An introductory paper on drug and alcohol use by youth in rural America advises that although rural communities may have slightly lower levels of drug-use problems than urban areas, these differences are increasingly small. Another paper used the American Drug and Alcohol Survey to compare drug use among youth in smaller rural towns, larger rural towns, and urban communities. The study found that most of the differences in drug use by community size were no longer present by the time rural youths reached the 12th grade. Prevention and treatment resources are more scarce in rural communities. Another paper reviews 65 reports of research on the use of alcohol, marijuana, and hard drugs by rural youth. The study found that only the use of hard drugs was significantly lower among rural youth. A study of drug use patterns among American Indian and Alaskan Native rural youth found exceptionally high levels of drug use, possibly due to uncertain economic conditions, family instability, and lack of access to cultural values. Remaining papers assess the accessibility of drug and alcohol treatment for rural youth, as well as rural drug abuse research needs and research policy. Tabular data, references, and a subject index