Drug use patterns and trends in rural communities

Context and Purpose: This study examines the prevalence of tobacco, alcohol, and illicit drug use among adolescents and adults in 3 types of counties: rural (nonmetropolitan counties with urban population 3 less than 20,000), urbanized nonmetropolitan (nonmetropolitan counties with urban population 20,000 or higher), and metropolitan (counties in metropolitan areas). Methods: Data from the 2002-2004 National Surveys on Drug Use and Health are used to compare residents of the 3 county types. Descriptive findings and a. multivariate model of marijuana use among adolescents are presented by county type. Findings: Past year illicit drug use is generally similar among adolescents in rural, urbanized nonmetropolitan, and metropolitan counties, except that Ecstasy use is higher among youth in metropolitan and urbanized nonmetropolitan counties than rural counties, while rural youth have a higher prevalence of stimulant and methamphetamine use than metropolitan youth: Gender; race/ethnicity, and family income functioned differentially across the 3 county types as predictors of youth marijuana use during the past year. Rural adults had generally lower rates of illicit drug use than: metropolitan adults, but adults in rural,and urbanized nonmetropolitan areas had higher rates of methamphetamine use than those in metropolitan areas: Rural youth had a higher prevalence of past month use of tobacco and alcohol. Rural adults had higher rates of tobacco use but lower rates of alcohol use. Conclusions: This study dispels the notion that substance abuse is only an urban problem and provides information useful in developing and implementing interventions that consider the unique characteristics of rural residents.