Photo: Flickr/Eric Norris
America’s rapidly increasing drug overdose problem isn’t just limited to rural areas, according to a new study by the Centers for Disease Control.
Between 1999 and 2010, the number of people dying of a drug overdose—whether prescription or illegal—increased from 16,849 to 38,329, according to the CDC. The rate of drug overdose deaths has increased from roughly 4 per 100,000 people in 1990 to 12 per 100,000 people in 2008, the latest year for which the CDC has data available.
The CDC and law enforcement groups say that much of that increase has been driven by the availability of prescription opioids such oxycodone and anti-anxiety drugs. The abuse of prescription painkillers are often seen as a “rural” problem, but data broken up by county suggests that cities have almost as much to worry about.
Between 1999 and 2009, drug poisoning deaths grew by 394 percent in rural areas and 279 percent for large metropolitan areas, according to the CDC’s county-level look at the data. The highest death rates from overdoses occurred in heavily populated areas, according to the study, published Tuesday in the American Journal of Preventative Medicine.
“It’s not just the urban/rural distinction that matters,” the CDC’s Lauren Rossen said. “In some rural areas like those in Appalachia, this is a huge problem. But others—in North and South Dakota, Northern Texas, and upstate New York—have been fairly isolated from this. It’s not as simple as an urban/rural divide.”
Rossen’s study did not differentiate between the types of drugs, so it’s possible that urban drug users are overdosing on heroin whereas rural drug users are overdosing on oxycodone or vice-versa, but previous national-scale studies have suggested that the majority of the OD uptick is being driven by prescription drugs.
According to the CDC, roughly 60 percent of all OD deaths in 2010 were caused by prescription drugs, with three-fourths of those cases involving painkillers.
It’s hard to say why rural populations in New York, Texas, and the Dakotas remained relatively insulated from the increase: New York has some of the strictest prescription drug laws in the country, including ID requirements when picking up prescriptions, tamper-resistant prescription forms, prescription limits, and laws against “doctor shopping,” but both North and South Dakota have some of the most lax prescription drug laws in the country. And though Rossen points to them as examples, the OD death rates there have increased by two or three people per 100,000 over the past decade—a rate slower than the rest of the country, but increasing nonetheless.
“We’re not sure what these states are doing right, but we’re hoping this study will cause other people to look at what they’re doing to see if there are strategies we can identify,” Rossen said.
States such as Florida, West Virginia, and Kentucky, meanwhile, have strong prescription drug laws but also high overdose rates.
Taking a look at the map, much of the country has gone from blue (a low OD death rate), to dark red (an OD death rate of more than 13 people per 100,000). Having the county-level data is helpful, but this has become a national problem, Rossen says.
“From the maps we’ve produced, it does seem to be spreading throughout the U.S. Most, if not all states have seen a fairly large rise over the past several decades,” she said. “You see it across the south, on the Pacific Coast, in New England.”