title: Contextual differences in substance use for rural Appalachian treatment-seeking women.
abstract: OBJECTIVE
  To examine differences in substance use among a sample of women entering treatment from rural Appalachian and non-Appalachian areas.
  
  
  METHODS
  A total of 2,786 women participating in state-funded substance abuse treatment programs statewide.
  
  
  METHODS
  Substance use measures were based on the SAMHSA CSAT Government Performance and Results Act (GPRA) gathering information on lifetime and past 12-month use of alcohol, marijuana, opiates, sedatives/tranquilizers, cocaine, and stimulants.
  
  
  RESULTS
  Women entering treatment in rural Appalachia had disproportionately high rates of opiate and sedative/tranquilizer use while methamphetamine, cocaine, marijuana, and alcohol were more prevalent for women in non-Appalachian areas.
  
  
  CONCLUSIONS
  Women entering treatment in rural Appalachia were significantly more likely to report opiate and sedative/tranquilizer use compared to non-Appalachian women. In order to begin to understand the elevated rates of prescription drug abuse in rural Appalachian Kentucky, substance use must be considered within the context of demographic, geographic, social, and economic conditions of the region.
authors.affiliation: Department of Behavioral Science, Center on Drug and Alcohol Research, University of Kentucky, Lexington, 40536-9824, USA. lisa.shannon@uky.edu
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Shannon
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Havens
authors.forename: Allison
authors.initials: A
authors.lastname: Mateyoke-Scrivner
authors.forename: Robert
authors.initials: R
authors.lastname: Walker
mesh_terms: D000328:Adult; D001061:Appalachian Region / Q000453:epidemiology; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D007629:Kentucky / Q000453:epidemiology; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation; D010342:Patient Acceptance of Health Care; D055553:Prescription Drugs / Q000009:adverse effects*; D012424:Rural Population / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D014149:Tranquilizing Agents / Q000009:adverse effects; D055815:Young Adult
chemical_list: D006993:Hypnotics and Sedatives; D055553:Prescription Drugs; D014149:Tranquilizing Agents