Predictors of Substance Abuse Treatment Entry among Rural Illicit Stimulant Users in Ohio, Arkansas, and Kentucky

Abstract

Illicit drug use in the rural United States is increasingly common, yet little is known about drug users’ treatment-seeking behaviors. This study identifies predictors of substance abuse treatment entry over 24 months among 710 illicit stimulant users in rural areas of Ohio, Arkansas, and Kentucky. Active users of powdered cocaine, crack cocaine, and/or methamphetamine (MA) were recruited using respondent-driven sampling. Participants completed structured interviews at baseline and follow-up questionnaires every 6 months for 24 months. Data were analyzed using the Cox proportional hazards model. The paper is informed by the Anderson-Newman Model. Overall, 18.7% of the sample entered treatment. Ohio or Kentucky residence, perceived need for substance abuse treatment, higher ASI legal problem composite scores, prior substance abuse treatment, and tranquilizer use were positively associated with treatment entry. Non-daily crack cocaine users and marijuana users were less likely to enter treatment. The findings can help inform rural substance abuse treatment program development and outreach.

Trajectories in Use of Substance Abuse and Mental Health Services Among Stimulant Users in Rural Areas

“…Subsequent analysis will explore potential predictors of the trajectories. Overall, we know much more regarding use of substance use services by substance users(1-2) than about mental health service use by substance users.…”

“…(9) Prior research with this sample found no association between age, race, gender, and treatment entry for substance use. (1)…”

“…We know little regarding the use of substance use and mental health services by rural drug users, although research has suggested significant interrural variation in substance usetreatment utilization(1) but few rural/urban differences in alcohol treatment attendance. (2)Overall, relatively few individuals with substance use disorders seek formal treatment.…”

“…(2)Overall, relatively few individuals with substance use disorders seek formal treatment. (3-4)Substance use treatment is generally less available to rural residents,(1; 5) partly because some rural areas do not have local programs.…”

Revisão sistemática sobre tratamentos psicológicos para problemas relacionados ao crack

“…No Brasil, não existem modelos de tratamento criados especificamente para essa demanda. Entre usuários de substâncias psicoativas em geral, usuários de crack são descritos como os que menos procuram ajuda 11 . Por isso e pela demora em buscar tratamento, a maioria dos pacientes já se apresenta aos serviços com muitos prejuízos, preferindo tratamentos em locais com internação e tendendo a ter baixa adesão ambulatorial após a internação 12 .…”