urban problem? According to a recent study, it’s not.

The results of a national comparison of drug use patterns across various types of counties throughout the United States dispel the myth that substance use among adolescents is higher in metropolitan areas.

On the contrary, based on data from the 2002 to 2004 National Survey on Drug Use and Health (NSDUH), adolescents in rural and urbanized nonmetropolitan counties are just as likely to use illegal drugs as their counterparts in metropolitan areas.

“This analysis is significant because we were able to take the most detailed look to date at drug use patterns in rural areas of the United States,” said Joseph C. Gfroerer, Director, Division of Population Surveys, at SAMHSA’s Office of Applied Studies (OAS).

The redesign and expansion of the NSDUH in 1999 enhanced its capability for studying rural substance use because of the much larger sample and better coverage. Previous studies on national drug use have offered limited information on use in rural areas, explained Mr. Gfroerer.

Study results were reported in an article, “Drug Use Patterns and Trends in Rural Communities,” which appeared recently in The Journal of Rural Health. Mr. Gfroerer was one of the authors along with another OAS staff member, James D. Colliver, Ph.D.

“Data from this study can guide treatment professionals and prevention planners in thinking about where the problems are and what needs to be done,” Dr. Colliver said.

Data on rural drug use may be helpful to substance abuse counselors and other health providers in developing substance use interventions specifically for youth. Targeting prevention resources to young people in rural areas could prevent a future increase in drug use among rural adults as today’s adolescents grow older.

In addition, by knowing basic drug use patterns and differences across geographic areas, care providers and other medical professionals may be able to meet the need for treatment services more efficiently.

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Major Findings

According to the report:

  • Adolescents (age 12 to 17) across all types of counties generally displayed similar levels of illegal drug use.

  • Adolescents in rural counties were more likely to have used stimulants and methamphetamine in the past year than their counterparts in metropolitan counties. Rural youth also had higher rates of alcohol and tobacco use.

  • Ecstasy use among adolescents was higher in metropolitan and urbanized nonmetropolitan counties than in rural counties.

The researchers also surveyed adults (age 18 or older) about their drug use. Overall, rural adults were less likely to have used illegal drugs and alcohol than adults in metropolitan areas. However, rural adults were more likely to have used methamphetamine and showed higher rates of tobacco use.

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Marijuana Use Patterns

Overall, levels of marijuana use were similar for adolescents in rural and metropolitan counties. The researchers compared risk factors for marijuana use and found that regardless of county type, marijuana use was higher among youth who used cigarettes and alcohol.

Other risk factors varied by county type. For example, in rural counties, males and females were equally likely to have used marijuana. In other counties, males were at higher risk for marijuana use than females.

In rural counties, adolescents whose family income was below $20,000 were at greater risk for marijuana use. This pattern was not seen in other counties.

For adolescents in all types of counties, the risk of marijuana use was higher for American Indians than for whites. In metropolitan counties, American Indian adolescents were 50 percent more likely to use marijuana than white adolescents, but in rural counties they were 500 percent more likely to do so.

For more on rural issues related to substance use, read SAMHSA News, July/August 2007. For additional reports and statistics, visit SAMHSA’s OAS Web site at Data collected from the 2007 NSDUH will be available later this year.

Citation: Joseph C. Gfroerer, B.A.; Sharon L. Larson, Ph.D.; James D. Colliver, Ph.D. Drug Use Patterns and Trends in Rural Communities. The Journal of Rural Health (2007); Volume 23, Issue s1, pages 10–15.

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