A dearth of substance abuse treatment facilities exacerbates the rural drug epidemic.

The Office of National Drug Control Policy has identified issues unique to the rural drug epidemic. In 2008, over 23 million Americans ages 12 or older needed treatment for an illicit drug or alcohol use problem. However, less than 10% received the necessary treatment for their disorders. In 2008, rural Americans used illicit drugs at lower overall levels of current use than their suburban and metropolitan counterparts and tended to also show lower rates of diagnosable drug abuse and dependence, but rural youth indicate higher rates of use, particularly for methamphetamines, prescription pain killers, and alcohol. Read more here.

Just under a month ago, the National Survey of Substance Abuse Treatment Facilities issued a report regarding the disparities between rural and urban drug treatment services. This report highlights yet another example of how those who live in rural areas are less likely to have access to critical social services simply by virtue of where they live. However, the data isn't as straightforward as that. There is actually some evidence that rural treatment facilities are providing more comprehensive care than their urban counterparts.

Based on this report, it appears as though rural facilities are lacking in a number of areas. Rural facilities are less likely to involve mentoring and/or peer support (32% of rural facilities contain these services whereas 51% of urban facilities have some such service), self-help groups (29% compared to 47%), and employment counseling or training for clients (25% instead of 40%). Urban facilities were also more likely to give HIV or AIDS education, counseling, or support (43% in rural facilities versus 63% in urban treatment centers), early intervention for HIV (15% instead of 34%), or general health education (35% compared to 58%). Other previously-issued reports from the Carsey Institute serve to further substantiate these claims.

However, despite these deficiencies, rural treatment centers are doing better than urban ones with respect to a few key issues. Rural facilities were more likely than their urban counterparts to combine treatment with mental health services (56% of urban facilities contained these services versus 64% of rural treatment centers). Both urban and rural facilities were equally likely to provide case management services, and there were only minor disparities in rural facilities' ability to provide assistance with obtaining social services, domestic violence—family or partner violence services, and child care for clients' children.

As someone whose family has dealt with finding suitable substance abuse treatment options, I can attest to the fact that having a range of options to choose from makes the process much easier. Something as simple as having a choice between a facility that provides only a 12-step program approach and one that provides a cognitive therapy model in conjunction with a 12-step program can go a long way in convincing a family member that the treatment facility will be effective and therefore worthwhile.

If the nation stands a chance of combating the growing epidemic of substance abuse, we will need to adequately research and address the disparities and inadequacies that exist as a result of rural spatial isolation, and also ferret out those programs that work well in rural areas in order to try replicating them in an urban setting.