Urban vs. Rural Drug Use

A report based on the Treatment Episode Data Set (TEDS) took a look at how drug use and treatment compares between city and rural settings.

The TEDS used guidelines established by the National Center for Health Statistics in order to determine what constituted an urban versus a rural environment.

The TEDS report noted some similarities but far more differences between the two in terms of what substances are abused and under what circumstances patients decide to enter a drug treatment program.

In many ways, things appear bleaker for those living in the countryside.

Where you live matters

Even what circumstances lead a person to enter treatment differed between city and country.  Based on 2009 figures, rural admissions into drug programs often came through criminal justice referrals. In other words, people decided to get treatment after they experienced a brush with the law related to their substance abuse. Urban dwellers were more likely to enter these programs voluntarily or due to family pressure.

Folks in the city and in the country are not abusing the same substances. Rural treatment programs saw the greatest number of entrants seeking help for the first time due to alcohol abuse.  Rural residents were also more likely to seek help for abuse of non-heroin opioids (prescriptions painkillers) and stimulants.

Urbanites, on the other hand, appeared more prone to abuse cocaine and heroin. Rural users reportedly used their substances intermittently rather than daily which is somewhat good news, but on the down side they also started using drugs at a younger age, often between 15 and 17 years.

There was an age and racial gap between urban and rural drug treatment admissions. Rural admissions tended to be younger (not surprising since they also start using at a younger age) than their urban counterparts. However, rural entrants also had more education and were more likely than urban ones to be employed at least part-time. Those entering treatment in the country were generally non-Hispanic and white (over 77%) compared to urban admissions (38%).

The report did note some similarities. Both city and country programs were similar in terms of gender distribution for example. In both cases more than two-thirds of those who enter programs are male. There was also a similar prevalence of concurrent mental health conditions which accompanied the substance abuse.

Essentially, the TEDS report said that rural residents were more likely to abuse marijuana, alcohol or prescription drugs. Rural-dwelling citizens often start using substances younger and seem to generally only seek out help once they have broken the law. Education and intervention programs in rural areas could become more targeted with this information in hand.

By contrast, urban drug users come from an ethnically diverse background, have low education and employment and tend to use harder drugs like cocaine and heroin. Prevention programs targeted toward these clients might do well to partner with other programs which address social plight issues that may be contributing to drug use.

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