Rural Methamphetamine & Cocaine Use
Stimulant Trafficking and Usage
In rural areas, there has been a significant increase in stimulant trafficking and usage, specifically methamphetamine and cocaine. However, there is also a strong association between stimulant usage and physical violence, especially in rural areas, as there is limited access to substance abuse treatment services. In fact, physical violence among stimulant users is of grave concern due to the injury and mortality detailed in countless reports. One such report states that in a community sample of crack cocaine users, 52 percent reported being involved in physical violence, most being daily users.
Stimulant Use and Violence
There have been a multitude of studies that have focused on the relationship between stimulant use and violence, including specific risk factors involved. A study of individuals who met the criteria for stimulant use reported that 85 percent of women and 69 percent of men had experienced lifetime physical violence. Women are also more likely to receive violence from partners, parents, and siblings, while men are more likely to receive violence from friends and other persons.5 Chermack, Booth, and Curran found that women stimulant users are at a greater risk of physical violence if they are young, alcohol dependent, or depressed, while men stimulant users are at a greater risk of physical violence if they are young, without a high school education, unemployed, married, alcohol dependent, or depressed. Stimulant users who consistently received physical violence are usually young, with a low income or unemployed, female, with substance abuse problems, and of higher psychological distress.
Teresa L. Kramer, Ph.D. and colleagues conducted a study in which they found that a quarter of their participants had reported receiving physical violence in the past year, mostly through kicking, punching, slapping, or choking by persons other than their partner. Specific demographic, clinical, and substance use variables differentiated between participants who received partner violence and those who delivered the violence.8 While men largely reported non-partner violence, women reported partner violence.8 Kramer and colleagues found that women were at a higher risk of being physically victimized if they were alcohol, cocaine, or methamphetamine dependent during the past year.8 Kramer and colleagues believe that women may become more vulnerable to the violence due to their substance use problems as they are put in more risky situations than they would be if they were not dependent upon a substance.8 These substance use problems may also exacerbate physical violence and abusive partnerships.8 Also, women who were older than 23 yet younger than 41 were more likely to receive partner violence, as this age range is associated with the child-bearing years.8 Other findings also state that women who experience partner violence are more likely to carry a weapon, which both reflects upon self-protection and aggressive behavior.8 Women in rural areas were less likely to use resources, such as police and victim advocates.8 Also, in rural areas there are not as many services available, and the woman may fear retaliation, blame, stigma, and confidentiality when seeking help.8
Stimulant Use in Rural Areas
The formation of services for individuals with stimulant use problems in rural areas could help decrease the amount of physical violence seen, especially if emphasis is put upon confidentiality and safety. Primary care doctors in rural areas should routinely screen their patients for stimulant use, where referrals can be made and violence can be cut. Interventions aimed at reducing stimulant use, including prevention and treatment programs, could significantly reduce violence among male and female stimulant users in rural areas.
 Strom, KJ.; Wong, L.; Weimer, B.; Rachal, V. NFLIS Special Report: Synthetic drugs, 2001–2004. Washington, DC: U.S. Department of Justice, Drug Enforcement Administration; 2005.
 Borders TF, Booth BM. Research on rural residence and access to drug abuse services: Where are we and where do we go? Journal of Rural Health. 2007; (23 Suppl):79–83. [PubMed: 18237329]
 Miller TR, Lestina DC, Smith GS. Injury risk among medically identified alcohol and drug abusers. Alcoholism: Clinical and Experimental Research. 2001; 25(1):54–99.
 Siegal HA, Falck RS, Wang J, Carlson RG. Crack-cocaine users as victims of physical attack. Journal of the National Medical Association. 2000; 92(2):76–82. [PubMed: 10800295]
 Cohen JB, Dickow A, Horner K, Zweben JE, Balabis J, Vandersloot D, et al. Abuse and violence history of men and women in treatment for methamphetamine dependence. The American Journal on Addictions. 2003; 12:377–385. [PubMed: 14660152]
 Chermack ST, Booth BM, Curran GM. Gender differences in correlates of recent physical assault among untreated rural and urban at-risk drinkers: role of depression. Violence and Victims. 2006; 21(1):67–80. [PubMed: 16494133]
 Walton MA, Chermack ST, Blow FC. Correlates of received and expressed violence persistence following substance abuse treatment. Drug and Alcohol Dependence. 2002; 67(1):1–12. [PubMed: 12062775]
 Kramer, T.L.; Borders, T.F.; Tripathi, S.; Lynch, C.; et al. (2012). Physical Victimization of Rural Methamphetamine and Cocaine Users. Violence Vict. 27(1): 109-124. stimulant.