The study found that while rural and metropolitan areas both saw an increase in overdose deaths, the rural and urban death rates converged in 2004, and rural areas edged out urban areas the year after. In 2015, the rural rate of 17 deaths per 100,000 people was slightly higher than the urban rate of 16.2. In raw numbers, metropolitan areas saw six times more OD deaths than rural areas, which have about six times fewer people than metropolitan areas.
Both rural and urban areas experienced significant increases in rates of people who reported using illicit drugs within the past month. But there were also significant declines in the percentages of people with drug use disorders among those self-reporting illicit drug use in the past year.
"The drug overdose death rate in rural areas is higher than in urban areas," said CDC Director Brenda Fitzgerald, M.D. “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."
One possible reason is less availability of naloxone, known by the brand name Narcan, is rural areas. The drug that stops overdoses "is less often administered by emergency medical technicians-basics (persons trained to provide basic-level life support), who are more common in rural areas than paramedics (who can provide advanced life support care)," the report says.