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Member Research and Reports

Member Research and Reports

East Tennessee Faculty Author Article on Substance Use Disorder Diagnosis

Dr. Bill Brooks, lecturer in the East Tennessee State University College of Public Health department of biostatistics and epidemiology, is lead author of an article in Addictive Behaviors: An International Journal. The article, “The effects of rurality on substance use disorder diagnosis: A multiple-groups latent class analysis” discusses the cultural differences between rural and urban populations that affect risk substance use disorders these communities.


[Photo: Dr. Bill Brooks]

Dr. Rob Pack, associate dean for academic affairs, and Dr. Arsham Alamian, assistant professor in the department of biostatistics and epidemiology, are co-authors along with Dr. Matthew McBee, associate professor in the department of psychology at East Tennessee State University.

Rates of accidental overdose mortality from substance use disorder (SUD) have risen dramatically in the United States since 1990. In rural areas, deaths from unintentional overdose have increased by > 250 percent since 1999 while urban deaths have increased at a fraction of this rate. Between 1999 and 2004 alone rates increased 62 percent nationwide, with rural overdose mortality increasing at a rate three times that seen in urban populations. Cultural differences between rural and urban populations (e.g., educational attainment, unemployment rates, social characteristics, etc.) affect the nature of substance use disorders, leading to disparate risk of overdose across these communities.

Substance abuse research has begun to consider latent classification of users as a tool for illuminating the clustering tendencies of multiple drug use. A latent class is the product of a structural equation model that represents a subtype of a population based on responses to a set of indicators. Past research into the latent classification of illicit substance users has identified distinct groups of users based on the probability of engaging in the illicit use of different drugs.

The aim of this study was to explore the possible differences in classes of latent substance abuse and dependence between rural and urban adult populations. The primary finding of this study is that rural and urban populations of adult past-year illicit substance users are qualitatively different in their risk and type of substance use disorder with respect to multiple types of drugs. Further research into the co-occurrence of substance use disorder across multiple drugs provides valuable information to prevention and treatment providers as they work to develop and implement effective programs in their target communities, whether rural or urban.

Addictive Behaviors is an international peer-reviewed journal publishing high quality human research on addictive behaviors and disorders since 1976.