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Related Guides on this Topic

You may also want to see these guides on related topics: Methamphetamine, Mental Health

Introduction

Substance abuse has long been perceived to be a problem of the inner city. However, alcohol abuse has long been a problem in rural areas and illicit drugs have infiltrated towns of every size. Today, adults and young teens in rural areas are just as likely to abuse substances as those in larger metropolitan areas. The problems may be the same, but smaller communities have limited resources to deal with the consequences of substance abuse.

Factors contributing to substance abuse in rural America include poverty, unemployment, underemployment, and the isolation of rural areas.  Substance abuse results in crime including buying and selling drugs, driving while intoxicated, and disorderly conduct, as well as poor grades in school and other serious complications. Substances abused include but are not limited to alcohol, drugs, prescription medications, over-the-counter drugs, and cigarettes.

According to the 2006 National Survey on Drug Use and Health, substance abuse dependence for persons 12 years or older varied by region.

  • In 2006, underage current alcohol use rates in small metropolitan areas were 28.9%, large metropolitan areas 27.8%, and nonmetropolitan areas 29.1%. The rate in completely rural nonmetropolitan areas was 28.2%.
  • The rates of binge alcohol use among youths aged 12 to 17 were 11.2% in nonmetropolitan areas, 9.8% in small metropolitan areas, and 10.3% in large metropolitan areas, where the rate increased from 9.3% in 2005. In completely rural counties of nonmetropolitan areas, 12.2% of youths reported binge drinking in 2006.
  • The rate of current illicit drug use among the population aged 12 or older in completely rural counties in 2006 was 7.8% and was similar to that observed in 2002 which was 6.7% and 2005 of 5.1%, but higher than the rate in 2003 which was 3.1% and 2004 of 4.6%.

Frequently Asked Questions

Tools

Antidrug.com
Web site
Part of the National Youth Anti-Drug Media Campaign. Provides information on drug prevention for parents, faith-based groups, teachers, and community involvement.
Sponsoring organization: White House Office of National Drug Control Policy

CMHS Mental Health Services Locator
Web site
Provides comprehensive information about mental health services, substance abuse treatment programs and resources nationwide for professionals, consumers and their families, and the public.
Sponsoring organization: Substance Abuse and Mental Health Services Administration

Communities That Care
Web site
Consists of a substance abuse prevention planning system to help prevent drug and alcohol abuse before it starts.
Sponsoring organization: Substance Abuse and Mental Health Services Administration

Impaired Driving
Web site
Provides impaired driving prevention information for employers from the Department of Labor's Working Partners for an Alcohol and Drug-Free Workplace program.
Sponsoring organization: U.S. Department of Labor

Join Together
Database
Provides news, research and funding opportunities for people working in the fields of tobacco, alcohol and drug prevention and treatment.
Sponsoring organization: Boston University School of Public Health

National Alcohol and Substance Abuse Information Call Center
Web site
Provides accurate information about alcohol and drug abuse at no charge. Hotline Call Center is available 24 hours a day, seven days a week at 1-800-784-6776.

National Registry of Evidence-based Programs and Practices (NREPP)
Web site
Searchable database of interventions for the prevention and treatment of mental and substance use disorders. Includes option to focus on interventions used in a rural or frontier setting.
Sponsoring organization: Substance Abuse and Mental Health Services Administration

National Substance Abuse Index
Web site
Provides a centralized, comprehensive, and easy-to-use directory for resources related to dealing with addiction. Provides drug climate information for each state.
Sponsoring organization: National Institute on Alcohol Abuse and Alcoholism

Office of Applied Studies
Database
Provides the latest national data on alcohol, tobacco, marijuana and other drug abuse; drug related emergency department episodes and medical examiner cases; and the nation's substance abuse treatment system.
Sponsoring organization: Substance Abuse and Mental Health Services Administration

Partners for Recovery
Web site
Facilitates communication and resource-sharing for organizations and groups that help individuals and families achieve and maintain recovery. Seeks to improve services and systems of care.
Sponsoring organization: Substance Abuse and Mental Health Services Administration

Prevline: National Clearinghouse for Alcohol and Drug Information
Web site
Available 24 hours a day, seven days a week at 1-800-729-6686. Staffs both English and Spanish speaking information specialists who can recommend publications, posters, and videocassettes; conduct customized searches; provide grant and funding information; and refer people to appropriate organizations.
Sponsoring organization: Substance Abuse and Mental Health Services Administration

Radar Network
Web site
Provides the largest substance abuse prevention and treatment network of its kind, offers free membership and provides an organized way for States to connect with one another and with national agencies.
Sponsoring organization: Substance Abuse and Mental Health Services Administration

