Black Pamela, Hendy Helen M
a Penn State University , Hazleton , Pennsylvania.
b Penn State University , Schuylkill Haven , Pennsylvania.
J Ethn Subst Abuse. 2019 Apr-Jun;18(2):224-236. doi: 10.1080/15332640.2017.1333478. Epub 2017 Jul 5.
Nonmedical use of painkillers has increased in recent years, with some authors suggesting that painkillers serve as "hillbilly heroin": a drug chosen by rural adults to cope with psychosocial stresses in their lives. The present study compared rural and urban adults for their reported use of 5 drugs during the past year (painkillers, marijuana, cocaine, methamphetamine, heroin) and for associations between these 5 drugs and their reported psychosocial stressors. This study conducted secondary analyses of anonymous survey data provided by the 2014 National Survey on Drug Use and Health with responses from 8,699 rural and 18,481 urban adults. The survey included demographics (gender, age, race, education, marital status, family income), reports of whether participants had used each of 5 illicit drugs during the past year, and measures of psychological distress and social functioning problems. Controlling for demographics, rural adults showed no greater prevalence of painkiller use than urban adults, but rural adults were more likely than urban adults to use methamphetamine and less likely to use marijuana, cocaine, and heroin. Controlling for demographics, rural adults showed no associations between psychological or social stressors and the use of painkillers, but such stressors were significantly associated with the use of marijuana, methamphetamine, and heroin. Urban adults showed significant associations of psychological and social stressors with the use of painkillers, as well as with the use of marijuana, cocaine, and heroin. Results suggest that painkillers are unlikely to serve as "hillbilly heroin" for rural adults, but they may serve as "big-city heroin" for urban adults.
近年来，止痛药的非医疗用途有所增加，一些作者认为止痛药充当了“乡村海洛因”：一种农村成年人用来应对生活中心理社会压力的药物。本研究比较了农村和城市成年人在过去一年中报告的5种药物（止痛药、大麻、可卡因、甲基苯丙胺、海洛因）的使用情况，以及这5种药物与他们报告的心理社会压力源之间的关联。本研究对2014年全国药物使用和健康调查提供的匿名调查数据进行了二次分析，这些数据来自8699名农村成年人和18481名城市成年人的回复。该调查包括人口统计学信息（性别、年龄、种族、教育程度、婚姻状况、家庭收入）、参与者在过去一年中是否使用过5种非法药物的报告，以及心理困扰和社会功能问题的测量。在控制人口统计学因素后，农村成年人止痛药的使用率并不高于城市成年人，但农村成年人比城市成年人更有可能使用甲基苯丙胺，而使用大麻、可卡因和海洛因的可能性更小。在控制人口统计学因素后，农村成年人的心理或社会压力源与止痛药的使用之间没有关联，但这些压力源与大麻、甲基苯丙胺和海洛因的使用显著相关。城市成年人的心理和社会压力源与止痛药的使用以及大麻、可卡因和海洛因的使用之间存在显著关联。结果表明，止痛药不太可能成为农村成年人的“乡村海洛因”，但它们可能成为城市成年人的“大城市海洛因”。
