The 15 states with more than half the population living in rural areas (Alaska, Montana, Wyoming, North Dakota, South Dakota, Iowa, Oklahoma, Arkansas, Mississippi, Alabama, Kentucky, West Virginia, Vermont, New Hampshire and Maine) went from 2,854 opioid overdose deaths in 2013 to 4,162 deaths in 2016, a 46 percent increase, Neely reports. Another 19 states with populations more rural than average (Oregon, Idaho, New Mexico, Kansas, Nebraska, Minnesota, Missouri, Louisiana, Tennessee, Indiana, Wisconsin, Michigan, Ohio, Pennsylvania, Vermont, Virginia, North Carolina, South Carolina and Georgia) went from 9,633 opioid deaths in 2013 to 17,365 deaths in 2016, an 80 percent jump.
But how do rural opioid deaths compare with urban deaths? In 1999 the opioid overdose death rate in urban areas was 6.4 per 100,000 residents, compared to 4.0 in rural areas. But by 2015 rural opioid overdose death rates were 17.0 per 100,000 compared to 16.2 in urban areas, Neely reports.
About 80 percent of people addicted to opioids don't receive treatment, according to a 2015 study. The reasons are various: fear of stigma, lack of money, or limited treatment options nearby. All three can be concerns for rural residents, especially lack of nearby treatment: 92 percent of treatment facilities in the U.S. are in urban areas. Click here to read more of DTN's deep dive into the rural opioid epidemic.