Alcohol Use Disorder and Marijuana Use Disorder Among Adolescents and Young Adults Aged 12 to 24 in the Rural and Urban U.S., 2021

This study describes the prevalence of alcohol use disorder (AUD) and marijuana use disorder (MUD) in the past year among adolescents and young adults aged 12 to 24 years in rural and urban counties and across U.S. Census Divisions in 2021.

Key Findings:

Alcohol Use Disorder

• In 2021, the prevalence of past-year AUD among adolescents and young adults aged 12 to 24 years old was 9.2% in urban and 8.5% in rural counties. AUD is a clinical diagnosis characterized by impaired control over alcohol use.
• Differences in the rates of past-year AUD between rural and urban counties and across U.S. Census Divisions were not statistically significant.
• The prevalence of past-year AUD was lowest in the rural West South Central Census Division (6.0%), while adolescents and young adults in urban counties of the West North Central (13.5%) and rural counties of the New England (13.1%) Census Divisions had the highest rates.

Marijuana Use Disorder

• In 2021, the prevalence of past-year MUD among adolescents and young adults age 12 to 24 years was 10.0% in both urban and rural counties. MUD is a diagnosable condition characterized by impaired control over cannabis use.
• The prevalence of past-year MUD varied significantly across U.S. Census Divisions overall and within both urban and rural counties by Census Divisions.
• Nationally, adolescents and young adults in completely rural counties had the lowest rate (4.2%) of past-year MUD, significantly lower than all other geographies.
• Rural adolescents and young adults in the Mountain Census Division had significantly lower rates of past-year MUD (10.7%) compared to adolescents and young adults in urban (14.9%) counties.
• The prevalence of past-year MUD in rural Pacific Census Division counties was more than double the national rate (25.3%), and significantly higher than in urban (9.6%) counties of this Census Division.