Rural Drug Users Experience Barriers To Treatment, Study Shows

November 24, 1997

COLUMBUS, Ohio -- Only about 5 percent of rural adults who used illegal drugs during a recent one-year period sought treatment, according to a study at Ohio State University.

The study, which appeared in a recent issue of the American Journal of Drug and Alcohol Abuse, found that rural drug users often don’t seek help because they can’t afford it, they lack health insurance, and they feel they lack anonymity at drug treatment centers.

Joseph Donnermeyer, associate professor of rural sociology at Ohio State, and Elizabeth Robertson of the National Institute on Drug Abuse in Rockville, MD, used statistics from the 1991 National Household Survey on Drug Abuse to track drug use among 3,629 adults who lived in small towns and farming communities. The survey defined as “rural” places with fewer than 2,500 residents.

Almost 43 percent of the rural adults admitted to using illegal drugs at some point in their lifetime. Of those, 14
percent reported that they used drugs currently, meaning within the last year. Of current users, 62 percent used only one illegal drug, most often marijuana. Another 18 percent used two drugs, while 20 percent used three or more.

Donnermeyer said he was not surprised at the prevalence of drug use in rural areas, which over time has come to resemble drug use in the cities. He said that while few researchers have investigated the drug habits of rural adults, some recent studies indicate that the gap between rural and urban drug use is closing. For example, a 1990 report from the United States General Accounting Office concluded that total alcohol and other drug use rates in rural states are about as high as those found in non-rural states.

“You can compare the spread of illegal drugs to the opening of a movie,” said Donnermeyer. “When a new movie first comes out, the only people to see the premiere live in New York and Los Angeles. Then gradually the rest of us get to see it -- maybe over the next six months. New drugs first become popular in the big city, but eventually knowledge of that drug spreads to the rural population.”

Almost 43 percent of current drug users reported one or more mental and physical health problems, such as not being able to think clearly (20.6 percent), arguing with family or friends (19 percent), feeling very nervous and anxious (17.5 percent), and feeling irritable and upset (16.5 percent). Only 5.6 percent of the current drug users who reported problems sought treatment.

Donnermeyer and Robertson said that the farm crisis of the 1980s and its subsequent economic hardship prevented rural residents from being able to afford treatment for drug problems. The researchers cited 1992 data from the National Center for Health Statistics in Hyattsville, MD, in which rural residents were 15.7 percent less likely to carry health insurance than their urban counterparts.

Even those rural drug users with adequate insurance may hesitate to seek help. Donnermeyer said that most treatment centers are located in urban areas, so rural people must have the means to travel to the city, and must be able to afford to take time off from work before they can receive treatment.

Moreover, Donnermeyer and Robertson learned through their discussions with treatment personnel that rural drug users are sometimes afraid to seek help because they feel they won’t be able to keep their treatment private.

“For instance, if they drive to a treatment center in their county seat, they’ll be afraid that someone from their hometown will drive by and see their car parked there,” said Donnermeyer. “They feel they have no anonymity.”

The researchers cautioned that while drug use is rising in rural areas on average, every small town is different. “Some small towns may have virtually no drug problems, and others may have huge drug problems,” said Donnermeyer. “We want to encourage treatment personnel and law enforcement in rural areas to do their own investigation and uncover the unique factors that influence drug use and treatment in their area.”

Ohio State University

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