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 2008 National Survey on Drug Use and Health, substance abuse dependence for persons 12 years or older (unless age is otherwise noted) varied by region.
- In 2008, underage current alcohol use rates in small metropolitan areas were 27.9%, large metropolitan areas 25.9%, and nonmetropolitan areas 25.3%.
The rate in completely rural nonmetropolitan areas was 24.6% in 2007.
- The 2008 rates of binge alcohol use among youths aged 12 to 17 were 9.8% in
nonmetropolitan areas, 9.0% in small metropolitan areas, and 8.4% in large
metropolitan areas.
- The 2008 rate of current illicit drug use in completely
rural counties was 6.1%, which was higher than that observed in 2007 (4.1 percent).
- In 2008, current cigarette smoking rates in nonmetropolitan areas were 28.7%, small metropolitan areas 23.6%, and large metropolitan areas 22.6%.
- The 2008 rates of current smokeless tobacco use in nonmetropolitan areas were 6.9%, small metropolitan areas 4%, and large metropolitan areas 2.1%.
Frequently Asked Questions
Tools
American Legacy/ Community Voices Tobacco Initiative
Web site
A four-year initiative, which represents a partnership between the American Legacy and W.K. Kellogg Foundations, designed to improve access to tobacco prevention and cessation services for the nation's most underserved populations. Together the two foundations form a collaboration that cuts across the racial and ethnic lines to reach the nation's poorest communities in both rural and urban settings.
CMHS Mental Health Services Locator
Web site
Provides state-specific information about mental health services, substance abuse treatment programs and resources nationwide for professionals, consumers and their families, and the public.
Co-Occuring and Homeless Activities Branch (CHAB)
Web site
Helps SAMHSA grantees, health professionals, and the public address problems of homelessness and co-occurring substance abuse and mental health disorders through a web site providing documents, tools, and contacts, including resources specific to rural America.
Communities That Care
Web site
Consists of a substance abuse prevention planning system to help prevent drug and alcohol abuse before it starts.
DUI Foundation: Education & Prevent
Web site
Serves as a database of resources covering health issues, legal information, current news and events, details on support programs and research to educate and prevent against the dangers of driving under the influence of alcohol and other impairing substances.
Health System Reform: Join the Conversation
Web site
Provides a space for posting and exchanging ideas about issues surrounding the future shape of the U.S. health system, specifically relevant to how reform may affect mental health and substance abuse prevention and treatment services. User posts will be public and used to inform upcoming national discussions on the topic.
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.
Maximizing Your Role as a Teen Influencer: What You Can Do To Help Prevent Teen Prescription Drug Abuse
Web site
This toolkit offers a workshop module to educate and equip teen influencers — parents, grandparents, teachers, coaches, community and school-based healthcare providers and others — with information about teen prescription drug abuse and strategies for preventative actions. Website also outlines this prescription abuse problem through statistics and its associated dangers.
National Alcohol Substance Abuse Information Center (NASAIC)
Web site
Provides 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 Clearinghouse for Alcohol and Drug Information (NCADI)
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.
National Registry of Evidence-based Programs and Practices (NREPP)
Database
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.
National Substance Abuse Index
Web site
Provides a directory for resources related to dealing with addiction. Provides drug climate information for each state.
OAS States in Brief Reports
Web site
Contains reports that summarize the substance abuse and mental health issues within the designated state. Includes the prevalence of substance use and abuse, treatment resources, mental health indicators, and SAMHSA (Substance Abuse and Mental Health Services Administration) grant funding. Browse by state or topic to access reports.
Office of Applied Studies: Substance Abuse and Mental Health Statistics
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.
Parents: The Anti-Drug
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.
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.
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.
Recovery Month
Web site
A public education effort which brings more awareness of substance abuse treatment issues to communities. Includes resources, publications, news, and events.
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.
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.
SAMHSA Disaster Technical Assistance Center (DTAC)
Web site
Supports SAMHSA's efforts to prepare States, Territories, and local entities to deliver an effective mental health and substance abuse (behavioral health) response during disasters through resource collections and toolkits as well as a quarterly e-newsletter.
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.
State Profiles of Mental Health and Substance Abuse Services in Medicaid
Web site
Consists of a summary of each state's coverage of behavioral health in Medicaid and in the State Children's Health Insurance Program (SCHIP).
Substance Abuse Treatment Facility Locator
Database
Locates drug and alcohol abuse treatment programs in each state as well as state substance abuse agencies.
Too Smart to Start
Web site
Works to help youth, families, educators, and communities prevent underage alcohol use and its related problems. Provides programs and strategies, downloadable materials, and interactive games and exercises.
Regulations, Forms & Other Useful Documents
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
20th Annual Partnership Attitude Tracking Study (PATS): Teens 2008 Report
Sponsoring organization: Partnership for a Drug-Free America
Tracks the attitudes that students in grades
7 through 12 and parents have about illegal drugs.
Date: 02 / 2009
Addressing Suicidal Thoughts And Behaviors in Substance Abuse Treatment: A Treatment Improvement Protocol TIP 50
Sponsoring organization: Substance Abuse and Mental Health Services Administration
A manual designed to assist substance abuse counselors working with adult clients who may be suicidal, and to help clinical supervisors and administrators support the work of substance abuse counselors. Includes references to rural.
