Differences in Substance Abuse in Urban and Rural Areas
The development of a substance abuse issue is something that can affect anyone, regardless of age, gender, race, geographic location, or socioeconomic status. Many of these factors can play a role in the causes and effects of an addiction, as well as the best way to go about treating it. When helping someone who is struggling with addiction, it is important to take these factors into account when determining how to get them the help they need. While most people tend to think of large cities and urban areas as being a mecca for drug use and alcohol abuse, the number of people addicted to illicit and mind-altering substances is on the rise and, in some cases, even more prevalent in rural areas.
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Despite America’s ongoing ‘War on Drugs’, there are many areas where opioid addiction, alcoholism, and the presence of other substance use disorders have reached almost epidemic proportions. In response to this, there has been a multitude of studies conducted in recent years seeking to find correlations between certain demographics and the misuse or abuse or particular substances.
In 2012, researchers sought to identify the differences between urban and rural drug users in terms of their recent and lifetime use, as well as the age of onset use of a certain substance. Their study interviewed 212 prescription drug users–101 subjects from a rural area in the Appalachian region and 111 urban subjects from a metropolitan area in Kentucky. Participants were given an interviewer-administered questionnaire examining sociodemographic traits, psychiatric characteristics, and self-reported drug use. Results found that rural drug users had significantly earlier ages of onset abuse of oxycodone, hydrocodone, benzodiazepines, cocaine, and crack. Rural drug users also tended to have significantly higher odds of lifetime and recent use of methadone, OxyContin, and oxycodone. Urban participants, however, had significantly higher odds of recent crack and cocaine use.
Another study in 2009 looked at prescription opioid misuse among 2 groups of felony probationers, 782 from rural areas and 743 from urban areas, that were participating in an HIV-intervention study. They found that rural participants were almost five times more likely than their urban counterparts to have misused prescription opioids, meaning the prevalence of prescription opioid misuse was significantly higher among the rural probationers. Researchers supposed that this substantial variance in prescription misuse is due to the face that there is a comparative scarcity of illicit opioids in rural areas and that, because of their more recent emergence, abuse treatment centers in rural areas were ill-prepared to treat prescription opioid misuse.
A study conducted in 2006 found that alcohol abuse exceeded illicit drug abuse in rural areas, and that it has been particularly prevalent among rural youth. They also found that the risk of early onset alcoholism is exacerbated by parental absence, a growing problem in rural America. Native Americans are particularly vulnerable to substance use disorders, and most areas with a concentrated Native American population are rural. They also found that less educated young adults are more likely to have an illicit drug abuse problem.
A separate study in 2009 based their findings on drug users who were, at the time, attending and receiving care at a treatment facility. Nationwide, 31.4% of all admitted individuals received treatment at facilities located in urban areas, while only 7.2% received treatment at facilities located in rural areas. In addition to this, the study found rural treatment populations to be significantly more likely than urban treatment populations to be referred to substance abuse treatment through the criminal justice system, to report primary alcohol abuse or primary abuse of non-heroin opioids, and to be aged 18 to 25. On the contrary, urban treatment populations were significantly more likely to be self- or individually referred to treatment, report primary heroin abuse or primary cocaine use, engage in daily use of their primary substance of abuse, and to be aged 18 or older during the onset of their substance abuse (where rural admissions tended to be even younger).
What Does This Tell Us About Rural and Urban Substance Abuse
The findings of all of the aforementioned studies seem to show similar and complimentary data. First, drug users in rural areas tend to start abusing substances earlier in life. This can be explained by poorer education quality and opportunities in rural areas as opposed to urban areas, as public education quality in smaller, rural areas tend to be lower grade and the opportunity to seek higher education tends to be less available. These characteristics in a community, along with a trend of increasingly absentee parental figures, can be used to explain the high number of teenage alcoholics in rural areas.
There are also, across all studies, a significantly higher number of prescription opioid misuse in these rural areas. In Urban areas, however, there appear to be significantly more heroin users. Heroin is an extremely addictive, illegally produced opiate synthesized from morphine. Many who try heroin were at first prescribed legal, prescription opioids that were given to them by a doctor. However, due to the highly addictive nature of these drugs, many people have ended up misusing them or becoming unknowingly addicted. Now reliant on the euphoric effects of their medication just to feel normal, when their prescription runs out, urban users may find that it is cheaper and easier to obtain street drugs such as heroin or fentanyl. However, this hasn’t always been the case in rural areas. For those addicted to prescription pain killers in smaller, more isolated areas, it can be easier to continue obtaining prescriptions, either from a doctor or a friend/family member. This is supported by the studies and data collected above.
Another notable finding regards the treatment of substance use disorders in urban vs. rural areas. In urban areas, treatment centers are significantly more accessible. This is because high-density urban areas are more likely to have the funds, resources, and infrastructure to treat substance abuse as a public health issue, directing those with substance abuse problems to prevention and treatment programs and facilities. Meanwhile, in rural areas, the ability of law enforcement, public officials, and health professionals to manage treatment and other intervention programs for residents is hindered by the very characteristics defining such areas: wide open spaces, limited funds, and the almost isolationist tradition of “taking care of your own” that is so common in rural regions.
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If someone you know is struggling with an addiction, it is important to recognize the characteristics their environment that may be influencing their harmful behaviors. There are many sources both online and locally that can help you learns what resources and aid your city can potentially offer. For those in areas where there are less facilities or opportunities to find professional help, community interventions can help draw on the existing resources of rural populations and provide struggling members with the information and support they need. To find out more, talk to a treatment provider today.