The metropolitan context of substance use and substance use disorders among US adults on probation or parole supervision

Background Rates of substance use and substance use disorders are higher among adults on probation or parole supervision compared to the general population. Substance use is a risk factor of not adhering to supervision requirements, which may result in revocation and incarceration. Examining associations of metropolitan area status with substance use and substance use disorders may identify specific substance use behaviors that can be targeted in community corrections prevention and treatment services. The present study examined associations of metropolitan area residency with substance use and substance use disorders among adults on probation or parole supervision. Methods: Data came from the 2015 to 2018 National Survey on Drug Use and Health ([NSDUH]; N = 4266 adults on parole or probation). Multivariable logistic regression was run for substance-specific models for each of the two outcomes of past-year use and substance use disorder. Results: Nonmetropolitan residency was associated with higher odds of methamphetamine use and lower odds of cocaine use. Nonmetropolitan residency was associated with higher odds of methamphetamine use disorder and lower odds of opioid use disorder and cocaine use disorder. Conclusions: Study findings highlight the differences of substance use and substance use disorders between levels of metropolitan areas for those on probation or parole. Findings suggest that cocaine use should be emphasized in clinical services in large metropolitan areas, whereas methamphetamine use may be prioritized in nonmetropolitan areas. Further study is needed to investigate the interface of substance use behaviors and community corrections outcomes across metropolitan and nonmetropolitan areas.