Driving themselves to drink: qualitative perspectives from "hardcore" DUI repeat offenders in Ohio.

Despite the continuing problem of repeat drunk driving (DUI) offenders, little is known of the characteristics of this population. This article reports findings from qualitative interviews with 12 incarcerated men who had been convicted for 5 or more DUIs. Participants' sociodemographic characteristics, patterns of substance abuse, treatment history, attitudes toward positive behavioral change, and recommendations for improving treatment are described. Three groups were identified in regard to the degree of recognition of substance abuse and level of motivation to engage in treatment and post-release rehabilitation. Participants also offered suggestions to improve treatment strategies for repeat DUI offenders by tailoring diverse educational and counseling programs that target the differing types of DUI recidivists. The findings provide preliminary qualitative insight into a unique population that may be used to inform future studies.

Criminality Among Rural Stimulant Users in the United States.

Despite the increase in media attention on "meth cooking" in rural areas of the United States, little is known about rural stimulant use, particularly the criminality associated with stimulant use. Data were collected from community stimulant users in rural Ohio, Arkansas, and Kentucky (N=709). Findings from three logistic regression models indicate that younger stimulant users (x =32.55, SD = 10.35), those with more convictions, and those who used crack frequently were significantly more likely to have been arrested for committing a substance-related crime, a property crime, or another crime in the 6-months before entering the study. Implications include the need for longitudinal studies to further understand rural stimulant use as well as increasing community and corrections-based drug abuse prevention and treatment interventions for stimulant users who live in rural areas.

"Tweaking and geeking, just having some fun": an analysis of methamphetamine poems.

There is a body of methamphetamine-themed poetry that speaks regretfully of the highly negative experiences of those in recovery from methamphetamine (MA) addiction or who feel trapped in an MA-using lifestyle. During ethnographic research in western Kentucky, the author collected two MA-themed poems from active MA users that differ from other MA poetry. They describe misadventures that occur during MA "binges." However, the text and tone of the poems are comically ironic and represent optimism rather than regret toward MA use. Analyzing these poems provides valuable insights into local patterns of MA use, related terminology, and attitudes toward MA use.

Predictors of substance abuse treatment entry among rural illicit stimulant users in Ohio, Arkansas, and Kentucky.

Illicit drug use in the rural United States is increasingly common, yet little is known about drug users' treatment-seeking behaviors. This study identifies predictors of substance abuse treatment entry over 24 months among 710 illicit stimulant users in rural areas of Ohio, Arkansas, and Kentucky. Active users of powdered cocaine, crack cocaine, and/or methamphetamine (MA) were recruited using respondent-driven sampling. Participants completed structured interviews at baseline and follow-up questionnaires every 6 months for 24 months. Data were analyzed using the Cox proportional hazards model. The paper is informed by the Anderson-Newman Model. Overall, 18.7% of the sample entered treatment. Ohio or Kentucky residence, perceived need for substance abuse treatment, higher Addiction Severity Index (ASI) legal problem composite scores, prior substance abuse treatment, and tranquilizer use were positively associated with treatment entry. Nondaily crack cocaine users and marijuana users were less likely to enter treatment. The findings can help inform rural substance abuse treatment program development and outreach.

An ethnographic exploration of self-reported violence among rural methamphetamine users.

Baseline and follow-up qualitative interviews with methamphetamine users in rural Kentucky and Arkansas examined their involvement in drug-related violence. Twelve baseline participants reported methamphetamine-related violence, whereas 20 reported violence linked to other substances. In follow-up interviews conducted 12 to 24 months later, four participants reported methamphetamine-related violence and three reported violence associated with other substances. Violence was rarely directly attributed to methamphetamine's psychoactive effects. Rather, violence was associated with disputes over methamphetamine or its use, paranoia, ill-tempers, and hallucinations during methamphetamine "binges." Implications of the findings for additional research and interventions are discussed.

Barriers to formal drug abuse treatment in the rural south: a preliminary ethnographic assessment.

This article describes barriers to obtaining drug abuse treatment in the rural South using qualitative interviews conducted with 86 illicit stimulant users recruited in rural Arkansas and Kentucky between 2003 and 2005. Fifty-nine (69.0%) of the interviewees had never entered drug abuse treatment. Sixteen (19.0%) participants reported current perceived need for treatment, while seven (8%) were ambivalent about seeking it. Interview data suggest five interrelated categories of barriers to accessing drug abuse treatment: (1) geographical, (2) organizational, (3) economic, (4) social, and (5) psychological. The study findings can inform further examination of rural treatment barriers and have important implications for developing strategies to overcome these obstacles.

The role of African-American clergy in providing informal services to drug users in the rural South: preliminary ethnographic findings.

To date, no ethnographic studies of the role of African-American clergy in providing informal services to drug users in the rural South have been reported. We use qualitative interviews with 15 African-American ministers and 26 African-American drug users in Arkansas' Mississippi River Delta region to explore this issue. All drug users reported significant religiosity, and 9 had discussed drug problems with clergy. Every minister had provided assistance to at least one drug user or their family during the previous year, including: direct counseling; referrals to treatment programs; aiding negotiations with formal institutions; and providing for basic needs. Ministers stated that clergy are not well-prepared to address drug problems, and most acknowledged a need for professional training. They also discussed barriers to education. The findings contribute to understanding rural informal drug treatment resources. They suggest that professional treatment providers should investigate the potential benefits of improving outreach efforts to assist African-American ministers engaged in drug abuse issues.

Methamphetamine use and adverse consequences in the rural southern United States: an ethnographic overview.

Research on methamphetamine use and related issues often uses data from in-treatment and post-treatment populations in urban areas. Rural ethnographic studies are less common, particularly self-assessments by active methamphetamine users that explore use patterns and their adverse consequences. Such work is especially rare in the rural South, where illicit methamphetamine manufacture and use have recently been increasing. This article presents an ethnographic overview of methamphetamine use in rural Kentucky and Arkansas based on qualitative interviews conducted with 34 active, not-in-treatment, primary methamphetamine users. Methamphetamine supply, distribution, and prevalence of methamphetamine use are described. Pathways and motivations for methamphetamine use and use patterns are outlined as well. A discussion of the adverse consequences and potential risks of methamphetamine use follows. The findings indicate that informed drug treatment outreach and reduction of potential adverse consequences among methamphetamine users in rural areas are important issues for public health and for interventions.

Barriers and pathways to diffusion of methamphetamine use among African Americans in the rural South: preliminary ethnographic findings.

There are no studies of African Americans methamphetamine use in the South where it is widespread among whites. We describe factors that inhibit or facilitate the diffusion of methamphetamine use among African Americans based on qualitative interviews with 86 drug users in rural Arkansas and Kentucky. Results suggest low prevalence of methamphetamine use among African Americans, and interviewees cited several barriers to its diffusion which were linked to the drug's ingredients, psychoactive and physiological effects, difficulty in accessing distribution networks, and established African-American preference for cocaine. Fourteen African Americans reported methamphetamine use and discussed pathways to it. Possible increases in African- American methamphetamine use merits further investigation.