Methamphetamine Use in Rural Midwesterners

"Methamphetamine use is affecting multiple segments of rural life," the authors wrote, yet little is known about rural methamphetamine use disorders. At five Midwestern substance use disorder centers, the researchers compared rural and urban meth use in adult study participants. After screening 329 patients with meth abuse/dependence at treatment entry, they enrolled 172 adults for the 12-month study period. The study population comprised 78 rural (45 percent) and 94 urban (55 percent) participants. Forty percent of participants were female.

Meth was listed as the drug of choice by 63 percent of rural and 69 percent of urban adults. The mean age of beginning regular meth use was 21.3 years for rural patients and 24.9 for urban patients. Fifty-four percent of rural subjects reported "any intravenous (IV) use," compared to 32 percent of urban subjects. Injecting as the exclusive meth use route was reported by 37 percent of rural users vs. 20 percent of urban users. Sixty percent of both groups reported daily meth use. Seventy-two percent of rural users met criteria for alcohol dependence/abuse vs. 45 percent of urban users. While 94 percent of the total group reported ever being regular tobacco users, rural subjects smoked more cigarettes per day at treatment entry than urban ones (16.41 vs. 11.70). Rural users reported more meth-related psychoses than urban users (44.8 percent vs. 28.7 percent).

"A comparison of rural and urban study participants shows a consistent pattern of earlier first regular use of methamphetamine, earlier onset of methamphetamine-related psychosis, and earlier presentation for treatment in rural persons," the authors wrote. "Taken together, these findings suggest that rural methamphetamine users may be at higher risk for medical and psychiatric complications of their methamphetamine use. The infectious complications associated with injection drug use and the medical risks associated with greater cigarette use and alcoholism may contribute to a higher frequency of infectious diseases, chronic lung disease, and alcohol-related liver disease in rural than urban methamphetamine users."

These findings, the authors concluded, are "of special concern, given the limited substance abuse, mental health, and specialty medical care typically available in rural Midwestern communities."

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