Risky Substance Use Among Rural and Urban Adults: An Update

Very little research has examined the prevalence of risky substance use (alcohol and drug use) among non-metropolitan adults relative to their metropolitan counterparts.

Using publicly available and nationally representative data from the 2022 National Survey on Drug Use and Health, this project aimed to: 1) Estimate and compare alcohol use and binge drinking between non-metropolitan and metropolitan adults, and 2) Estimate and compare drug use (marijuana, other illicit drugs, and non-medical use of other drugs) between non-metropolitan and metropolitan adults.

The goal was to provide evidence about the prevalence of these risky behaviors among non-metropolitan residents that informs the allocation and implementation of prevention programs aimed at reducing risky alcohol and drug use among rural Americans.

Publications

• Non-Metropolitan vs. Metropolitan Variations in Alcohol, Illicit Drug, and Prescription Therapeutic Drug Misuse
  Policy Brief
  Rural and Underserved Health Research Center
  Date: 08/2026
  This report uses 2023 and 2024 National Survey on Drug Use and Health data to provide contemporary prevalence rates for alcohol use, illicit drug use, and prescription psychotherapeutic drug misuse among metropolitan and non-metropolitan residents nationally.