Drug Overdose Death Rates in Rural Areas Exceed Rates in Urban Areas

Drug overdoses are now the leading cause of injury death in the U.S., according to a recent report from the Centers for Disease Control and Prevention (CDC) that analyzed trends in illicit drug use and disorders from 2003 to 2014 and drug overdose deaths from 1999 to 2015 in urban and rural areas. Although drug overdose death rates increased in both urban and rural areas, the rates in rural areas began to outpace those in urban areas in 2006.

“We need to understand why this is happening so that our work with states and communities can help stop illicit drug use and overdose deaths in America,” said CDC Director Brenda Fitzgerald, MD.

The researchers also reported that the percentage of people reporting illicit drug use increased in urban and rural areas during the study period:

  • large metropolitan areas: 8.3% in 2003-2005, 10.1% in 2012-2014
  • small metropolitan areas: 8.2% in 2003-2005, 9.5% in 2012-2014
  • nonmetropolitan areas: 6% in 2003-2005, 6.8% in 2012-2014

However, the effects of drug use appeared to be greater in rural areas. In 1999, drug overdose death rates in urban areas were higher than in rural areas (6.4 per 100,000 population versus 4.0 per 100,000); the rates converged in 2004; and by 2006, the rural rate was slightly higher than the urban rate (17.0 per 100,000 and 16.2 per 100,000).

“Most overdose deaths occurred in homes, where rescue efforts may fall to relatives who have limited knowledge of or access to life-saving treatment and overdose follow-up care,” the researchers explained. “Understanding differences in illicit drug use, illicit drug use disorders, and drug overdose deaths in urban and rural areas can help public health professionals to identify, monitor, and prioritize responses.”

Source: CDC press release, October 19, 2017; Mack KA, Jones CM, Ballesteros MF. Illicit drug use, illicit drug use disorders, and drug overdose deaths in metropolitan and nonmetropolitan areas – United States. MMWR. 2017;66:1-12.