The CDC Reports Overdose Deaths Are Now Higher In Urban Cities Than Rural Towns

For the past ten years, drug overdose deaths in the U.S. have been most common in rural areas such as Appalachia and Coastal Plains region; however, according to a new report released by the Centers for Disease Control and Prevention (CDC) this past Friday, they are beginning to become more concentrated in cities once more. The CDC found that both urban and rural overdose deaths have been rising nationally, but the urban rate dramatically increased and exceeded the other during 2016.

The report details the years from 2016 to 2017, of which the urban overdose death rate surpassed the rural rate both years. The rates for last year and this year are not yet available, however, officials don’t predict the statistics to revert.

The CDC’s National Center for Health Statistics examined drug overdose death rates across the country using the most recent data from the National Vital Statistics System (NVSS). The NVSS data included urban and rural differences in drug overdose death rates by sex, age group, and specific drugs involved.

In 2017, there were 22 overdose deaths out of every 100,000 people in urban areas and 20 overdose deaths in rural areas. Urban counties reported higher death rates among those who overdosed on heroin, cocaine, and synthetic opioids. The CDC found that the high urban rates are driven by deaths in men and deaths from opioid drugs, particularly that of heroin and fentanyl. The drug overdose death rates were also higher for most age groups in urban areas compared to that of rural areas, especially for those ages 45 to 64.

What Caused This Change?

Many officials are contributing the CDC’s findings to be a direct result of the opioid epidemic that is currently ravaging America. The epidemic was initially driven by opioid pain pills, which were widely available in both the country and city. However, once restrictions were put in place on the amount of opioid pain medications doctors are legally allowed to prescribe, many addicted people then turned to illicit opiates. The illegal drug distribution system and resulting availability for those drugs is more developed in urban areas than in rural regions.

The rates of drug overdose deaths involving heroin, fentanyl, and tramadol were higher in urban than rural counties. It’s important to note that many people that use and become addicted to these deadly types of opioid drugs were first addicted to prescription opioid medications. Therefore, this surge in urban overdose deaths can then be tied back to the opioid crisis.

Another possible explanation includes rising overdose deaths among minorities, including African Americans and Hispanics. These populations are much more concentrated in urban areas compared to rural ones, and this could contribute to the discrepancy between the two types of communities.

Early on, the epidemic was seen as affecting whites more than other groups. Increasingly, [however,] deaths in urban areas are starting to look brown and black.

- Dr. Daniel Ciccarone, Drug Policy Expert at the University of California, San Francisco

Regardless of the reason, the nation is battling the deadliest drug overdose epidemic in history. In an effort to combat the growing number of overdoses, the CDC report also includes information about the importance of educating the public and providing appropriate pain management alternatives. In the case of an opioid overdose, the CDC advocates the use of Naloxone and to immediately seek medical assistance.

Officials are hoping that the report will generate and increase awareness, and in turn, decrease the number of deadly overdoses affecting Americans today.

Last Updated:


Jena Hilliard

Photo of Jena Hilliard
  • Jena Hilliard earned her Bachelor’s of Arts degree from the University of Central Florida in English Literature. She has always had a passion for literature and the written word. Upon graduation, Jena found her purpose in educating the public on addiction and helping those that struggle with substance dependency find the best treatment options available.

  • More from Jena Hilliard