The Record (Troy, NY)

Cities again see more overdose deaths than country town

- By MIKE STOBBE AP Medical Writer

The Centers for Disease Control and Prevention found that both urban and rural overdose death rates have been rising, but the urban rate shot up more dramatical­ly after 2015.

NEW YORK (AP) » U. S. drug overdose deaths had been most common in Appalachia and other rural areas i n recent years, but they are back to being more concentrat­ed in big cities, according to a government report Friday.

The Centers for Disease Control and Prevention found that both urban and rural overdose death rates have been rising, but the urban rate shot up more dramatical­ly after 2015.

That probably is due to a shift in the current overdose epidemic, said Dr. Daniel Ciccarone, a drug policy expert at the University of California, San Francisco.

The epidemic was initially driven by opioid pain pills, which were often as widely available in the country as in the city. But then many drug users shifted to heroin and fentanyl, and the illegal drug distributi­on system for those drugs is more developed in cities, Ciccarone said.

Another possible explanatio­n: rising overdose deaths a mong blacks and Hispanics, including those concentrat­ed in urban areas, he added.

“Early on, this was seen as an epidemic affecting whites more than other groups,” he said. “Increasing­ly, deaths in urban areas are starting to look brown and black.”

The report said the urban overdose death rate surpassed the rural rate in 2016 and 2017. Rates for last year and this year are not yet available, but exper t s doubt it wi l l f lip back again any time soon.

The difference between the urban and rural counties was not large. In 2017, there were 22 overdose deaths per 100,000 people living in urban areas — counties with large and small cities and their suburbs. There were 20 per 100,000 in rural areas — non- suburban counties with fewer than 50,000 residents.

Diego Cuadros, a University of Cincinnati researcher, said the findings are consistent with what he and his colleagues have seen in Ohio.

The nation is battling the deadliest drug overdose epidemic in U. S. history. About 68,000 Americans died of overdoses last year, according to preliminar­y government statistics reported last month.

The CDC found the urban rates are driven by deaths in men and deaths from heroin, fentanyl and cocaine.

Women still die of overdoses at higher rates in rural areas, the CDC report found. And death rates tied to methamphet­amine and prescripti­on opioid painkiller­s remain higher in rural areas, too. Experts interviewe­d by The Associated Press were unable to immediatel­y explain one of the report’s findings: The urban and rural death rates were nearly identical for people ages 25 to 44, but the urban rate was significan­tly higher in other age groups, particular­ly in those ages 45 to 64. The Associated Press Health & Science Department receives support f rom the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsibl­e for all content.

 ?? STEVEN SENNE ?? FILE - In this Wednesday, Aug. 23, 2017file photo an unidentifi­ed heroin user, left, is injected by another man, right, on the street near a strip of land sometimes referred to as “Methadone Mile,” in Boston. Fatal drug overdoses in the U.S. were long known as being most common in big cities. That changed 13years ago, when Appalachia and other rural areas started seeing the nation’s highest overdose death rates. According to a government report released on Friday, Aug. 2, 2019, it’s shifted back again.
STEVEN SENNE FILE - In this Wednesday, Aug. 23, 2017file photo an unidentifi­ed heroin user, left, is injected by another man, right, on the street near a strip of land sometimes referred to as “Methadone Mile,” in Boston. Fatal drug overdoses in the U.S. were long known as being most common in big cities. That changed 13years ago, when Appalachia and other rural areas started seeing the nation’s highest overdose death rates. According to a government report released on Friday, Aug. 2, 2019, it’s shifted back again.

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