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According to combined 2005 to 2011 NSDUH data, 209 million persons aged 12 or older (83.6 percent) lived in counties that were in metropolitan areas, 17 million (6.7 percent) lived in counties that were urbanized non-metropolitan, and 24 million (9.7 percent) lived in counties that were rural.
About 15.7 million persons aged 12 or older (6.3 percent) used prescription-type drugs nonmedically in the past year, and 6.7 million (2.7 percent) did so in the past month. Past year nonmedical use of prescription-type drugs was lower among persons living in rural counties than among those in metropolitan and urbanized non-metropolitan counties (5.4 vs. 6.4 and 6.6 percent) (Figure 1). Past month use, however, was similar among all three types of counties.
County Type | Past Year | Past Month |
---|---|---|
Metropolitan | 6.4% | 2.7% |
Urbanized Non-metropolitan | 6.6% | 2.8% |
Rural | 5.4% | 2.4% |
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health (NSDUHs), 2005, 2006 to 2010 (revised March 2012), and 2011. |
Similar patterns in past year and past month nonmedical use of prescription-type drugs by county type were seen for both genders (Figure 2). For example, past year use was lower among persons living in rural counties than among those in metropolitan and urbanized non-metropolitan counties among both males (5.7 vs. 6.9 and 7.1 percent) and females (5.1 vs. 5.8 and 6.1 percent).
County Type | Past Year | Past Month | ||
---|---|---|---|---|
Male | Female | Male | Female | |
Metropolitan | 6.9% | 5.8% | 3.0% | 2.4% |
Urbanized Non-metropolitan | 7.1% | 6.1% | 3.2% | 2.5% |
Rural | 5.7% | 5.1% | 2.7% | 2.2% |
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health (NSDUHs), 2005, 2006 to 2010 (revised March 2012), and 2011. |
Patterns varied, however, when examined by age (Figure 3). Lower rates of past year nonmedical use of prescription-type drugs in rural counties were only seen among persons aged 26 or older. Among adolescents aged 12 to 17, the rate of past year use was lower among those in counties that were in metropolitan areas than among those in urbanized non-metropolitan counties (7.8 vs. 8.7 percent) but was not statistically different from those in rural counties. Among young adults aged 18 to 25, no differences were seen in past year use.
County Type | Past Year | Past Month | ||||
---|---|---|---|---|---|---|
Aged 12 to 17 |
Aged 18 to 25 |
Aged 26 or Older |
Aged 12 to 17 |
Aged 18 to 25 |
Aged 26 or Older |
|
Metropolitan | 7.8% | 14.6% | 4.7% | 3.0% | 5.9% | 2.1% |
Urbanized Non-metropolitan | 8.7% | 15.5% | 4.8% | 3.6% | 6.4% | 2.1% |
Rural | 8.0% | 14.4% | 3.8% | 3.2% | 6.1% | 1.8% |
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health (NSDUHs), 2005, 2006 to 2010 (revised March 2012), and 2011. |
As with the overall rates, rates of past month nonmedical use of prescription-type drugs were generally similar across county type for each of the age groups. The one exception was among adolescents aged 12 to 17. In this age group, the rate of past month use was higher among those in urbanized nonmetropolitan counties than among those in counties that were in metropolitan areas (3.6 vs. 3.0 percent).
Overall, 4.8 percent of persons aged 12 or older reported past year nonmedical use of pain relievers, 2.1 percent reported nonmedical use of tranquilizers, 1.2 percent reported nonmedical use of stimulants, and 0.3 percent reported nonmedical use of sedatives. The rate of past year nonmedical use of pain relievers was lower in rural counties than in metropolitan and urbanized non-metropolitan counties (4.2 vs. 4.9 and 5.1 percent), as was the rate of nonmedical use of tranquilizers (1.8 vs. 2.1 and 2.3 percent) (Figure 4). The rate of nonmedical use of stimulants and sedatives did not vary by type of county.
