Department for Local Government
ARC Study: Disproportionately High Rates of Substance Use in Appalachia

Press Release Date:  Thursday, August 14, 2008  
Contact Information:  Cindy Lanham

(LONDON, Ky) April 12, 2008—According to an ARC commissioned study announced today by Kentucky Governor Steven Beshear and ARC Federal Co-Chair Anne Pope, Appalachia suffers from disproportionately high rates of substance use and mental health disorders, including the alarmingly increasing abuse of prescription painkillers. Conducted for ARC by the National Opinion Research Center (NORC) at the University of Chicago, the study also reveals that Appalachia is doing better than the rest of the nation in terms of access to treatment for substance use and mental health problems.

The study analyzes the disparities in mental health status and substances abuse prevalence, as well as access to treatment services, across the 410 counties and 13 states of Appalachia by using community hospital discharge data, national household survey data, and treatment episode data. To supplement quantitative data sources, case studies were conducted in partnership with East Tennessee State University (ETSU) to gather additional information.

The study’s findings demonstrate particular disparities associated with Appalachian sub-regions, county economic distress level, and within coal-mining areas that all confirm the presence of a place-based disparity in the Region.

Governor Beshear stated that the study “clearly illuminates a major problem we are facing all across Appalachia, and particularly in our state’s 51 ARC counties.  This is why it is imperative that we do not lose productive members of our workforce, or particularly our kids, the future of our towns, to drug addiction.”

Noting that substance abuse had become a “major impediment to economic growth in the Appalachian Region,” ARC Federal Co-Chair Anne Pope said that the report was a great help to “scientifically understand the scope of the problem.” But, Pope noted, it was then essential “to doing something about it.”

To that end, Pope and Beshear announced a $250,000 ARC grants competition to assist communities in improving their intervention and service programs dealing with illegal drugs and prescription drug abuse. The grants being offered will range from $40,000 for individual communities, with the possibility of as much as $75,000 for multi-state grants. More information about the grants competition is available at

Key findings from the study include the following:

Substance Abuse:

·         Prescription Painkillers: The admission rates for primary abuse of other opiates and synthetics are higher in Appalachia that the rest of the nation, especially in coal-mining areas. The trend is rising all across the nation, but at a faster pace in Appalachia. The rate in Appalachia is more than twice that of the U.S., and it doubled from 2000-2004.

·         Meth: Usage and admission rates for methamphetamine are lower across Appalachia than in the rest of the nation although the regional trend is rising.

·         Alcohol: The study finds that alcohol is still the predominant substance of abuse nationally and in Appalachia.

Mental Health

·         Mental health diagnoses for serious problems independent from substance abuse are proportionately higher in Appalachia than in the rest of the nation.

·         Mental health problems are not equally distributed across the Region, with higher rates of serious psychological stress and major depressive episodes in central Appalachia as compared to northern and southern Appalachia.


Treatment of Substance Use and Mental Health Disorders:

·         Adults in the Appalachian Region with mental health problems reported a somewhat greater likelihood of having received outpatient mental health treatment or counseling in the past year as compared to adults outside the Appalachian region, according to the national household survey.

·         The vast majority of Appalachia treatment facilities offer some substance abuse treatment.

·         While access to substance abuse and mental health treatment is a problem across the U.S., in some respects, treatment availability is better in Appalachia when compared to the rest of the nation.


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