Substance use and abuse rates are similar in urban and rural areas of the United States, according to a recent report by the Carsey Institute’s Center on Rural Families and Communities at the University of New Hampshire. But while the overall rates are similar, some distinctions exist.

Researchers examined data primarily from the Substance Abuse Mental Health Services Administration’s (SAMHSA) National Survey on Drug Use and Health (NSDUH). They define substance use as using a substance in the past year, and substance abuse as meeting the criteria for substance abuse or dependence specified in the Diagnostic and Statistical Manual of Mental Disorder (DSM).

Alcohol use and abuse
Alcohol remains the most used and abused substance in both rural and urban areas. However, rural youth have overtaken urban youth in their reported alcohol consumption. Rural youth appear to have significantly greater problems with alcohol than their urban counterparts. Underage drinking is higher in rural youth populations than in urban youth populations. Rural youth age 12 to17 are more likely to report alcohol use than urban youth. When it comes to alcohol abuse, rural youth 12 to 13 are twice as likely to abuse alcohol, and 13 percent of rural youth age 16 to 17 meet definitions of alcohol abuse compared to 10 percent of urban youth.

Illicit drug use and abuse
Generally, illicit drug use is lower in rural populations—a steady trend going back more than 20 years. In recent years, the spotlight has been on the meth “epidemic” considered by many to be a significant concern in rural areas. The Carsey report indicates that while “rural America does face some unique challenges with meth…only a very small proportion of rural Americans abuse methamphetamines.” One difference that raises concern is that urban and rural meth use occurred at similar rates until 2003, at which time the NSDUH data show a continued increase in rural youth meth use but a decline in use by urban youth.

The 2003 NSDUH data also indicate that rural adults have higher levels of stimulant (which includes meth) abuse than urban adults. Unemployment appears to be a critical factor in stimulant abuse. People who were unemployed in rural areas were seven times more likely to meet the DSM criteria for stimulant abuse than unemployed urban residents.

In rural areas, African Americans appear to have the lowest rates of substance abuse while American Indians report the highest rates. Rural American Indian youth are also the only group that is just as likely to abuse drugs as alcohol.

For more information, visit The Carsey Institute at the University of New Hampshire's Web site and download Substance Abuse in Rural and Small Town America, part of a series of Carsey Institute policy reports on topics concerning rural America.