In some ways, substance abuse is worse in urban areas, but rural drug users are less likely to get treatment, according to two studies by the Rural and Underserved Health Research Center at the University of Kentucky and reported by Melissa Patrick of Kentucky Health News.
One study found that the percentage of adults with substance-use disorders was about the same in rural areas as in metropolitan areas. However, researchers Tyrone Borders and Hefei Wen note that there are "statistically significant" differences that indicate more serious problems in urban areas. For example, the share of urban adults with an illicit drug-use disorder in the previous year, 3.33 percent, was significantly higher than the rural rate of 2.86 percent. Also, the share of urban adults with any type of drug-use disorder in 2014-15 was significantly higher than in 2011-13, when it was 3.07 percent.
The number of adults with heroin-use disorders in the past year was "significantly higher" in metropolitan areas, 0.31 percent than rural areas, 0.20 percent. Disorders involving prescription painkillers were more common in rural areas, involving 1 percent of the rural population and 0.87 percent of the urban. Overall opioid-use disorders were virtually the same in urban and rural areas, 1.07 percent and 1.09 percent respectively, and those rates have been stable over time.
The other study, by the same authors, looked at the perceived need for treatment of substance-use disorders, compared to the actual use of treatment. They found that overall, the rates of perceived need for treatment and actual use of treatment were low among rural residents with drug-use disorders, and have changed little since 2008, despite the implementation of policies to increase access to treatment.
They found that the rates of perceived need for treatment for use of illicit drugs and opioid-use disorders were about the same in urban and rural areas, but the perceived need for treatment in rural areas more than doubled between 2008-10 and 2011-13, from 7.8 percent to 18.5 percent. The rate declined to 13.4 percent in 2014-15.
The study found that 26.7 percent of urban adults with an opioid-use disorder got treatment during the study period, significantly higher than the 17.9 percent among rural adults. The gap almost disappeared in 2014-15, when the urban and rural rates were 24.3 and 24.1 percent, respectively. The difference was even greater in treatment for heroin use, 48.6 percent for urban adults and 25.7 percent for rural ones.
There was little difference in treatment rates for abuse of prescription painkillers: 19.5 percent for urban adults and 20.6 percent for rural. However, the perceived need for treatment of disorders related to prescription painkillers was significantly higher in rural areas, 13.2 percent, than the urban rate of 8.1 percent.
The researchers suggest "a need for improved insurance reimbursements for screening and treatment in rural primary care; a need to address the limited access to behavioral-health and substance-abuse treatment in rural areas; the need for targeted substance-abuse treatment, needle exchanges, and safe-sex education programs in areas with rising heroin use; and issues around the limits on the number of patients that can receive medication assisted treatment for opioid use," Patrick reports. "They also say that stimulating positive perceptions about treatment among illicit drug users and their families and friends could encourage them to get treatment."
One study found that the percentage of adults with substance-use disorders was about the same in rural areas as in metropolitan areas. However, researchers Tyrone Borders and Hefei Wen note that there are "statistically significant" differences that indicate more serious problems in urban areas. For example, the share of urban adults with an illicit drug-use disorder in the previous year, 3.33 percent, was significantly higher than the rural rate of 2.86 percent. Also, the share of urban adults with any type of drug-use disorder in 2014-15 was significantly higher than in 2011-13, when it was 3.07 percent.
The number of adults with heroin-use disorders in the past year was "significantly higher" in metropolitan areas, 0.31 percent than rural areas, 0.20 percent. Disorders involving prescription painkillers were more common in rural areas, involving 1 percent of the rural population and 0.87 percent of the urban. Overall opioid-use disorders were virtually the same in urban and rural areas, 1.07 percent and 1.09 percent respectively, and those rates have been stable over time.
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| Rates in 2014-15 of perceived need for treatment, and use of treatment, among rural Americans with drug use disorders in the previous year. |
They found that the rates of perceived need for treatment for use of illicit drugs and opioid-use disorders were about the same in urban and rural areas, but the perceived need for treatment in rural areas more than doubled between 2008-10 and 2011-13, from 7.8 percent to 18.5 percent. The rate declined to 13.4 percent in 2014-15.
The study found that 26.7 percent of urban adults with an opioid-use disorder got treatment during the study period, significantly higher than the 17.9 percent among rural adults. The gap almost disappeared in 2014-15, when the urban and rural rates were 24.3 and 24.1 percent, respectively. The difference was even greater in treatment for heroin use, 48.6 percent for urban adults and 25.7 percent for rural ones.
There was little difference in treatment rates for abuse of prescription painkillers: 19.5 percent for urban adults and 20.6 percent for rural. However, the perceived need for treatment of disorders related to prescription painkillers was significantly higher in rural areas, 13.2 percent, than the urban rate of 8.1 percent.
The researchers suggest "a need for improved insurance reimbursements for screening and treatment in rural primary care; a need to address the limited access to behavioral-health and substance-abuse treatment in rural areas; the need for targeted substance-abuse treatment, needle exchanges, and safe-sex education programs in areas with rising heroin use; and issues around the limits on the number of patients that can receive medication assisted treatment for opioid use," Patrick reports. "They also say that stimulating positive perceptions about treatment among illicit drug users and their families and friends could encourage them to get treatment."
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