County Type | Pain Relievers | Tranquilizers | Stimulants | Sedatives |
---|---|---|---|---|
Metropolitan | 4.9% | 2.1% | 1.2% | 0.3% |
Urbanized Non-metropolitan | 5.1% | 2.3% | 1.3% | 0.3% |
Rural | 4.2% | 1.8% | 1.1% | 0.3% |
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health (NSDUHs), 2005, 2006 to 2010 (revised March 2012), and 2011. |
Respondents who reported nonmedical use of prescription type drugs were asked when their first use was4; responses to these questions were used to identify persons at risk for substance use initiation (i.e., persons who had not ever used the substance prior to the 12 months preceding the survey) and to identify recent initiates (i.e., persons who used the substance for the first time in the 12 months prior to the survey). An estimated 2.5 million persons aged 12 or older reported using prescription-type drugs nonmedically for the first time in the past year, representing 1.2 percent of those who were at risk for initiation of use. Rates of initiation were lower among those living in rural counties than among those living in metropolitan and urbanized non-metropolitan counties (1.0 vs. 1.3 and 1.4 percent, respectively). This pattern was seen among males (Figure 5). All three types of counties had similar rates of past year initiation among females and among persons aged both 18 to 25 and 26 or older. Among adolescents aged 12 to 17, the difference in the rate of past year initiation between those living in urbanized non-metropolitan counties and those in metropolitan counties, although small, did reach statistical significance (4.2 vs. 3.6 percent).
County Type | Age | Gender | |||
---|---|---|---|---|---|
Aged 12 to 17 | Aged 18 to 25 | Aged 26 or Older | Male | Female | |
Metropolitan | 3.6% | 3.7% | 0.5% | 1.1% | 1.4% |
Urbanized Non-metropolitan | 4.2% | 4.2% | 0.5% | 1.2% | 1.5% |
Rural | 3.7% | 3.5% | 0.4% | 0.8% | 1.2% |
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health (NSDUHs), 2005, 2006 to 2010 (revised March 2012), and 2011. |
With at least 5 percent of the population in rural, urbanized non-metropolitan, and metropolitan counties misusing prescription-type drugs in the past year, misuse of these drugs remains a health concern in all communities. Data in this report indicate that misuse of prescription-type drugs is generally less common in rural counties than in metropolitan and urbanized non-metropolitan counties. Prevention and treatment efforts require public health information-sharing efforts that raise awareness of the extent of prescription drug misuse. Although the national rate of nonmedical use of prescription-type drugs declined between 2010 and 2011,1 Federal, State, and local policymakers must continue to plan for and allocate resources to improve prevention, intervention, and treatment programs in varying types of communities to reduce the misuse of prescription-type drugs.
The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The combined 2005 to 2011 data used in this report are based on information obtained from 477,000 persons aged 12 or older. The survey collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at their place of residence. The NSDUH Report is prepared by the Center for Behavioral Health Statistics and Quality (CBHSQ), SAMHSA, and by RTI International in Research Triangle Park, North Carolina. (RTI International is a trade name of Research Triangle Institute.) Information on the most recent NSDUH is available in the following publication: Center for Behavioral Health Statistics and Quality. (2012). Results from the 2011 National Survey on Drug Use and Health: Summary of national findings (HHS Publication No. SMA 12-4713, NSDUH Series H-44). Rockville, MD: Substance Abuse and Mental Health Services Administration. Also available online: https://www.samhsa.gov/data/data-we-collect/nsduh-national-survey-drug-use-and-health. |
County Type | Past Month: Number |
Past Month: Percentage |
