Methamphetamine Use Lower, Opiate Use Higher in Appalachia than Nationwide

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Study Finds Methamphetamine Use Lower, Opiate Use Higher in Appalachia than Nationwide

BETHESDA, MD -- Results from a study of health disparities in the Appalachian Region show that hospital admission rates for methamphetamine use are lower across Appalachia than in the rest of the nation, while admission rates for abuse of opiates and synthetic drugs (like codeine and oxycodone) are higher, especially in coal-mining areas. Use of other illicit drugs (other than marijuana and cocaine) and non-medical use of prescription drugs are also cited more frequently as major reasons for treatment admission in coal mining areas than in other areas in Appalachia.

The study also found that mental health diagnoses for serious problems independent from substance abuse are proportionately higher in Appalachia than in the rest of the nation and that the availability of treatment for substance abuse and mental health issues is better in Appalachia.

Researchers at the National Opinion Research Center (NORC) were commissioned by the Appalachian Regional Commission to analyze differences in mental health conditions, substance abuse prevalence, and access to treatment services in the 410-county Appalachian Region as compared to the rest of the nation.

"This is the first effort to study substance abuse and mental health disparities within the Appalachian region," said Dan Gaylin, NORC's Executive Vice President for Health Research. "While many of the findings confirm concerns that have existed within the region, there are also surprises and reasons for optimism. In particular, access to substance abuse and mental health treatment is actually better in Appalachia in many ways. The case studies also highlighted several innovative programs."

Key Findings

The study found that there are place-based disparities for substance use and mental health in and across the Appalachian region. Key findings include:

Methamphetamine is not as large of a problem across Appalachia as is widely reported. While our data sources were insufficient to identify specific pockets of methamphetamine abuse that are likely to exist within the region, on the whole and admission rates for methamphetamine treatment are lower across Appalachia than in the rest of the nation. As is true across the nation, however, the regional trend for methamphetamine abuse is rising.
Opiate abuse is a primary concern across the region, especially in coal mining areas. Admission rates for primary abuse of opiates and synthetics are higher in Appalachia than the rest of the nation, especially in coal-mining areas. These drugs include codeine, hydrocodone, hydromorphone, meperidine, morphine, opium, oxycodone, pentazocine, propoxyphene, tramadol, and any other drug with morphine-like effects except methadone.
Mental health is a key area for concern in Appalachia, independent from substance abuse. While focus is often placed on mental health and substance abuse comorbidity, mental health diagnoses for serious problems independent from substance abuse are proportionately higher in Appalachia than in the rest of the nation.
While access to substance abuse and mental health treatment is a problem across the U.S., in some respects, treatment availability is better in Appalachia when compared to the rest of the nation. More forms of payment are accepted; there is greater availability of low/no cost treatment and family counseling; and 98% of facilities offer substance abuse treatment.

"Future studies may consider primary data collections on outcome assessments and evaluations of the quality and the effectiveness of clinical and community-based mental health and substance abuse interventions in Appalachia," said Zhiwei Zhang, Ph.D., NORC senior research scientist and the principal investigator of the study.

The Study Team

The study - "An Analysis of Disparities in Mental Health Status and Substance Abuse Prevalence, and Access to Treatment Services in the Appalachian Region" -- was conducted by four NORC researchers: Zhiwei Zhang, Ph.D., Alycia Infante, M.P.A. , Michael Meit, M.A., M.P.H., and Ned English, M.S. External Link

Image of Zhiwei Zhang Alycia infante Image of Michael Meit Image of Ned English

Zhiwei Zhang Alycia Infante Michael Meit Edward English

The analysis draws on four major sources of public information on mental health and substance abuse diagnoses and treatment:

National household survey of mental health and substance abuse (2002-2005);
Treatment episodes data on admissions to specialty substance abuse treatment facilities (2000-2004);
Community hospital discharge reports of diagnoses and treatment of mental health conditions and substance abuse (2004);
National survey of treatment services reported by selected participating mental health and substance abuse treatment facilities (2005).

Findings demonstrate that communities in Appalachia are targeting resources to prevent substance abuse and mental health illness, including churches, youth activities, life skills enrichment programs, school-based prevention efforts, and anti-drug coalition activities. Additional interventions, such as school based prevention programs, are needed in Appalachian communities.

In conducting the study, NORC worked with East Tennessee State University to conduct stakeholder focus groups in Central Appalachia to gain insights into community perceptions about mental health and substance abuse disparities, and community resources that are being developed to address them.

To learn more about NORC, visit www.norc.org.