Cities see more overdose deaths than rural cities

NEW YORK (AP) – Drug overdose deaths in the United States have been more prevalent in the Appalachians and other rural areas in recent years, but are again concentrated in major cities, according to a government report released Friday.

The Centers for Disease Control and Prevention found that rates of overdose deaths in urban and rural areas had increased, but that the rate in urban areas had increased more dramatically after 2015.

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 and fentanyl, and the system of illegal distribution of these drugs 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 affecting whites more than other groups," he said. "More and more, deaths in urban areas are beginning to appear brown and black."

The report indicates that the rate of overdose deaths 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, but experts doubt that He will return in the near future.

The difference between urban and rural counties was not great. In 2017, there were 22 overdose deaths per 100,000 population in urban areas – counties comprising large and small towns and their suburbs. There were 20 per 100,000 in rural areas – non-suburban counties with fewer than 50,000 inhabitants.

Diego Cuadros, a researcher at the University of Cincinnati, said the results were consistent with what he and his colleagues saw in Ohio.

The nation is struggling with the most deadly drug overdose epidemic in US history. According to preliminary government statistics released last month, about 68,000 Americans died of an overdose last year.

The CDC found that urban rates are due to deaths among men and deaths caused by heroin, fentanyl and cocaine.

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.

Experts interviewed by the Associated Press were unable to immediately explain one of the report's findings: urban and rural mortality rates were almost identical for people aged 25 to 44, but the urban rate was significantly higher in other age groups, especially among the 45 to 64 age groups.

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