Recovery Month
Web site
Provides a public education effort which brings more awareness of substance abuse treatment issues to communities. Consists of resources, publications, news, events, and more.
Sponsoring organization: Substance Abuse and Mental Health Services Administration

Resources for Returning Veterans and Their Families
Web site
Provides information for returning veterans on accessing mental health and substance abuse services and for military families on coping with trauma.
Sponsoring organization: Substance Abuse and Mental Health Services Administration

Rural Health Research: Substance Abuse
Web site
Provides summaries of current and completed rural health research projects and related publications addressing the topic of substance abuse, produced by the Office of Rural Health Policy's funded rural health research centers.
Sponsoring organization: Rural Health Research Gateway

State and Local Resources
Web site
Provides state and local profiles, contacts, and resources. Includes drug use statistics and drug prevention efforts for each state.
Sponsoring organization: White House Office of National Drug Control Policy

State Profiles of Mental Health and Substance Abuse Services in Medicaid
Web site
Consists of a summary of each states' coverage of behavioral health in Medicaid and in the State Children's Health Insurance Program (SCHIP).
Sponsoring organization: Substance Abuse and Mental Health Services Administration

Substance Abuse Treatment Facility Locator
Database
Locates drug and alcohol abuse treatment programs in each state as well as state substance abuse agencies.
Sponsoring organization: Substance Abuse and Mental Health Services Administration

Funding

Appalachian Regional Commission Substance Abuse Grants
Grants to assist communities in building sustainable capacity to provide for improved community interventions and services addressing issues of illegal drugs and prescription drug abuse.

HUD Shelter Plus Care (S+C)
Provides rental assistance to homeless persons with disabilities.

Research on Rural Mental Health and Drug Abuse Disorders (R01)
Grants to stimulate research on mental health, HIV/AIDS and/or drug abuse problems in rural and frontier communities.

Strategic Prevention Framework State Incentive Grant Program
Cooperative agreements to implement SAMHSA’s Strategic Prevention Framework.

Inactive Funding

Inactive Funding Opportunities - Lists additional funding programs for this topic that are not currently accepting applications. Programs that are inactive may be offered again in the future.

Regulations, Forms & Other Useful Documents

19th Annual Partnership Attitude Tracking Study (PATS)
Sponsoring organization: Partnership for a Drug-Free America
Finds significant decrease in parent/teen discussions about drugs and alcohol.
Date: 08 / 2007

2007 Report to the Secretary: Rural Health and Human Service Issues
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
Report to the Secretary of the U.S. Department of Health and Human Services. Examines three key topics in health and human services and their effects in rural areas: Medicare Advantage in Rural Communities, Head Start in Rural Communities, and Substance Abuse in Rural America. Includes recommendations to address these topics.
Date: 01 / 2007

Alcohol Use Among Youth
Author(s): Andrew R. Sommers, Ramya Sundararaman
Sponsoring organization: Congressional Research Service
Describes the extent of underage alcohol use, recent legislative activity on this issue, and various policy implications.
Date: 04 / 2007

Cities Without Drugs: The Major Cities Guide to Reducing Substance Abuse in Your Community
Sponsoring organization: White House Office of National Drug Control Policy
Discusses the Major Cities Initiative, a program which promotes and energizes partnerships among those working to stop drug abuse in America's cities. Recognizes that large or small, urban or rural, communities throughout America confront many of the same threats.
Date: 11 / 2005

Distribution of Substance Abuse Treatment Facilities Across the Rural – Urban Continuum (Research & Policy Brief)
Author(s): Jennifer Lenardson, John A. Gale
Sponsoring organization: Maine Rural Health Research Center
Highlights findings from a recent study examining the distribution of substance abuse treatment facilities in rural and urban counties and identifying the type and intensity of services provided.
Date: 02 / 2008

Distribution of Substance Abuse Treatment Facilities Across the Rural—Urban Continuum
Author(s): Jennifer Lenardson, John A. Gale
Sponsoring organization: Maine Rural Health Research Center
Examines the distribution of substance abuse treatment services across the continuum of rural and urban counties, identifying the type and intensity of services provided.
Date: 08 / 2007

Early Alcohol Use, Rural Residence, and Adulthood Employment
Author(s): Michael Mink, Jong-Yi Wang, Kevin J. Bennett, Charity G. Moore, M. Paige Powell, Janice C. Probst
Sponsoring organization: South Carolina Rural Health Research Center
Examines early onset of alcohol consumption and the increases of physical disease and psychological disorders; discusses the consequences of abusive drinking in rural youth.
Date: 10 / 2005

