Rural counties have seen a disproportionate jump in deaths from prescription-drug overdoses in the past 15 years, increasing at a pace three times that of the nation’s most urban counties. About three-quarters of all U.S. deaths caused by prescription drugs in 2014 were from opioid pain killers, making prescriptions a major part of the nation’s opioid epidemic. Rural – or “noncore” – counties saw an average increase in prescription drug deaths rates of about 9 percent per year from 1999 to 2014. Central counties of large metropolitan areas (1 million residents or more), on the other hand, saw the death rate climb by less than 3 percent per year on average over the same period. Rural counties started with lower prescription-drug death rates than cities, so smaller increases in raw numbers of deaths in rural places can mean a sharper growth in the death rate. But by the end of the study period, rural counties’ prescription-drug death rates equaled or exceeded the rates in metropolitan areas.