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 Addiction Severity Index (ASI) legal problem composite scores, prior substance abuse treatment, and tranquilizer use were positively associated with treatment entry. Nondaily 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.

KEYWORDS:

• Cocaine
• crack
• drug abuse treatment
• methamphetamine
• rural
• substance abuse

This research was supported by National Institute on Drug Abuse grant R01 DA15363 to Brenda M. Booth and grant R01 DA14340 to Harvey A. Siegal, who died on December 22, 2004. Robert G. Carlson was appointed principal investigator of R01 DA14340. The contents of this study are solely the responsibility of the authors and do not necessarily represent the official views of the National Institute on Drug Abuse or the universities involved. The authors thank Patricia Wright, Joni Furlong, Kathy Russell, Leslie Cena-Talley, Michelle Jones, Ever Jean Ford, Rance Lewis, Abe Lovelace, Brad Johnson, and Desi Sims for data collection in Arkansas and Kentucky. In Ohio, the authors thank Terrie Hottle, Heather Overbay, James “Smitty” Smith, Jr., and Mekia Winder for data collection, and Paul Draus for ethnographic research and recruitment of study participants. The author thank Linna Li for data management and Janet Kuester for proofreading. A previous version of this paper was presented at the Addiction Health Services Conference, Little Rock, Arkansas, October 2006.

Notes

^a Number of cases in drug treatment by period.

^b Conditional probability of being in drug treatment in each period.

^a Use versus no use in the previous 30 days.

∗Statistically significant at .05 level.