Date: 2009
Alcohol Treatment: Need, Utilization, and Barriers
Sponsoring organization: Substance Abuse and Mental Health Services Administration
Examines the demographics of persons in the general population aged 12 or older who met criteria for needing alcohol treatment and for those who received alcohol treatment. This Report is based on data from SAMHSA's National Survey on Drug Use & Health (NSDUH).
Date: 04 / 2009
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
Availability, Characteristics, and Role of Detoxification Services in Rural Areas
Author(s): Jennifer D. Lenardson, Melanie M. Race, John A. Gale
Sponsoring organization: Maine Rural Health Research Center
Indicates that few detox providers serve rural America and that 82% of rural residents live in a county without a detox provider.
Date: 12 / 2009
Barriers to Treating Alcohol and Drug Problems Among Adolescents
Author(s): Hannah K. Knudsen,
Study presents barriers to substance use treatment adolescents face, such as: availability and accessibility. Website offers access to the study overview, policy brief, plus its key results, resources, and researchers.
Date: 12 / 2009
Children Living with Substance-Dependent or Substance-Abusing Parents: 2002 to 2007
Sponsoring organization: Substance Abuse and Mental Health Services Administration
Compiles and interprets findings of the National Survey on Drug Use and Health (NDSUH), revealing that over 8.3 million children under 18 lived with at least one parent who was dependent on or abused alcohol or an illicit drug during the past year.
Date: 04 / 2009
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
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
Few and Far Away: Detoxification Services in Rural Areas (Research & Policy Brief)
Author(s): Jennifer D. Lenardson, Melanie M. Race, John A. Gale
Sponsoring organization: Maine Rural Health Research Center
Indicates that most rural residents live in a county without a detox provider and that rural providers are concentrated in large rural towns.
Date: 12 / 2009
Monitoring the Future: National Results on Adolescent Drug Use Overview of Key Findings 2008
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 / 2009
National Drug Threat Assessment 2009
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 substances such as cocaine, methamphetamine, marijuana, heroin, MDMA, pharmaceutical drugs.
Date: 12 / 2008
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
Race and Ethnicity in Fatal Motor Vehicle Traffic Crashes 1999 - 2004
Author(s): Judith Hilton
Sponsoring organization: National Highway Traffic Safety Administration
Describe the differences among racial and ethnic groups in the frequency of occurrence of characteristics or behaviors associated with fatalities in motor vehicle traffic crashes. Includes the role of alcohol these traffic accidents, and the differences in rural and urban areas.
Date: 05 / 2006
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, especially methamphetamine; recommendations for programs and policies; and provides rural and urban data.
Date: 2006
Results from the 2008 National Survey on Drug Use and Health: National Findings
Sponsoring organization: Substance Abuse and Mental Health Services Administration
Presents the 2008 survey results, which is the primary source of information on the use of illicit drugs, alcohol, and tobacco in the civilian, noninstitutionalized population of youth and adults.
Date: 09 / 2009
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
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 and Suicide Prevention: Evidence and Implications: A White Paper
Sponsoring organization: Substance Abuse and Mental Health Services Administration
Explores the role of substance abuse in the interplay of factors that result in a greater risk for suicidal behaviors.
Date: 11 / 2008
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 Treatment Facilities Serving American Indians and Alaska Natives
Sponsoring organization: Substance Abuse and Mental Health Services Administration
An overview of the current substance abuse treatment facilities and the services they provide.
Date: 07 / 2009
Substance Abuse Treatment Need and Use Among Hispanics
Sponsoring organization: Substance Abuse and Mental Health Services Administration
Examines the need for and receipt of alcohol and illicit drug use treatment among Hispanics aged 12 or older, based on combined 2002 to 2007 data.
Date: 07 / 2009
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
Tobacco Control in Rural America
Examines tobacco-related disparities facing rural areas, socioeconomic and cultural conditions that cause these disparities, challenges to tobacco control and prevention efforts, and explores effective strategies that have shown measurable outcomes for tobacco control in rural America.
Date: 07 / 2009
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
Organizations
2-1-1
Nonprofit/Foundation
Provides callers with information about and referrals to human services for everyday needs and in times of crisis.
American Legacy Foundation
National organization
The American Legacy Foundation is dedicated to building a world where young people reject tobacco and anyone can quit. The foundation is a 501(c)(3) organization that was established in March 1999 as a result of the Master Settlement Agreement (MSA) between a coalition of attorneys general in 46 states and five U.S. territories and the tobacco industry, and is funded primarily by payments designated by the settlement.
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 on Addiction and Substance Abuse at Columbia University (CASA)
National organization
Provides research on substance abuse and addiction, works with schools, conducts surveys, and hosts conferences.
National Crime Prevention Council (NCPC)
National organization
Enables people to create safer and more caring communities by addressing the causes of crime and violence (such as drug abuse) and reducing the opportunities for crime to occur.
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, and articles.
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 FBCI)
Federal government
Supports faith-based and community organizations that benefit people with or at risk for mental and substance abuse disorders.
UCLA Integrated Substance Abuse Programs (ISAP)
Academic/Research
Coordinates substance abuse research to develop, evaluate, and initiate treatment programs for substance abuse disorders.
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.
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