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No Place to Hide

From the Center on Addiction and Substance Abuse

Smoking, drinking and drug use among young teens is higher in rural America than in the nation's large urban centers, according to a White Paper, No Place to Hide: Substance Abuse in Mid-Size Cities and Rural America, by Center on Addiction and Substance Abuse.

According to the report, eighth graders living in rural America are 104% likelier to use amphetamines, including methamphetamine, than those in urban areas, and 50% likelier to use cocaine.

The CASA study, the first comprehensive assessment of substance abuse by population centers, reports that by any measure, the drug crisis is as common on Main Street as in Manhattan: AIDS is rising faster in rural areas than in large urban centers; more workers test positive for drugs in rural areas of Florida, Tennessee and Indiana than in the three largest metropolitan areas in these states; since 1990 drug law violations have increased more in small communities than in large cities; drugs are as available in small communities as they are in large cities, and adult drug use in such communities is equal to that in large metropolitan centers.

Not Equipped

At the same time, mid-size cities and rural areas are less equipped to deal with the consequences. Methamphetamine use has hit many areas of the West and Midwest especially hard, placing enormous pressure on hospitals, child welfare systems, treatment and law enforcement.

"Bluntly put, meth has come to Main Street, along with other drugs and with magnum force aimed at our children," said Joseph A. Califano, Jr., CASA President and former U. S. Secretary of Health, Education and Welfare. "It's time for all Americans to recognize that drugs are not only an urban problem."

Eighth-graders living in rural America are:
  • 34% likelier than in urban centers to smoke marijuana
  • 83% likelier to use crack cocaine
  • 29% likelier to drink alcohol and 70% likelier to have been drunk
  • more than twice as likely to smoke cigarettes and nearly five times likelier to use smokeless tobacco


  • Adult Use About the Same

    Among tenth graders, use rates in rural areas exceed those in large urban areas for every drug, except Ecstasy (MDMA) and marijuana. Among twelfth graders, use rates in rural America exceed those in large urban areas for cocaine, crack, amphetamines, inhalants, alcohol, cigarettes and smokeless tobacco.

    The study finds that adult drug use is about equal across communities of all sizes.

    Cocaine, crack, heroin and marijuana are reported to be easy to obtain regardless of location. Drug trafficking organizations from Mexico appear to be growing more involved in all aspects of the distribution of illicit drugs in mid-size cities and rural areas.

    Next page > Emergency Aid Requested > Page 1, 2


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