title: Correlates of rural methamphetamine and cocaine users: results from a multistate community study.
abstract: OBJECTIVE
  Use and production of methamphetamine (MA) has dramatically increased in the United States, especially in rural areas, with concomitant burdens on the treatment and criminal justice systems. However, cocaine is also widely used in many rural areas. The purpose of this article is to contrast MA and cocaine users in three geographically distinct rural areas of the United States.
  
  
  METHODS
  Participants were recent not-in-treatment adult cocaine and MA users living in rural Ohio, Arkansas, and Kentucky, who were recruited by a referral recruitment method for sampling hidden community populations. Participants were interviewed for demographics, drug and alcohol use, criminal justice involvement, and psychological distress (Brief Symptom Inventory).
  
  
  RESULTS
  The sample of 706 comprised 29% nonwhite and 38% female participants; the average age was 32.6 years; 58% had a high school education or higher, and 32% were employed. In the past 6 months, they had used either MA only (13%), cocaine only (52%), or both (35%). MA users were seldom (8.2%) nonwhite, but type of stimulant use did not vary by gender. Combined MA/cocaine users reported significantly greater use of alcohol and other drugs, including marijuana and nonprescribed opiates and tranquilizers, and reported significantly higher psychological distress. MA users (with or without cocaine use) had greater odds of recent criminal justice involvement compared with cocaine-only users.
  
  
  CONCLUSIONS
  There is a clear need for accessible substance-use treatment and prevention services in rural areas of the United States, including services that can address MA, cocaine, polydrug use, and mental health needs. There is a particular need of these services for polydrug users.
authors.affiliation: Division of Health Services Research, Department of Psychiatry, University of Arkansas for Medical Sciences, 5800 West 10th Street, Suite 605, Little Rock, Arkansas 72204, USA. boothbrendam@uams.edu
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Booth
authors.forename: Carl
authors.initials: C
authors.lastname: Leukefeld
authors.forename: Russel
authors.initials: R
authors.lastname: Falck
authors.forename: Jichuan
authors.initials: J
authors.lastname: Wang
authors.forename: Robert
authors.initials: R
authors.lastname: Carlson
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D019969:Amphetamine-Related Disorders / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D001131:Arkansas / Q000453:epidemiology; D019970:Cocaine-Related Disorders / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D003415:Crime / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D007629:Kentucky / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology; D008694:Methamphetamine; D009820:Ohio / Q000453:epidemiology; D012424:Rural Population; D012959:Socioeconomic Factors
chemical_list: D008694:Methamphetamine