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Published in Print: February 2, 2000, as Health Update

Health Update

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Drug Use More Prevalent Among Rural Teenagers, Study Warns: Contrary to the popular image, teenagers in rural and small-town America are much more likely than their urban peers to have used drugs, concludes a study released last week.

The report, "No Place to Hide," by the National Center on Addiction and Substance Abuse at Columbia University, says that 8th graders in rural areas are 104 percent more likely than those in big cities to pop amphetamines, and 50 percent more likely to smoke or sniff cocaine.

The study also found that 8th graders living in rural areas were 83 percent more likely to use crack cocaine, 34 percent more likely to smoke marijuana, and 29 percent more likely to drink alcohol.

"As we begin the 21st century in America, there is no place to hide from the problem of substance abuse and addiction," said Joseph A. Califano Jr., the president of the New York City-based research group.

The rate of use for 10th graders in rural areas exceeded that of sophomores in large urban areas for every drug except marijuana and the so-called designer drug Ecstasy, according to the study. High school seniors in rural areas used more powdered cocaine, crack, amphetamines, inhalants, and alcohol than 12th graders in large urban areas.

Mr. Califano, a former U.S. secretary of health, education, and welfare, called on the Clinton administration and Congress to provide money to fight drugs in rural areas and small and midsize cities that would match the $1.6 billion aid plan the administration has proposed to help with Colombia's drug war.

The study is based on analyses of previously unreleased substance-abuse research, state statistics and studies, and interviews with local law-enforcement officials. Read the report, No Place To Hide. (Requires Adobe's Acrobat Reader.)


Mass Hysteria?: In November 1998, a Tennessee high school temporarily closed after a number of students and teachers fell ill from symptoms attributed to toxic fumes. An exhaustive investigation found nothing. But an article in the Jan. 13 issue of The NewEngland Journal of Medicine says the culprit may have been mass hysteria.

"There was no toxic exposure that would have explained the overall outbreak," said Dr. Timothy F. Jones, an epidemiologist with the Tennessee health department and the lead author.

The outbreak at 1,800-student Warren County High School in McMinnville began after a teacher noticed a gasoline-like smell in her classroom. Shortly thereafter, she began experiencing headache, nausea, shortness of breath, and dizziness. Similar symptoms developed in a number of her students.

As her classroom was evacuated, more students reported symptoms, and a schoolwide alarm was sounded. Classes were canceled, and 100 people went to the local hospital emergency room, where they reported symptoms believed to be associated with exposure at the school. When Warren County High reopened five days later, students again reported symptoms, and the school was evacuated and closed.

Following that closing, an extensive environmental and epidemiological investigation took place that included the U.S. Environmental Protection Agency, the state health department, and local emergency personnel.

While no medical or environmental cause could be identified, the researchers writing in the Journal of Medicine noted that the illness had the characteristics of mass hysteria.

"There was a wide variety of symptoms which didn't fit with a known medical cause," Dr. Jones said in an interview. And, he noted, those who saw another ill person during the outbreak or knew a classmate who had been taken ill were more likely to become sick themselves.

Doctors and others may be reluctant to pronounce such an outbreak as mass hysteria because the interpretation is that those involved "made this up," Dr. Jones said. But such a diagnosis is not meant as a criticism. "This is an example of the powerful impact environment can have on you," he said.


Anorexia: The incidence of the eating disorder anorexia continues to increase in young women, according to a recent study from the Mayo Clinic.

Researchers updated a 50-year study in the diagnosis of the disorder in residents of Rochester, Minn., where the clinic is located.

Mayo Clinic researchers had previously reported on 50-year trends in the incidence of anorexia in Rochester dating to 1935. Looking at medical records—those of 2,806 mostly female patients ages 10 to 57—they found that the incidence of the disorder in women was stable, except for 15- to 24-year-olds. The overall rate, however—again excluding the young women—dropped during the period 1985 to 1989 from its peak between 1980 and 1984.

But for the group considered most vulnerable to societal and psychological pressures, 15- to 24-year-olds, anorexia continued its steady rise from the 1930s during 1985 to 1989, the most recent period studied. A major reason is "the cultural ethos to be thin," the researchers write.

—Adrienne D. Coles

Vol. 19, Issue 21, Page 8

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