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"Methamphetamine
use is affecting multiple segments of rural life," the authors wrote, yet
little is known about rural methamphetamine use disorders. At five
Midwestern substance use disorder centers, the researchers compared rural
and urban meth use in adult study participants. After screening 329 patients
with meth abuse/dependence at treatment entry, they enrolled 172 adults for
the 12-month study period. The study population comprised 78 rural (45
percent) and 94 urban (55 percent) participants. Forty percent of
participants were female.
Meth was listed as the drug of choice by 63 percent of rural and 69 percent
of urban adults. The mean age of beginning regular meth use was 21.3 years
for rural patients and 24.9 for urban patients. Fifty-four percent of rural
subjects reported "any intravenous (IV) use," compared to 32 percent of
urban subjects. Injecting as the exclusive meth use route was reported by 37
percent of rural users vs. 20 percent of urban users. Sixty percent of both
groups reported daily meth use. Seventy-two percent of rural users met
criteria for alcohol dependence/abuse vs. 45 percent of urban users. While
94 percent of the total group reported ever being regular tobacco users,
rural subjects smoked more cigarettes per day at treatment entry than urban
ones (16.41 vs. 11.70). Rural users reported more meth-related psychoses
than urban users (44.8 percent vs. 28.7 percent).
"A comparison of rural and urban study participants shows a consistent
pattern of earlier first regular use of methamphetamine, earlier onset of
methamphetamine-related psychosis, and earlier presentation for treatment in
rural persons," the authors wrote. "Taken together, these findings suggest
that rural methamphetamine users may be at higher risk for medical and
psychiatric complications of their methamphetamine use. The infectious
complications associated with injection drug use and the medical risks
associated with greater cigarette use and alcoholism may contribute to a
higher frequency of infectious diseases, chronic lung disease, and
alcohol-related liver disease in rural than urban methamphetamine users."
These findings, the authors concluded, are "of special concern, given the
limited substance abuse, mental health, and specialty medical care typically
available in rural Midwestern communities."
The American
Journal on Addictions Vol. 16: P. 79-84 (03.04.07):: Kathleen M. Grant,
MD; Stephanie Sinclair Kelley, BS; Sangeeta Agrawal, MSc; Jane L. Meza, PhD;
James R. Meyer, MPAS; Debra J. Romberger, MD |
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