“…Rural residents account for 42% of the functionally illiterate, and in all but seven states, rural illiteracy rates exceed urban areas (Rural Clearinghouse, 1993). Services are hindered because rural areas tend to be less acceptable of prevention and treatment activities, have fewer trained staff, have greater transportation difficulties, and generally have higher service costs (Leukefeld, Clayton, Meyers, 1992;Vicary et al, 1996). One early study reported that rural clients were more likely than were urban clients to report marijuana, amphetamines, and sedatives as their primary drugs, whereas urban clients were more likely than rural clients to report opiates as their primary drugs (Brown, Voskuhl, & Lehman, 1977).…”