Reckoning with Opioids in Farm Country

Rampant drug abuse has long been perceived as an urban plight. But when it comes to opioid painkillers—including oxycodone, hydrocodone, fentanyl, and heroin—rural communities are on the frontlines. Five of the states with the highest rates of drug overdose deaths—Ohio, Kentucky, West Virginia, New Hampshire, and Pennsylvania—are predominantly rural. The Centers for Disease Control (CDC) has reported that rates of overdose death in rural areas have been rising higher than they have in urban areas since 2006. Today, the agency says, people living in rural areas are almost twice as likely to overdose on opioids as urban residents.Drug overdoses killed 72,000 people in 2017, according to the most recent estimates from the CDC. Claiming nearly 200 victims per day, drug overdose has become the leading cause of death for people under 50 years of age. But it does not only affect the young: In 2015, adults in the 45-to-54 age group experienced the highest death rate from overdose.In rural areas where demographics skew older, the societal impacts of nonmedical opioid use run deep. And that population is declining not only due to lower birth rates, out-migration of young adults, and an aging population, but also from mortality of working-age adults from opioid overdose.