Rural Substance Abuse

Rural Addiction Treatment IndianaAddiction and substance abuse are global problems, but people who live in rural communities face greater challenges and barriers when it comes to getting help for substance abuse.
Most people living in metropolitan areas don’t consider the subject of rural health. For city-dwelling residents, access to healthcare is typically a matter of affordability and convenience. If they have to commute, they simply get in the car and drive a few miles. When it comes to rural communities, however, the access to hospitals, rehab facilities and other substance abuse services and resources is extremely limited. Even if someone is able to reach a hospital, paramedics and medical staff are less likely to be skilled in treating an overdose.
The growing epidemic of alcohol abuse and drug addiction in rural communities is often overshadowed by the crime rates and drug usage in noteworthy cities like New York and Chicago, but cities don’t make up the majority of America. Rural communities account for 97 percent of the United States’ total land area. One in five Americans lives in a small town with fewer than 2,500 people. These individuals face many obstacles when it comes to overcoming substance abuse, and it’s time to evaluate these challenges and find solutions.

If you live in a rural area and are seeking help for your addiction, read on. We’ve put together this article to help people in rural communities better understand their situation and to shed light on a problem that deserves greater attention. You may feel isolated, but we see you, and we want to help you.

Rural Substance Abuse Statistics

While drug use is typically reported as a city problem, adults in rural areas consistently demonstrate greater substance abuse. According to the Substance Abuse and Mental Health Services Administration, 37.8 percent of adults ages 12-20 used alcohol in rural areas compared to 35.3 and 34.3 in small and large metropolitan regions, respectively.

Nearly half of patients in rural addiction treatment programs reported alcohol as their primary addiction.

The greatest number of smokers in the U.S. reside in non-metropolitan areas, and while the American opioid epidemic is often viewed through an urban lens, rural communities are just as affected.

There have not been many studies that concentrate on substance abuse in rural communities, but as the drug problem in America continues to evolve and impact millions every year, greater research is being dedicated to understanding the impact of addiction on rural health.

The Causes of Rural Substance Abuse

There are several primary reasons why people living in rural communities are more likely to abuse drugs or alcohol:

  • Geographic limitations
  • Unemployment
  • Less education
  • Higher poverty levels
  • Risky behavior
  • Stigma around addiction treatment

People who live in rural areas tend to have less awareness and understanding about the health risks and long-term consequences of substance abuse. The limited data available suggests that the differences between rural and urban drug users span far beyond age and gender.

Across all demographics, research reveals that alcohol and drug abusers in rural areas demonstrate different behavioral patterns related to their different social and environmental influences, lower incomes, limited social networks, greater stigma around rehab, and insufficient access to medical resources and rehab facilities.


Living in a small town is a paradise to some and a prison to others. Rural communities today have fewer job opportunities and lower pay, making it difficult to grow and prosper. Many people who want to relocate don’t have the ability to because they’re financially dependent on low-paying jobs to survive.

While some people don’t mind staying in the same town their whole lives and following in the footsteps of their parents and grandparents, others become depressed and seek escapism in the form of illicit drugs and alcohol.

Rural areas have been proven to have higher rates of opioid prescription and a stronger kinship than that found in urban areas, which makes informal drug trafficking much easier and more accessible.

Limited Resources

A staggering 60 percent of all rural counties in the U.S. do not have access to a physician with a DEA waiver to prescribe buprenorphine for opioid addiction treatment. As more youth leave their rural hometowns in favor of metropolitan areas, the lack of resources and medical staff shortage in small towns continues to worsen.

Detox and addiction treatment options are limited to nonexistent in the majority of rural areas. Patients who need treatment have to travel to get help, but people who live in rural areas are more likely to live in poverty and be uninsured. A lack of financial ability and health insurance make rehab much more difficult for rural substance abusers.

The smaller law enforcement departments responsible for large areas of land also contribute to the crime rates and widespread drug usage in rural areas. Without the manpower and funding necessary to accurately monitor, track and stop drug trafficking, it’s far easier for substance abusers to repeatedly access drugs in their neighborhoods.

Risky Behavior

One in four adults in rural American partakes in four out of five risky behaviors outlined by the Center for Disease Control. Rural adults smoke more, drink more, and exercise and sleep less than city-dwellers. Combined with a higher probability of substance abuse, rural health is a serious subject that has to be addressed.

Alcohol Abuse in Rural Areas

While the drug problem pervading America’s rural communities shouldn’t be ignored, alcohol abuse is far more prevalent and long-standing. Two out of five young people between the ages of 12 and 20 are underage drinkers. Alcohol-related car accidents are the leading cause of death among 12- to 19-year-olds in rural communities.

Parents in rural areas are less likely to see underage drinking as a problem as many of them grew up doing it too. With less awareness and education, teens are more likely to regularly binge drink and experiment with other substances as well. The indulgence of such risky behaviors at a young age means that rural teens are far more likely to grow into adults who struggle with addiction.

Alcohol Abuse and Rural Health

In 2017, 35,092 Americans were killed in a car accident. Out of the fatal car crashes that year, 48 percent occurred in rural areas. According to the U.S. Census Bureau, 19 percent of Americans live in rural areas, but rural drivers were responsible for 49 percent of all traffic fatalities in 2015.

All 50 states have made it illegal to drive with a blood alcohol concentration greater than 0.8 percent. In 2016, drunk drivers in rural areas accounted for half of all drunk driving deaths that year.

On a crime-related level, the results of alcohol abuse and binge drinking impact rural areas much more significantly than urban regions. Many alcohol-related crimes such as theft, vandalism and assault can ravage small towns and have devastating consequences on the community.

Other Alcohol Health Risks

Chronic alcohol abuse has been tied to liver disease, heart problems, depression, dementia and more.

The National Cancer Institute reports that higher levels of alcohol consumption can cause certain types of cancer. According to a 2009 report, alcohol contributed to 3.5 percent of all American cancer deaths.

Alcohol abuse also weakens the immune system. With the body’s natural defenses compromised, people are more likely to get sick. Those who abuse alcohol have a higher chance of contracting serious illnesses like tuberculosis and pneumonia.

Many people in rural areas don’t have health insurance and can’t afford to pay the hefty medical bills that accompany treatment. If they can’t reach a doctor’s office or hospital, they’re more likely to suffer at home and try to treat themselves. Naturally, this can lead to greater illness and even life-threatening complications.

Addiction Treatment in Rural Areas

The greatest challenge for people in rural areas struggling with substance abuse is access to proper healthcare. Most people don’t live near a medical facility, and even fewer have access to a drug or alcohol treatment center. In fact, 82 percent of rural adults have no access to a detox program in their area. This could be because of the stigma attributed to seeking help in rural areas; an unfavorable perspective about drug addiction and rehab cause many to feel shameful of their addiction and avoid seeking help. In one study, people who suffered from substance abuse problems identified a lack of privacy and fear of being gossiped about as some of their greatest barriers to treatment.

In order to combat the issues of privacy and accessibility, SAMHSA suggests teleconferencing as a possible solution to treating addiction among rural communities. The internet makes it possible to bring rehab directly to people who can’t afford to travel for treatment, and they can receive counseling from the security of their own homes.

The widespread integration of online substance abuse treatment is still a challenge, however. In a recent study, only 78 percent of Americans in rural areas had internet access at home compared to 85 percent of people in urban areas.

Although access is more limited, it’s undeniable that people in rural areas will still turn to the web for help when it comes to tackling addiction. If you’re currently looking for help and want to know about your options, one of our addiction specialists will be happy to talk to you and work together to find the help you need.