Prevention Of Drug Use And Treatment Of Drug Use Disorders In Rural Settings

Drug use has traditionally been viewed as an urban and inner city problem. However, with the past decade’s increase in prevalence of substance use disorders and substance-related mortality in rural areas, there is growing international recognition that the problem of drug and other substance use has spread to rural settings across the globe. This is true for both developing and industrialized countries. The use of opioids (including heroin and the non-medical use of prescription medications), methamphetamine, cocaine, cannabis and other substances is growing. 

The United Nations Office on Drugs and Crime (UNODC) estimated that more than 247 million people between the ages of 15 and 64 used at least one drug in 2014. This represents an increase of 39 million users since 2006. Of this group, approximately 29 million people (12 per cent) have a drug use disorder. In 2016, 183 million people had used cannabis,34 million had used amphetamines and 33 million had used opioids. Roughly half of all opioid users used heroin or opium, and the remaining half used diverted prescription opioids.

Although data on the prevalence of rural drug use are not available for many countries, existing evidence suggests differing patterns of use. For example, evidence from the United States suggests that the rates of drug use across urban and rural settings are very similar. In contrast, evidence from countries such as Afghanistan reflects the growing nature of drug use in rural areas of developing countries, where drug use is greater in rural settings than in urban settings. The evidence from South America regarding rural and urban drug use is less clear. Some studies have documented the growth of drug trafficking and related problems in rural Colombia, Mexico and other countries as being  driven primarily by the limited alternative opportunities in depressed rural economies. Older studies have suggested that, despite the greater prevalence of drug use in urban settings, government officials in Chile, Ecuador and Mexico recognized the emergence of frontier patterns of use and that rural use is associated with traditional consumption (opium in Asia, coca leaves in Latin America). Given the evidence, it is reasonable to assume that rural settings are being equally damaged, if not more severely, by this growing global trend. The differing evidence across disparate countries also highlights the need for policymakers to undertake studies to quantify the prevalence of substance use in rural settings.