Some rural areas hit by opioid epidemic don't get priority for federal response grants; CDC cites lack of county drug data

"A federal agency recommended steering the $100 million Congress appropriated for rural counties to battle the opioid epidemic to those dealing with high rates of hepatitis C infection and HIV/AIDS instead," leaving out many rural counties hit by the epidemic, Susannah Luthi reports for Modern Healthcare.

In April, the Health Resources and Services Administration said it would award 75 grants to counties to develop plans for opioid-abuse treatment and recovery, selecting counties considered "at risk" by the Centers for Disease Control and Prevention. But the CDC prioritized counties based on confirmed cases of hepatitis C instead of opioid-overdose rates, according to emails obtained by Modern Healthcare. A CDC official wrote in one that the agency's selected counties are not those "most at risk for overdose or with the highest rate of opioid overdose." The emails said the agency chose hepatitis C infection rates as the key indicator because there is no county-level measure of injection drug use.

While there is a great deal of overlap between the counties facing hepatitis C and those with many  overdoses, some counties with high overdose rates and low hepatitis C rates were left out of the CDC's recommendations. "The CDC's metrics excluded some states battling the highest rates of opioid deaths, including New Mexico, New Hampshire and Florida. Other states with equally high rates, such as Nevada and Pennsylvania, have only a few counties flagged even though they are heavily rural," Luthi reports. "Kentucky, Tennessee, West Virginia and Missouri hold the most counties recommended for funding. These states face the same high opioid overdose death rates as excluded states like New Mexico and New Hampshire. But counties in other states with significantly lower death rates, such as Kansas and Georgia, also made CDC's priority list."