Impaired Driving Prevention in Rural Communities
Sponsoring organization: National Association of County and City Health Officials
Profiles health departments in rural jurisdictions working to combat the problem of impaired driving, their approaches to addressing impaired driving, successes they have achieved, and the obstacles they have encountered during program implementation.
Date: 08 / 2007

Monitoring the Future: National Results on Adolescent Drug Use Overview of Key Findings 2007
Sponsoring organization: National Institutes of Health
Results of the national survey which interviews 50,000 8th, 10th, and 12th grade students in over 400 secondary schools nationwide. Highlights recent trends in the use of licit and illicit drugs, as well as trends in the levels of perceived risk and personal disapproval associated with each drug.
Date: 04 / 2008

National Drug Threat Assessment 2008
Sponsoring organization: National Drug Intelligence Center
Addresses the status and outlook of the drug threat to the United States. Covers the trafficking and abuse patterns associated with cocaine, methamphetamine, marijuana, heroin, MDMA, pharmaceutical drugs, and other dangerous drugs.
Date: 10 / 2007

National Rural Alcohol and Drug Abuse Network Awards for Excellence 2004: Submitted and Award-Winning Papers
Sponsoring organization: Substance Abuse and Mental Health Services Administration
Describes effective and innovative models of substance abuse treatment and prevention services in rural populations. Includes seven papers submitted to the 2004 National Rural Alcohol and Drug Abuse Network (NRADAN) Awards for Excellence.
Date: 2006

NSDUH Report: Parent Awareness of Youth Use of Cigarettes, Alcohol, and Marijuana
Sponsoring organization: Substance Abuse and Mental Health Services Administration
Presents data from the 2006 National Survey on Drug Use and Health which indicates that 17%of youths aged 12 to 17 used cigarettes in the past year, 32.9 % used alcohol, and 13.2% used marijuana.
Date: 04 / 2008

Reports on Rural America: Substance Abuse in Rural and Small Town America
Author(s): Karen Van Gundy
Sponsoring organization: Carsey Institute
Discusses patterns of substance abuse, recommendations for programs and policies, and rural and urban data.
Date: 2006

Results from the 2006 National Survey on Drug Use and Health: National Findings
Sponsoring organization: Substance Abuse and Mental Health Services Administration
Presents the 2006 survey, which is the primary source of information on the use of illicit drugs, alcohol, and tobacco in the civilian, noninstitutionalized population of the United States aged 12 years old or older.
Date: 09 / 2007

Rural Healthy People 2010: Substance Abuse - Trends in Rural Areas
Author(s): Linnae Hutchison, Craig Blakely
Sponsoring organization: Southwest Rural Health Research Center
Addresses rural health issues associated with the Healthy People 2010 focus area on substance abuse.
Date: 2003

Rural Healthy People 2010: Substance Abuse - Trends in Rural Areas: A Literature Review
Author(s): Linnae Hutchison, Craig Blakely
Sponsoring organization: Southwest Rural Health Research Center
Detailed literature review of rural health issues associated with the Healthy People 2010 focus area on substance abuse.
Date: 2003

Rural Substance Abuse: Overcoming Barriers to Prevention and Treatment
Author(s): Rebecca Clay
Sponsoring organization: Substance Abuse and Mental Health Services Administration
Describes factors that make providing substance abuse prevention and treatment services in rural areas difficult.
Journal citation: SAMHSA News Volume 15 Issue 4
Date: 08 / 2007

Rural Substance Abuse: State of Knowledge and Issues
Sponsoring organization: National Institute on Drug Abuse
Monograph of papers from a technical review held on April 26-27, 1994 at the National Institute on Drug Abuse. Includes an overview of substance abuse issues in rural areas. In the 2007 NACRHHS Report, one of the recommendations is that this report get updated.
Date: 1997

Rural-Urban Differences in Health Care Benefits of Community-Based Sample of At-Risk Drinkers
Author(s): John C. Fortney, Brenda M. Booth, JoAnn E. Kirchner, Xiaotong Han
Sponsoring organization: WICHE Center for Rural Mental Health Research
Compares the cost-containment strategies used by health plans of insured at-risk drinkers residing in rural and urban areas.
Journal citation: Journal of Rural Health Volume 19 Issue 2
Date: 2003

State Estimates of Substance Use from the 2005-2006 National Surveys on Drug Use and Health
Sponsoring organization: Substance Abuse and Mental Health Services Administration
Presents State estimates for 23 measures of substance use or mental health problems based on the 2005 and 2006 National Surveys on Drug Use and Health (NSDUHs).
Date: 02 / 2008

