Country vs. City Addictions Differ, Says SAMHSA

Country vs. City Addictions Differ, Says SAMHSA

By Hunter R. Slaton 08/16/12

Country folk are reportedly more likely to hit the bottle, while city dwellers are partial to the powders.

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"Country Cousin" likes "likker." Photo via

Just like the mid-2000s Saturday Night Live sketch, “Appalachian Emergency Room,” wherein country folk get admitted to the hospital for reasons far different from their citified counterparts—such as a nasty ferret bite or getting one’s hand stuck in a tampon machine—it turns out that urban and rural substance abusers also have significantly different drugs of choice, as well as using habits and characteristics, according to a new report from the Substance Abuse and Mental Health Services Administration (SAMHSA). Based on data from 2009, the report reveals that rural substance-abuse treatment admissions are far more likely to be court-mandated, at a rate of 51.6% (rural) to 28.4% (urban). Rural treatment clients also report primary abuse of alcohol at a much higher rate—49.5%—than do their city cousins (36.1%), in addition to non-heroin opiates (10.6% country vs. 4% city).

As you might imagine, primary abuse of traditional street drugs like heroin and cocaine score more highly in urban areas, with 21.8% of city treatment admissions citing heroin as their main poison (vs. 3.1% in the country), and 11.9% cocaine (5.6% out in the sticks). Other differences include: rural substance abusers are less likely to hit the bottle or the pipe on a daily basis (23.5% do so, as opposed to 43.1% in the city)—perhaps because they are more likely to be employed full- or part-time than those in urban areas—and more likely to have first used their drug of choice prior to turning 18 (32.1% versus 26.7% on the mean streets).