title: Drug use patterns and trends in rural communities.
abstract: OBJECTIVE
  This study examines the prevalence of tobacco, alcohol, and illicit drug use among adolescents and adults in 3 types of counties: "rural" (nonmetropolitan counties with urban population less than 20,000), "urbanized nonmetropolitan" (nonmetropolitan counties with urban population 20,000 or higher), and "metropolitan" (counties in metropolitan areas).
  
  
  METHODS
  Data from the 2002-2004 National Surveys on Drug Use and Health are used to compare residents of the 3 county types. Descriptive findings and a multivariate model of marijuana use among adolescents are presented by county type.
  
  
  RESULTS
  Past year illicit drug use is generally similar among adolescents in rural, urbanized nonmetropolitan, and metropolitan counties, except that Ecstasy use is higher among youth in metropolitan and urbanized nonmetropolitan counties than rural counties, while rural youth have a higher prevalence of stimulant and methamphetamine use than metropolitan youth. Gender, race/ethnicity, and family income functioned differentially across the 3 county types as predictors of youth marijuana use during the past year. Rural adults had generally lower rates of illicit drug use than metropolitan adults, but adults in rural and urbanized nonmetropolitan areas had higher rates of methamphetamine use than those in metropolitan areas. Rural youth had a higher prevalence of past month use of tobacco and alcohol. Rural adults had higher rates of tobacco use but lower rates of alcohol use.
  
  
  CONCLUSIONS
  This study dispels the notion that substance abuse is only an urban problem and provides information useful in developing and implementing interventions that consider the unique characteristics of rural residents.
authors.affiliation: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Rockville, MD 20857, USA. Gfroerer@samhsa.hhs.gov
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Gfroerer
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Larson
authors.forename: James D
authors.initials: JD
authors.lastname: Colliver
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D012424:Rural Population; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology