The Forgotten Fifth: Rural Youth and Substance Abuse
Pruitt, Lisa R., Stanford Law & Policy Review
This Article seeks to raise the visibility of the roughly twenty percent of the U.S. population who live in rural places--an often forgotten fifth--in relation to the particular challenges presented by adolescent substance abuse. Despite popular notions that substance abuse is essentially an urban phenomenon, recent data demonstrate that it is also a significant problem in rural America. Rural youth now abuse most substances, including alcohol and tobacco, at higher rates and at younger ages than their urban peers.
The Article assesses the social, economic and spatial milieu in which rural adolescent substance abuse has burgeoned. Features of some rural communities, such as a tolerance for youth and lenient and informal law enforcement responses, appear to benefit youth. Indeed, these are consistent with juvenile justice trends, such as diversion programs. Yet other characteristics of rural communities, such as limited social service and healthcare infrastructures, undermine the efficacy of such programs.
Arguing that national drug policies often reflect urban agendas and leave rural communities disserved, this Article calls for policies that are more sensitive to rural contexts. It advocates nuanced empirical research that will provide a more comprehensive understanding of rural risk factors and, in turn, inform rural prevention, treatment, and diversion programs. Finally, it argues that federal, state, and local responses to adolescent substance abuse must tackle deficiencies in rural infrastructure, while keeping in mind factors that differentiate rural places from what has become the implicit urban norm in law- and policy making.
I. THE RURAL SOCIOECONOMIC AND CULTURAL MILIEU II. SUBSTANCE ABUSE BY RURAL YOUTH A. THE PHENOMENON B. ACCESS AND AVAILABILITY III. RESPONDING TO THE PROBLEM: RURAL CHALLENGES A. EDUCATION AND PREVENTION 1. Schools 2. D.A.R.E 3. After-school programs 4. Media B. TREATMENT 1. Transportation 2. Cost C. CRIME, POLICING, AND SENTENCING D. DIVERSION PROGRAMS E. FUNDING IV. CONCLUSION
Let me bring to mind two popular and apparently unrelated American images. First, our drug problem is an urban one, manifest in cities, where men of color traffic in cocaine, crack, and other hard drugs. (1) Second, rural communities and small towns are particularly safe places to raise children. (2) In fact, both images are at least part myth--one urban legend, the other rural legend.
Substance abuse is now a greater problem among rural youth than among their urban counterparts. Rural youth not only abuse tobacco and alcohol at higher rates than urban youth, (3) they also use hard drugs such as cocaine and methamphetamine at higher rates. (4) Further, rural adolescents tend to begin using drugs at a significantly earlier age, (5) and they are more likely than their urban counterparts to sell drugs. (6)
About one-fifth of our nation's populace lives in rural (7) areas, (8) which makes rural residents a sizeable minority group. Yet, over the course of the twentieth century, as our nation evolved from a rural one into one that is dominated by cities, (9) we have become urban focused. (10) That orientation has rendered largely invisible to law- and policy-makers the rural manifestations of social problems such as illicit drug use. (11)
In fact, substance abuse has long been a problem in rural America, albeit a little known one. (12) The situation has worsened in the past few decades as rural places have increasingly become sites of drug production and shipment. This trend, along with technological advancements such as the Internet, has enhanced the rural availability of methamphetamine, cocaine, and prescription drugs. Rural communities have struggled to adjust to this evolving challenge, but they often lack the resources to provide prevention and treatment programs, and cultural differences may render national programs ineffective in rural contexts. …