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NEW YORK – The number of drug overdose deaths in the United States, which have been concentrated in the Appalachian and other rural areas for more than a dozen years, is again widespread in major cities government report released Friday.
The report from the Centers for Disease Control and Prevention indicates that the overdose mortality rate in urban areas has exceeded the rate in rural areas in 2016 and 2017. Rates for last year and this year are not yet available. . The experts, citing the available data, believe, however, that the urban rate should remain higher in the near future.
The difference between urban and rural counties was not great. In 2017, there were 22 overdose deaths per 100,000 people in urban areas, compared with 20 per 100,000 in rural areas.
The nation is struggling with the most deadly drug overdose epidemic in US history. About 68,000 Americans died of overdoses last year, according to preliminary CDC statistics released last month.
Experts believe that the epidemic is unfolding differently in different parts of the country and believe that it is better understood by comparing geographical regions, for example Appalachian and Northeast.
The new CDC report examined overdose deaths in urban and rural areas across the country. The researchers found that both rates were rising, but that the urban rate increased more dramatically after 2015 to exceed the rural rate.
New York, Chicago and Baltimore have all reported dramatic increases in the number of overdose deaths in recent years, and they are not the only ones.
Diego Cuadros, a researcher at the University of Cincinnati, said the findings of the CDC were consistent with what he and his colleagues saw in Ohio.
"Most hot spots are in urban areas," he said.
The CDC found that urban rates are due to deaths among men and deaths caused by heroin, fentanyl and cocaine.
This is likely due to a change in the current overdose epidemic, said Dr. Daniel Ciccarone, an expert on drug policy at the University of California at San Francisco.
The epidemic was initially caused by opioid pills for pain, which were often as widely available in the country as in the city. However, many drug users have turned to heroin, then fentanyl, and the illicit drug distribution system for heroin and fentanyl is more developed in cities, said Ciccarone.
Another possible explanation is the increase in overdose deaths among blacks and Hispanics, including those concentrated in urban areas, he added.
"At first, it was perceived as an epidemic that affects whites more than other groups," he said. "More and more, deaths in urban areas are beginning to appear brown and black."
Women still die from overdoses at higher rates in rural areas, according to the CDC report. And death rates for methamphetamine and prescription opioid badgesics also remain higher in rural areas.
Using data from death certificates, CDC researchers examined whether overdose victims lived in rural or urban counties at the time of death. They defined urban areas as counties with big and small cities and their suburbs. Rural areas were non-suburban counties with fewer than 50,000 inhabitants.
The report examined trends from 1999 to 2017. Overdose death rates for 2018 will be released later this year.
Mortality rates in urban and rural areas were almost identical for people aged 25 to 44 – the age group with the most serious fatal overdose problem. "Drug epidemics tend to affect young people," said Ciccarone.
However, the urban prevalence rate was significantly higher in the other age groups, especially among those aged 45 to 64 years. Experts interviewed by the Associated Press explained that the reasons why the urban overdose mortality rate was significantly higher among middle-aged and older Americans.
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