Non-Metropolitan vs. Metropolitan Variations in Alcohol, Illicit Drug, and Prescription Therapeutic Drug Misuse

Date
08/2026
Description

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 (metro) and non-metropolitan (non-metro) residents nationally.

Key Findings:

  • Alcohol Use. The prevalence of past year and past 30-day drinking was lower among non-metro than metro residents. However, non-metro drinkers engaged in more frequent binge drinking than metro drinkers. Drinking 3-5, 6-19, and 20-30 days over the past 30 days were higher among non-metro than metro residents.
  • Illicit Drug Use. Hallucinogens were the mostly commonly used illicit drugs among non-metro as well as metro residents. Methamphetamine use was significantly higher among non-metro than metro residents.
  • Prescription Pain Reliever Use. The misuse of prescription pain killers, primarily prescription opioids, was higher among non-metro than metro residents.
Center
Rural and Underserved Health Research Center
Authors
Tyrone Borders