State Mandates for Treatment for Mental Illness and Substance Use Disorders
Author(s): Gail K. Robinson, Jerome B. Connolly, Melanie Whitter, Candy A. Magaña
Sponsoring organization: Substance Abuse and Mental Health Services Administration
Reports on state-mandated benefits, state laws regulating mental health and addiction treatment workers, and state-recognized mental health clinicians with authority to prescribe psychotropic medications.
Date: 2007

Substance Abuse Among Rural Youth: A Little Meth and a Lot of Booze
Sponsoring organization: Maine Rural Health Research Center
Research and policy brief examining substance abuse among rural youth, with rural-urban comparisons methamphetamine, oxycontin, and alcohol abuse.
Date: 06 / 2007

Substance Abuse in Rural America
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
Chapter from the 2007 Report to the Secretary: Rural Health and Human Service Issues. Addresses rural access to substance abuse services, with a focus on alcohol, methamphetamine and narcotics addiction.
Date: 01 / 2007

Substance Abuse or Dependence in Metropolitan and Non-Metropolitan Areas: 2004 Update
Sponsoring organization: Substance Abuse and Mental Health Services Administration
Results of the National Survey on Drug Use and Health which questioned persons aged 12 or older to report on their use of alcohol and illicit drugs, as well as their symptoms of substance abuse or dependence during the past year.
Date: 10 / 2005

Suicidal Thoughts, Suicide Attempts, Major Depressive Episode, and Substance Use among Adults
Sponsoring organization: Substance Abuse and Mental Health Services Administration
Provides a brief overview about the relationships between suicidal thoughts, suicide attempts, and substance use among adults aged 18 or older who have had at least one major depressive episode (MDE) during the past year.
Date: 2006

Treatment Episode Data Set (TEDS) Highlights - 2005: National Admissions to Substance Abuse Treatment Services
Sponsoring organization: Substance Abuse and Mental Health Services Administration
Provides information on the demographic and substance abuse characteristics of the 1.9 million annual admissions to treatment for abuse of alcohol and drugs in facilities that report to individual State administrative data systems.
Date: 11 / 2006

Underage Drinking in Rural Areas
Sponsoring organization: Substance Abuse and Mental Health Services Administration
Presents statistics and data on binge drinking in rural areas vs. non-rural areas. Discusses demographics and risk factors for alcohol use in youth.
Date: 08 / 2004

Urbanity, Rurality, and Adolescent Substance Use
Author(s): Jeremy M. Wilson, Joseph F. Donnermeyer
Sponsoring organization: RAND Corporation
Reports results of a study of substance abuse among adolescents in a Southwestern state of the U.S. Focuses primarily on alcohol and marijuana use, with some information on other types of substance abuse. Examines whether there are differences in the association between peer and family factors with use between youth living in rural and urban areas.
Journal citation: Criminal Justice Review Volume 31 Issue 4 Pages: 337-356
Date: 12 / 2006

Violence and Rural Teens: Teen Violence, Drug Use, and School-Based Prevention Services in Rural America (Executive Summary)
Author(s): Michael D. Mink, Charity G. Moore, Andy Johnson, Janice C. Probst, Amy Martin
Sponsoring organization: South Carolina Rural Health Research Center
Describes a study which had three main purposes: (1) to explore the prevalence of violence-related exposures and drug use among rural teens, (2) to investigate the effects of race and gender on the risk of exposure to violence and drug use, and (3) to compare the policies and mental health care services of rural and urban schools.
Date: 03 / 2005

Organizations

2-1-1
Nonprofit/Foundation
Provides callers with information about and referrals to human services for everyday needs and in times of crisis.

Drug Abuse Resistance Education (D.A.R.E.)
Nonprofit/Foundation
Teaches kids how to recognize and resist the direct and subtle pressures that influence them to experiment with alcohol, tobacco, marijuana, and other drugs.

National Alliance for Drug Endangered Children (DEC)
National organization
Supports a nationwide network of professionals serving drug endangered children by providing referrals to experts, updated research on topics concerning drug endangered children, and best practice information.

National Center for Health Statistics (NCHS)
Federal government
The United States' principal health statistics agency. Compiles statistical information to guide actions and policies to improve health. Part of the Centers for Disease Control and Prevention (CDC), U.S. Department of Health & Human Services.

National Center on Addiction and Substance Abuse at Columbia University (CASA)
National organization
Provides research on substance abuse and addiction, works with schools, conducts surveys, provides conferences and more.

