UAMS Researchers Find Many Rural Meth, Cocaine Users Quitting Without Treatment

By todd

LITTLE ROCK – Researchers at the University of Arkansas for Medical Sciences (UAMS) recently reported a two-year study of rural methamphetamine and cocaine users in three states that showed that many stopped using without formal substance abuse treatment during that time.


Interviews with more than 700 users of the illegal stimulants living in rural counties in Arkansas, Kentucky and Ohio also showed that despite increased use of meth in rural areas of the United States, still very few African-Americans use the drug. In addition, the study found that laws restricting purchase of over-the-counter cold medications that include ingredients used to make methamphetamine could be responsible for an increase in cocaine use.


The research results were published in the May 2008 issue of the journal Addiction. The study was intended to see how race and methamphetamine laws were associated with changes in use among rural drug users.


Regardless of race, meth and cocaine use by study participants decreased over the two-year study. The rates of recent meth use dropped from 48 percent among respondents to just about 19 percent, while cocaine (crack or powder) use decreased from 86 percent to about 60 percent.


“It is possible that some people simply get burned out,” said article lead author Tyrone F. Borders, Ph.D., an associate professor of Health Policy and Management and Epidemiology in the Fay W. Boozman UAMS College of Public Health. “We also should recognize that many stimulant users likely need treatment in order to help them reduce their use.”


Brenda Booth, Ph.D., a professor of psychiatry in the UAMS College of Medicine, was lead investigator in the Rural Stimulant Study. “Substance use is often episodic, with alternative periods of use and abstinence, but it is interesting that so many quit without formal substance abuse treatment,” she said.


Booth theorized that some individuals may have quit because of difficulties related to their substance use, such as family, law enforcement or financial problems.


“However it is important to note that a large number of people in the study continued to use methamphetamine or cocaine and have been diagnosed as having a drug dependence, which would indicate they need treatment but didn’t get it,” Booth said.


Use of cocaine and methamphetamine, both illegal and highly addictive stimulant drugs, continue to be a substantial public health problem in rural areas and small towns, the researchers said.


The study consisted of interviews between October 2002-September 2004 with users of meth or cocaine. A total of 706 stimulant users were identified in three rural counties of Arkansas, Ohio and Kentucky. The Arkansas counties were Lee, Phillips and St. Francis. For the study, a rural area was defined as a non-metropolitan area or a county with 50,000 or fewer residents.


Study participants were interviewed about their drug use at six-month intervals over the course of two years.


Among respondents living where laws restricted access to items with meth ingredients, there was a 9 percent increase in those saying they had used cocaine after the laws went into effect. The increase occurred while there was a decrease in meth use in those areas.


“While methamphetamine use declined over time among our sample of known cocaine and methamphetamine users, we did not find any association between laws targeting meth ingredients and meth use,” Borders said. “We did find that the use of cocaine increased slightly after the implementation of these laws, which suggests that some people might have increased their use of cocaine or switched from methamphetamine to cocaine when the laws reduced the supply of meth.”


Borders added that those laws may yield other benefits that would not have been revealed by this study, such as preventing new meth users. The laws also may be reducing the risk of injuries or deaths from meth lab fires or explosions, he said.


Other researchers suggested that African-American users prefer cocaine over meth because of a perception that meth had more harmful consequences and because they had limited access to the drug.


Initial interviews with study participants showed only 13 percent of African-Americans reported using meth, compared to 65 percent of white users. The data also found powder cocaine was more commonly used by whites while crack cocaine was more frequently used by African Americans.


“Methamphetamine has historically been largely produced by small scale producers, many of whom are white and may not have social networks with African-American drug users,” Borders said. “As methamphetamine production shifted to more large-scale producers, there has been concern about whether African-Americans might be able to gain easier access to methamphetamine, but this study shows methamphetamine use among African-American cocaine users remains rare.”


The researchers will continue analyzing the data to further understand the psychiatric, physical and public health consequences of stimulant use.


Along with Borders and Booth, other UAMS authors of the research article included Xiaotong Han, a research associate in the UAMS Department of Psychiatry, and Patricia Wright, a program director in the UAMS Boozman College of Public Health. UAMS collaborated with researchers in the Department of Behavioral Science at the University of Kentucky and the Center for Interventions, Treatment and Addictions Research at Wright State University in Dayton, Ohio.


The research was supported by grants from the National Institute on Drug Abuse of the National Institutes of Health.


UAMS is the state’s only comprehensive academic health center, with five colleges, a graduate school, a medical center, six centers of excellence and a statewide network of regional centers. UAMS has 2,538 students and 733 medical residents. Its centers of excellence include the Winthrop P. Rockefeller Cancer Institute, the Jackson T. Stephens Spine & Neurosciences Institute, the Myeloma Institute for Research and Therapy, the Harvey & Bernice Jones Eye Institute, the Psychiatric Research Institute and the Donald W. Reynolds Institute on Aging. It is one of the state’s largest public employers with about 9,600 employees, including nearly 1,150 physicians who provide medical care to patients at UAMS, Arkansas Children’s Hospital, the VA Medical Center and UAMS’ Area Health Education Centers throughout the state. UAMS and its affiliates have an economic impact in Arkansas of $5 billion a year. Visit