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
www.oas.samhsa.gov.
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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