Structural Deprivation, Rural Segregation, and Substance Use—A Hungarian Case Study

New designer drugs are a major public health concern, particularly in disadvantaged, segregated communities. While the phenomenon is better understood in urban settings, it remains unexplored in rural areas. This gap explains our research rationale: an interdisciplinary survey was designed; the fieldwork took place in Hungary, in a segregated rural area (n = 425), in 2022. The complex sociological-psychological-existential trap represented by rural segregation is characterized by the lack of prospects for change. As the individual’s attention is narrowed to the present, such a burdensome existence is managed through escapist strategies of substance use. Our research investigates whether substance use is a cause or a consequence of structural deprivation. K-means cluster analysis was used to differentiate between the idealtypical patterns of substance use (e.g. self-controlling vs. risk-taking) and abstinence (e.g. vulnerable vs. consistent); chi-square tests were used to map the structural background and trajectories leading from abstinence to substance use.