Barriers to Formal Drug Abuse Treatment in the Rural South: A Preliminary Ethnographic Assessment

Abstract

This article describes barriers to obtaining drug abuse treatment in the rural South using qualitative interviews conducted with 86 illicit stimulant users recruited in rural Arkansas and Kentucky between 2003 and 2005. Fifty-nine (69.0%) of the interviewees had never entered drug abuse treatment. Sixteen (19.0%) participants reported current perceived need for treatment, while seven (8%) were ambivalent about seeking it. Interview data suggest five interrelated categories of barriers to accessing drug abuse treatment: (1) geographical, (2) organizational, (3) economic, (4) social, and (5) psychological. The study findings can inform further examination of rural treatment barriers and have important implications for developing strategies to overcome these obstacles.

Screening and Follow-Up Monitoring for Substance Use in Primary Care: An Exploration of Rural–Urban Variations

“…Additionally, lack of transportation, service costs, and perceived stigma associated with substance abuse treatments may prevent rural residents from seeking and participating in treatment, which may result in refusal to complete screening and follow-up assessments. 55,56 Notwithstanding, our findings show that substance use problems are prevalent among primary care patients enrolled in this mental health integration program. While initial substance screening was associated with patient's treatment history and severity of psychopathology, follow-up monitoring was appreciably associated with clinics' rural-urban geographical locations.…”

Prevalência e fatores associados ao uso de drogas ilícitas em gestantes da coorte BRISA

“…O questionário é composto por 21 itens, que identificam os sintomas de ansiedade apresentados na última semana e quantificam sua intensidade em uma escala que varia de 0 (ausente) a 3 (severo). O escore total é alcançado pela soma dos escores apresentados em cada questão e permite a classificação do nível de ansiedade em normal (0-9 pontos), leve (10-18), moderada (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29) e intensa (30-63 pontos) 19,20 . Essa variá-vel foi categorizada em ansiedade normal/leve e moderada/intensa.…”

Source of prescription drugs used nonmedically in rural and urban populations

“…A recent study documented that the majority of people with nonmedical use of prescription drugs acquire these drugs from a non-physician source, such as from family and friends (16), and that factors associated with a physician source of nonmedical opioids use include older age, nonwhite race, and opioid use disorder (17). Given the influence of rural culture on illicit drug use and use of mental health and substance use services, the lower density of physicians in rural areas and differences in healthcare utilization between urban and rural populations, we hypothesized that a greater proportion of rural residents would obtain their prescription drugs for nonmedical use from a non-physician source (18)(19)(20)(21).…”