New report on opioid crisis in rural and small-town America

The Carsey Institute has just published this policy brief by Shannon Monnat and Khary Rigg.  An excerpt follows:

Over the last two decades, opioid overdose deaths have increased over 400 percent, reaching 45,838 in 2016.  Although the crisis is not disproportionately worse in rural than in urban America, opioid mortality rates have grown faster in rural areas, particularly in the Northeast and Midwest. Rural areas also face unique challenges in dealing with the crisis, including a smaller health care infrastructure than is available in more densely populated areas, community and family factors, and labor market stressors.

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Among nonmetro counties, those in the Northeast have the highest opioid mortality rates by far (21.1), nearly double the rates in nonmetro counties in each of the other regions.
Although overall rates are higher in urban than in rural counties, rates increased more in rural than in urban counties across all regions over the last two decades (Figure 2). Between 1999 and 2016, the rate increased by 158 percent in large central metro counties, 507 percent in large fringe metro counties, 429 percent in medium/small metro counties, and 740 percent in nonmetro counties. The largest increases occurred in the rural Midwest (1,600 percent) and rural Northeast (1,141 percent).

I have blogged previously about Monnat's work regarding deaths of despair here.

P.S.  On June 20, NPR ran a comprehensive story on how some communities--the one featured is in Appalachian Ohio--are seeing a shift from opioids back to meth.  Now, however, the meth is being supplied by Mexican cartels, not home-cooked.