In both rural and urban communities, two key factors—economic distress and the supply of opioids—predict the rate of opioid deaths, according to a working paper by Shannon Monnat, an Associate Professor of Sociology at Syracuse University, published by the Institute for New Economic Thinking.
Monnat argued that the notion of the modern opioid crisis as a “disproportionately rural phenomenon that emerged outside of the cities where the ‘War on Drugs’ has been raging for more than three decades” is inaccurate.
Instead, she contended the current drug overdose crisis is not disproportionately rural.
“I really do want to push back against this cliche that addiction does not discriminate,” she said. “The physiological processes that underlie addiction themselves may not discriminate, but the factors that put people in communities at higher risk are are not spatially random.”
She examined county-level drug mortality rates for non- Hispanic whites and found that the average drug mortality rates are highest in large metro counties, and the rates decline the further one moves away from urban areas.
Compared to urban counties, the average rate for most rural ones was 6.2 fewer deaths per 100,000 people in the 2014 to 2016 time period.
More, characteristics like family distress, population loss, and heavy reliance on mining and service industries drove up mortality rates.
“Drug mortality rates aren’t higher in economically distressed places because they’ve had a greater supply of opioid prescribing there, but because there’s something about economic distress in and of itself that helps to explain the variation that we’re seeing across the country and the magnitude of the drug crisis,” she explained.
Morrat also acknowledged that, nationally, counties characterized by more economic and family distress– such as dependence on mining or service employment, persistent population loss, higher rates of prescribing, proximity to high-prescribing counties, and counties located in states with high fentanyl exposure — have significantly higher drug mortality rates.
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Megan Hadley is a senior staff reporter for The Crime Report