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At baseline, almost half of the participants met criteria for abuse\/dependence of cocaine\u2014the primary stimulant used\u2014which decreased to 25% by the final follow-up. Similar decreases were noted in rates of alcohol and marijuana abuse\/dependence, although monthly use remained high. Participants reported minimal utilization of mental health or substance abuse services, but demonstrated significant improvements on physical and mental health measures. In summary, cocaine use declined, but other substances were used at high rates, suggesting a significant need for intervention services that address multisubstance use in rural areas.<\/jats:p>","DOI":"10.1080\/08897070903442509","type":"journal-article","created":{"date-parts":[[2010,1,28]],"date-time":"2010-01-28T11:37:25Z","timestamp":1264678645000},"page":"12-23","source":"Crossref","is-referenced-by-count":2,"title":["Two-Year Trajectory of Stimulant Use in 18- to 21-Year-Old Rural African Americans"],"prefix":"10.1177","volume":"31","author":[{"given":"Teresa L.","family":"Kramer","sequence":"first","affiliation":[{"name":"Division of Health Services Research, Department of Psychiatry and Behavioral Sciences, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brenda M.","family":"Booth","sequence":"additional","affiliation":[{"name":"Division of Health Services Research, Department of Psychiatry and Behavioral Sciences, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA"},{"name":"Center for Mental Healthcare Outcomes and Research, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaotong","family":"Han","sequence":"additional","affiliation":[{"name":"Division of Health Services Research, Department of Psychiatry and Behavioral Sciences, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2010,1,1]]},"reference":[{"key":"bibr1-08897070903442509","doi-asserted-by":"publisher","DOI":"10.3109\/10826089909037230"},{"key":"bibr2-08897070903442509","volume-title":"The DAWN Report: Amphetamine and Methamphetamine Emergency Department Visits, 1995\u20132002","author":"Roberts D L","year":"2004"},{"key":"bibr3-08897070903442509","unstructured":"Community Epidemiology Work Group (CEWG). 2004. 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