Rural-urban differences in substance use and treatment utilization among prisoners

Surveys of incarcerated offenders and arrestees consistently report high ra tes of both alcohol and drug use in this population. This drug-crime connec tion has highlighted the need to learn more not only about drug treatment e ffectiveness, but also about drug treatment utilization. While studies have begun to examine drug treatment utilization, most of these studies have be en based on urban substance abusers. Little is known about the extent to wh ich urban and rural substance abusers may be different in terms of treatmen t utilization. This study, therefore, examines differences between urban an d rural drug use patterns and treatment utilization among chronic drug abus ers to determine whether, and in what ways, rurality may affect substance a buse and treatment seeking. The study examines these issues in a group of c hronic drug users who were incarcerated at the time of the study. Findings show significant differences in drug use and treatment utilization of urban and rural offenders. Chronic drug abusers from rural and very rural areas have significantly higher rates of lifetime drug use, as well as higher rat es of drug use in the 30 days prior tr, their current incarceration than ch ronic drug abusers fi om urban areas. Nonetheless, being from a very rural area decreased the likelihood of having ever been in treatment after contro lling tor the number of years using and race. While problem recognition app ears to explain much of the effect of very rural residence on treatment uti lization for alcohol abuse, the effects of being from a very rural area on seeking treatment for drug abuse remain statistically significant even afte r controlling for several other variables. The findings point to the import ance of providing culturally appropriate education to very rural communitie s on the benefits of substance abuse treatment and of providing substance a buse treatment within the criminal justice system.