Past Month: Standard Error |
Past Year: Number |
Past Year: Percentage |
Past Year: Standard Error |
---|---|---|---|---|---|---|
TOTAL | 6,680 | 2.7% | 0.04 | 15,732 | 6.3% | 0.06 |
Metropolitan Counties |
5,611 | 2.7% | 0.04 | 13,313 | 6.4% | 0.07 |
Urbanized Non-metropolitan Counties |
478 | 2.8% | 0.13 | 1,111 | 6.6% | 0.21 |
Rural Counties | 591 | 2.4% | 0.11 | 1,308 | 5.4% | 0.16 |
*Low precision; no estimate reported. NOTE: Nonmedical use of prescription-type psychotherapeutics includes the nonmedical use of pain relievers, tranquilizers, stimulants, or sedatives and does not include over-the-counter drugs. NOTE: Estimates in this table include data from methamphetamine items added in 2005 and 2006 and are not comparable with estimates presented in NSDUH reports prior to the 2007 National Findings report. See Section B.4.8 in Appendix B of the Results from the 2008 National Survey on Drug Use and Health: National Findings. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2005-2011. |
Demographic Characteristic |
Metropolitan: Number |
Metropolitan: Percentage |
Metropolitan: Standard Error |
Urbanized Non- metropolitan: Number |
Urbanized Non- metropolitan: Percentage |
Urbanized Non- metropolitan: Standard Error |
Rural: Number |
Rural: Percentage |
Rural: Standard Error |
---|---|---|---|---|---|---|---|---|---|
TOTAL | 13,313 | 6.4% | 0.07 | 1,111 | 6.6% | 0.21 | 1,308 | 5.4% | 0.16 |
Aged 12-17 | 1,624 | 7.8% | 0.10 | 145 | 8.7% | 0.38 | 188 | 8.0% | 0.25 |
Aged 18-25 | 4,137 | 14.6% | 0.14 | 346 | 15.5% | 0.47 | 397 | 14.4% | 0.42 |
Aged 26 or Older |
7,552 | 4.7% | 0.08 | 620 | 4.8% | 0.23 | 723 | 3.8% | 0.18 |
Male | 7,030 | 6.9% | 0.10 | 577 | 7.1% | 0.32 | 670 | 5.7% | 0.23 |
Female | 6,283 | 5.8% | 0.07 | 534 | 6.1% | 0.28 | 638 | 5.1% | 0.20 |
*Low precision; no estimate reported. NOTE: Nonmedical use of prescription-type psychotherapeutics includes the nonmedical use of pain relievers, tranquilizers, stimulants, or sedatives and does not include over-the-counter drugs. NOTE: Estimates in this table include data from methamphetamine items added in 2005 and 2006 and are not comparable with estimates presented in NSDUH reports prior to the 2007 National Findings report. See Section B.4.8 in Appendix B of the Results from the 2008 National Survey on Drug Use and Health: National Findings. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2005-2011. |
Demographic Characteristic |
Metropolitan: Number |
Metropolitan: Percentage |
Metropolitan: Standard Error |
Urbanized Non- metropolitan: Number |
Urbanized Non- metropolitan: Percentage |
Urbanized Non- metropolitan: Standard Error |
Rural: Number |
Rural: Percentage |
Rural: Standard Error |
---|---|---|---|---|---|---|---|---|---|
TOTAL | 5,611 | 2.7% | 0.04 | 478 | 2.8% | 0.13 | 591 | 2.4% | 0.11 |
Aged 12-17 | 637 | 3.0% | 0.06 | 60 | 3.6% | 0.23 | 76 | 3.2% | 0.16 |
Aged 18-25 | 1,674 | 5.9% | 0.09 | 144 | 6.4% | 0.29 | 167 | 6.1% | 0.26 |
Aged 26 or Older |
3,301 | 2.1% | 0.05 | 274 | 2.1% | 0.15 | 348 | 1.8% | 0.14 |
Male | 3,000 | 3.0% | 0.07 | 259 | 3.2% | 0.21 | 316 | 2.7% | 0.16 |
Female | 2,611 | 2.4% | 0.05 | 218 | 2.5% | 0.16 | 276 | 2.2% | 0.13 |
*Low precision; no estimate reported. NOTE: Nonmedical use of prescription-type psychotherapeutics includes the nonmedical use of pain relievers, tranquilizers, stimulants, or sedatives and does not include over-the-counter drugs. NOTE: Estimates in this table include data from methamphetamine items added in 2005 and 2006 and are not comparable with estimates presented in NSDUH reports prior to the 2007 National Findings report. See Section B.4.8 in Appendix B of the Results from the 2008 National Survey on Drug Use and Health: National Findings. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2005-2011. |
Type of Psychotherapeutic |
Total: Number |
Total: Percentage |
Total: Standard Error |
Metropolitan: Number |
Metropolitan: Percentage |
Metropolitan: Standard Error |
