"Rural adolescents more likely to use Rx drugs" - Is this about the people or place?
A new research paper by Jennifer Havens from the University of Kentucky suggests that rural adolescents are more likely to abuse prescription drugs than their urban and suburban counterparts. Dr. Havens analyzed data from the National Survey of Drug Use and Health, a national study funded by you, the federal tax payer.
But, I wonder -- do rural, suburban and urban adolescents all have the same opportunity to abuse prescription drugs (or, the same availability)? If there are more Rx drugs floating around per capita in rural areas, and there are more illicit drugs floating around per capita in the other areas, is the observation more a result of the people or the place?
Nonmedical Prescription Drug Use in a Nationally Representative Sample of Adolescents
Evidence of Greater Use Among Rural Adolescents
Jennifer R. Havens, PhD, MPH; April M. Young, MPH; Christopher E. Havens, RN, BSN
Arch Pediatr Adolesc Med. Published online November 1, 2010. doi:10.1001/archpediatrics.2010.217
Objectives To compare the prevalence of nonmedical prescription drug use among adolescents residing in urban, suburban, and rural areas of the United States and to determine factors independently associated with rural nonmedical prescription drug use among adolescents aged 12 to 17 years.
Design Cross-sectional, population-based survey.
Setting Noninstitutionalized residents in the United States.
Participants Participants included adolescents aged 12 to 17 years (N = 17 872), most of whom were residing in urban areas (53.2%), male (51%), and white (59%).
Main Exposure Living in rural compared with urban area.
Main Outcome Measures Nonmedical use of prescription drugs (pain relievers, tranquilizers, sedatives, and stimulants). Data were from the 2008 National Survey on Drug Use and Health.
Results Rural adolescents were 26% more likely than urban adolescents to have used prescription drugs nonmedically (adjusted odds ratio, 1.26; 95% confidence interval, 1.01-1.57) even after adjustment for race, health, and other drug and alcohol use. When examining the rural adolescents in particular, factors positively associated with nonmedical use of prescription drugs included decreased health status, major depressive episode(s), and other drug (marijuana, cocaine, hallucinogens, and inhalants) and alcohol use. Protective factors for nonmedical prescription drug use among rural adolescents included school enrollment and living in a 2-parent household.
Conclusions Rural adolescents were significantly more likely than urban adolescents to report nonmedical prescription drug use. However, these results suggest there are multiple potential points of intervention to prevent initiation or progression of use among rural adolescents including preventing school dropout, increased parental involvement, and increased access to health, mental health, and substance abuse treatment.
Author Affiliations: Center on Drug and Alcohol Research, Department of Behavioral Science, University of Kentucky College of Medicine, Lexington (Dr Havens and Ms Young); Department of Health Behavior, University of Kentucky College of Public Health, Lexington (Ms Young); Department of Nursing, Midway College, Midway, Kentucky (Mr Havens).