National Institute on Alcohol Abuse and Alcoholism (NIAAA)
National organization
Provides leadership in the effort to reduce alcohol-related problems by conducting and supporting research, coordinating and collaborating with other research institutes, and disseminating research findings to health care providers, researchers, policymakers, and the public.

National Institute on Drug Abuse (NIDA)
Federal government
Provides education resources and materials on drugs of abuse, information & facts, curriculum guides, classroom tools, grants & funding, research, clinical trials, and meetings.

National Rural Institute on Alcohol and Drug Abuse (NRI)
National organization
Provides rural alcohol and drug abuse information to rural alcohol and drug abuse professionals, federal agency representatives, and nationally known institute faculty and resource persons.

Office of Safe and Drug-Free Schools (OSDFS)
Federal government
Administers, coordinates, and recommends policy for improving quality and excellence of programs and activities for drug and violence prevention that promote the health and well being of students in elementary and secondary schools, and institutions of higher education.

Partnership for a Drug-Free America
Nonprofit/Foundation
Consists of a coalition of communication, health, medical and educational professionals working to reduce illicit drug use and help people live healthy, drug-free lives. Provides research-based, educational campaigns, state offices, events, personal stories, articles and more.

Substance Abuse and Mental Health Services Administration (SAMHSA)
Federal government
Works to improve the quality and availability of prevention, treatment, and rehabilitative services in order to reduce illness, death, disability, and cost to society resulting from substance abuse and mental illnesses. Part of the U.S. Department of Health & Human Services.

Substance Abuse and Mental Health Services Administration Faith-Based and Community Initiatives (SAMHSA)
Federal government
Supports faith-based and community organizations that benefit people with or at risk for mental and substance abuse disorders.

United Way of America
Nonprofit/Foundation
Works to improve people's lives by mobilizing the caring power of communities. Includes contact information and links for local United Way organizations.

White House Office of National Drug Control Policy (ONDCP)
Federal government
Establishes policies, priorities, and objectives for the Nation's drug control program. Works to reduce illicit drug use, manufacturing, and trafficking, drug-related crime and violence, and drug-related health consequences.

Terms & Acronyms

Addict A person who is controlled by a drug or substance.

Addiction Compulsive continued use of a drug or substance and a complete inability to stop.

Detoxification Physical withdrawal from a substance.

Substance Abuse Misuse of medications, alcohol or other illegal substances.

Success Stories

RAC Success Stories: Substance Abuse

In addition to the RAC Success Stories, SAMSHA Model Programs have been tested in communities, schools, social service organizations, and workplaces across America and have prevented or reduced substance abuse and other related high-risk behaviors.

Contacts

National Alcohol and Substance Abuse Information Call Center - Hotline Call Center is available 24 hours a day, seven days a week at 1-800-784-6776

Substance Abuse Treatment Facility Locator - to find a treatment center in your area.

Mental Health Services Locator - to find mental health services and resources for professionals, consumers and families in your area.

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Page last updated 9/3/2008
Topic last reviewed 7/1/2008

Events
Sep 8 - 9, 2008
Meeting of the Substance Abuse and Mental Health Services Administration (SAMHSA) Advisory Council
Substance Abuse and Mental Health Services Administration
This meeting is open to the public.
1 Choke Cherry Road, Sugarloaf & Seneca Conference Rooms
Rockville, MD
Contact:
  Toian Vaughn
  240.276.2307
  toian.vaughn@samhsa.hhs.gov


Sep 10, 2008
Substance Abuse in Rural America: One SORH’s Response for Statewide Education
National Organization of State Offices of Rural Health
1:00 EST 866.910.4857, Access #: 983448 Nationwide
Contact:
  Betty King
  520.271.5641
  betty.king@juno.com


Sep 15 - 17, 2008
3rd National Conference on Women, Addiction and Recovery
Substance Abuse and Mental Health Services Administration
Tampa Marriott Waterside Hotel and Marina
Tampa, FL
Contact:
  FADAA Marketing Director
  850.878.2196
  fadaa@fadaa.org


Sep 22 - 23, 2008
National LGBTQ Anti-Tobacco Summit
National LGBT Tobacco Control Network
Sheraton Suites Country Club Plaza
Kansas City, MO
Contact:
  lgbttobacco@gmail.com


Oct 6 - 8, 2008
5th Annual National DEC Conference
National Alliance for Drug Endangered Children
Radisson Hotel
Salt Lake City, UT
Contact:
  Julie Ray
  303.413.3065
  jray@nationaldec.org


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Credits

Thanks goes to Leander Russell McDonald, Director for the National Resource Center on Native American Aging and for the Spirit Lake Planning Office.

Developed by:
Mary Reinertson-Sand



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