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

B. D. Warner, C. G. Leukefeld

Research output: Contribution to journalArticlepeer-review

89 Scopus citations


Surveys of incarcerated offenders and arrestees consistently report high rates of both alcohol and drug use in this population. This drug-crime connection has highlighted the need to learn more not only about drug treatment effectiveness, but also about drug treatment utilization. While studies have begun to examine drug treatment utilization, most of these studies have been based on urban substance abusers. Little is known about the extent to which urban and rural substance abusers may be different in terms of treatment utilization. This study, therefore, examines differences between urban and rural drug use patterns and treatment utilization among chronic drug abusers to determine whether, and in what ways, rurality may affect substance abuse and treatment seeking. The study examines these issues in a group of chronic drug users who were incarcerated at the time of the study. Findings show signifi- cant 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 rates of drug use in the 30 days prior to their current incarceration than chronic drug abusers from urban areas. Nonetheless, being from a very rural area decreased the likelihood of having ever been in treatment after controlling for the number of years using and race. While problem recognition appears to explain much of the effect of very rural residence on treatment utilization for alcohol abuse, the effects of being from a very rural area on seeking treatment for drug abuse remain statistically significant even after controlling for several other variables. The findings point to the importance of providing culturally appropriate education to very rural communities on the benefits of substance abuse treatment and of providing substance abuse treatment within the criminal justice system.

Original languageEnglish
Pages (from-to)265-280
Number of pages16
JournalAmerican Journal of Drug and Alcohol Abuse
Issue number2
StatePublished - 2001

Bibliographical note

Funding Information:
This project was supported by the National Institutes of Health grant RO1 DA 11309 from the National Institute on Drug Abuse.

Funding Information:
The current study was part of a 5-year project funded by the National Institute on Drug Abuse concerning health service utilization among chronic drug abusers. The project focused on 660 incarcerated male chronic drug abusers in four Kentucky prisons, with data collected in the prisons and, subsequently, in the community approximately 1 year after the initial interview.


  • Drug treatment utilization
  • Prisoners
  • Rural drug use

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health


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