Booth Brenda M, Leukefeld Carl, Falck Russel, Wang Jichuan, Carlson Robert
Division of Health Services Research, Department of Psychiatry, University of Arkansas for Medical Sciences, 5800 West 10th Street, Suite 605, Little Rock, Arkansas 72204, USA.
J Stud Alcohol. 2006 Jul;67(4):493-501. doi: 10.15288/jsa.2006.67.493.
Use and production of methamphetamine (MA) has dramatically increased in the United States, especially in rural areas, with concomitant burdens on the treatment and criminal justice systems. However, cocaine is also widely used in many rural areas. The purpose of this article is to contrast MA and cocaine users in three geographically distinct rural areas of the United States.
Participants were recent not-in-treatment adult cocaine and MA users living in rural Ohio, Arkansas, and Kentucky, who were recruited by a referral recruitment method for sampling hidden community populations. Participants were interviewed for demographics, drug and alcohol use, criminal justice involvement, and psychological distress (Brief Symptom Inventory).
The sample of 706 comprised 29% nonwhite and 38% female participants; the average age was 32.6 years; 58% had a high school education or higher, and 32% were employed. In the past 6 months, they had used either MA only (13%), cocaine only (52%), or both (35%). MA users were seldom (8.2%) nonwhite, but type of stimulant use did not vary by gender. Combined MA/cocaine users reported significantly greater use of alcohol and other drugs, including marijuana and nonprescribed opiates and tranquilizers, and reported significantly higher psychological distress. MA users (with or without cocaine use) had greater odds of recent criminal justice involvement compared with cocaine-only users.
There is a clear need for accessible substance-use treatment and prevention services in rural areas of the United States, including services that can address MA, cocaine, polydrug use, and mental health needs. There is a particular need of these services for polydrug users.
在美国，甲基苯丙胺（MA）的使用和生产急剧增加，尤其是在农村地区，给治疗和刑事司法系统带来了相应负担。然而，可卡因在许多农村地区也被广泛使用。本文旨在对比美国三个地理位置不同的农村地区的甲基苯丙胺和可卡因使用者。
研究对象为近期未接受治疗的居住在俄亥俄州、阿肯色州和肯塔基州农村地区的成年可卡因和甲基苯丙胺使用者，通过转介招募方法对隐藏的社区人群进行抽样。对参与者进行人口统计学、药物和酒精使用、刑事司法参与情况以及心理困扰（简明症状量表）方面的访谈。
706名样本中，29%为非白人，38%为女性参与者；平均年龄为32.6岁；58%拥有高中及以上学历，32%有工作。在过去6个月里，他们仅使用甲基苯丙胺（13%）、仅使用可卡因（52%）或两者都使用（35%）。甲基苯丙胺使用者很少是非白人（8.2%），但兴奋剂使用类型不存在性别差异。同时使用甲基苯丙胺和可卡因的使用者报告称酒精和其他药物（包括大麻、非处方阿片类药物和镇静剂）的使用量显著更高，且心理困扰程度也显著更高。与仅使用可卡因的使用者相比，使用甲基苯丙胺的使用者（无论是否同时使用可卡因）近期参与刑事司法活动的几率更高。
美国农村地区显然需要可及的物质使用治疗和预防服务，包括能够满足甲基苯丙胺、可卡因、多药使用及心理健康需求的服务。多药使用者尤其需要这些服务。