---|---|---|---|---|---|---|
Pain Relievers | 12,105 | 4.8% | 0.05 | 10,231 | 4.9% | 0.06 |
Tranquilizers | 5,270 | 2.1% | 0.03 | 4,448 | 2.1% | 0.04 |
Stimulants1 | 3,030 | 1.2% | 0.02 | 2,529 | 1.2% | 0.02 |
Sedatives | 774 | 0.3% | 0.01 | 657 | 0.3% | 0.01 |
Type of Psychotherapeutic |
Urbanized Non- metropolitan: Number |
Urbanized Non- metropolitan: Percentage |
Urbanized Non- metropolitan: Standard Error |
Rural: Number |
Rural: Percentage |
Rural: Standard Error |
---|---|---|---|---|---|---|
Pain Relievers | 859 | 5.1% | 0.18 | 1,015 | 4.2% | 0.13 |
Tranquilizers | 385 | 2.3% | 0.14 | 437 | 1.8% | 0.09 |
Stimulants1 | 227 | 1.3% | 0.09 | 275 | 1.1% | 0.07 |
Sedatives | 55 | 0.3% | 0.05 | 62 | 0.3% | 0.03 |
*Low precision; no estimate reported. NOTE: Nonmedical use of prescription-type psychotherapeutics includes the nonmedical use of pain relievers, tranquilizers, stimulants, or sedatives and does not include over-the-counter drugs. NOTE: Estimates in this table include data from methamphetamine items added in 2005 and 2006 and are not comparable with estimates presented in NSDUH reports prior to the 2007 National Findings report. See Section B.4.8 in Appendix B of the Results from the 2008 National Survey on Drug Use and Health: National Findings. 1 Estimates of Nonmedical Use of Stimulants and Methamphetamine in the designated rows include data from new methamphetamine items added in 2005 and 2006 and are not comparable with estimates presented in NSDUH reports prior to the 2007 National Findings report. See Section B.4.8 in Appendix B of the Results from the 2008 National Survey on Drug Use and Health: National Findings. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2005-2011. |
County Type | Number | Percentage | Standard Error |
---|---|---|---|
TOTAL | 2,506 | 1.2% | 0.02 |
Metropolitan Counties | 2,113 | 1.3% | 0.02 |
Urbanized Non-metropolitan Counties | 185 | 1.4% | 0.09 |
Rural Counties | 208 | 1.0% | 0.05 |
*Low precision; no estimate reported. NOTE: Past Year Initiates are defined as persons who used the substance(s) for the first time in the 12 months prior to date of interview. NOTE: Nonmedical use of prescription-type psychotherapeutics includes the nonmedical use of pain relievers, tranquilizers, stimulants, or sedatives and does not include over-the-counter drugs. These estimates do not include data from new methamphetamine initiation items added in 2007 or new methamphetamine use items added in 2005 and 2006. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2005-2011. |
Demographic Characteristic |
Metropolitan: Number |
Metropolitan: Percentage |
Metropolitan: Standard Error |
Urbanized Non- metropolitan: Number |
Urbanized Non- metropolitan: Percentage |
Urbanized Non- metropolitan: Standard Error |
Rural: Number |
Rural: Percentage |
Rural: Standard Error |
---|---|---|---|---|---|---|---|---|---|
TOTAL | 2,113 | 1.3 | 0.02 | 185 | 1.4 | 0.09 | 208 | 1.0 | 0.05 |
Aged 12-17 | 698 | 3.6% | 0.07 | 64 | 4.2% | 0.24 | 80 | 3.7% | 0.18 |
Aged 18-25 | 781 | 3.7% | 0.08 | 67 | 4.2% | 0.29 | 71 | 3.5% | 0.24 |
Aged 26 or Older |
634 | 0.5% | 0.03 | 54 | 0.5% | 0.09 | 57 | 0.4% | 0.05 |
Male | 915 | 1.1% | 0.03 | 76 | 1.2% | 0.10 | 78 | 0.8% | 0.06 |
Female | 1,197 | 1.4% | 0.03 | 109 | 1.5% | 0.14 | 130 | 1.2% | 0.09 |
*Low precision; no estimate reported. NOTE: Past Year Initiates are defined as persons who used the substance(s) for the first time in the 12 months prior to date of interview. NOTE: Nonmedical use of prescription-type psychotherapeutics includes the nonmedical use of pain relievers, tranquilizers, stimulants, or sedatives and does not include over-the-counter drugs. These estimates do not include data from new methamphetamine initiation items added in 2007 or new methamphetamine use items added in 2005 and 2006. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2005-2011. |
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