The Forgotten Fifth: Rural Youth and Substance Abuse

Lisa R. Pruitt, University of California, Davis

Abstract

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. Some 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.