Rural Stimulant Use & Mental Health: Services and Outcomes

The scientific literature offers little information about the use of stimulants, particularlymethamphetamine ("me1h"), cocaine, and crack, in rural America. We know little about the characteristics of rural stimulant 'users, how stimulant use is organized, the course of stimulant use, or about drug treatment and ether Iservice use in rural areas. Rural characteristics suggest that inferencesfrom urban drug users may not be generalizable to rural stimulant users. Recently, Wright State University (WSU) in Dayton, Ohio was funded by NIDA to study rural Ohic stimulant users, and to Identify factors associated with their drug use and use of health services. This application proposes to expand and enhance the Ohio rural stimulant research to the Arkansas Mississippi Delta and Appalachian Kentucky, by contributing a substantially wider range of rural ecologies, participant demographic and cuUural characteristics, service availability, I land service use. We willexpand the primary focus of the Ohio study to a broader-based natural history . of rural stimulant use and health services, highlighting the critical role of co-occurring mental dis9rders in relationship to trajectories of drug use and use of health servjces, including mental health services. We will also target interactions with the criminal justice system as longitudinal measures. We propose to develop complementary projects using parallel specific aims and procedures. and commondata collection instruments, with the Ohio project. We will study 450 stimulant users over a three-yearinterval with six-monthly follow-ups. Using both qualitative and quantitative methods, our overall specific aim is to characterize stimulant use and use of health services in two dIstinct rural ecologies. We plan to study the longitudinalcourse of drug use and predictors of drug use, and use of treatment, mental health, general medical, and ER services, and to conduct pooled analyses of the Arkansas, Kentucky, and Ohio samples. This expanded research fram three diverse rural ecologies will provide convincing and cogent data for health planning and health policy far prevention and treatment of stimulant users in rut'sl areas.