Substance abuse among rural and very rural drug users at treatment entry.

Historically, researchers and policymakers concerned with the problems of substance abuse have focused their attention almost exclusively on urban America. However, this focus now includes the special needs of rural areas. In the past, rural areas were more sheltered from the problems of mainstream America, but now, mass communication has decreased the isolation of rural areas. The purpose of this study is to examine rural and very rural drug users; including: (a) demographic and other selected background characteristics of rural and very rural drug users admitted to substance abuse treatment, (b) lifetime drug use patterns, (c) current drug use, (d) age of first drug use, (e) recognition of drug abuse as a problem, and (f) correlates of drug use behavior to identify potential predisposing factors. It was hypothesized that drug users from very rural areas would be more sheltered and the severity of their involvement with drug use would be less than that of drug users from rural areas. Between November 15, 1999 and January 31, 2001, face-to-face interviews were conducted in three geographic regions of Kentucky (N=604); eastern Kentucky (n=206), south central Kentucky (n= 165)--both frequently are considered rural (n=371)--and Western Kentucky, which is considered more urban (N=233). Over half of the participants were admitted to outpatient treatment (57%). The majority of participants were male (75%), White (94%), had no religious preference (51%), had been referred to by the criminal justice system (64%), and had a history of prior substance abuse treatment (55%). Findings indicate that being from very rural areas may be somewhat protective with lower current drug use and older age at drug use initiation. While alcohol remains the most used substance in terms of lifetime and current use, cocaine use was three times higher in rural areas than in very rural areas. Implications are discussed and recommendations are presented for substance abuse treatment providers and policymakers.