Aug 7, 2019

Drug overdose deaths spike in urban America

Reproduced from NCHS; Chart: Axios Visuals

For years, death rates from drug overdoses surged in rural America. But now, overdose death rates are rising faster in cities, according to a newly released data analysis from the Centers for Disease Control.

What's happening: The opioid crisis has devastated many rural areas while heroin deaths are climbing in urban centers.

  • Deaths involving fentanyl, a potent synthetic opioid that's been a major factor in the drug epidemic, are higher in urban areas. Heroin and cocaine are also bigger problems in cities.
  • Overdoses linked to natural and semi-synthetic opioids like oxycodone and morphine are higher in rural counties. So are deaths linked to psychostimulants like methamphetamine.

The big picture: Urban and rural America have taken turns in leading the overdose toll, but the rates have never been very far apart. So while cities took the lead since 2016, the real takeaway from the data is that the drug epidemic is everywhere.

  • One level deeper: A recent analysis of CDC data by Axios' Sam Baker shows that the drug epidemic is hitting hardest in the suburbs of big cities.

Silver lining: The CDC report covers data through 2017, so it does not include provisional 2018 data indicating that drug overdose deaths may be on the decline for the first time in 30 years.

  • Yes, but: While overdoses from prescription opioids are falling, deaths from fentanyl, cocaine and meth all continued to increase last year.

Go deeper: Critical opioid funding is running out

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The rural America death spiral

Illustration: Sarah Grillo/Axios

Many of the nation's current pathologies are taking a heavy toll on the majority-white population living in rural America, which was severely impacted by the opioid crisis and has dealt with falling populations, job losses and rising suicide rates.

Why it matters: The malaise and discontent that President Trump has tapped into goes beyond the racism we've seen over the past few weeks and includes anger at a changing world and frustration at dwindling opportunities close to home. These trends are further entrenching the rural-urban schism that came to light in the 2016 election.

Go deeperArrowAug 12, 2019

The dire state of rural mental health care

Photo: John Fedele/Getty Images

There is one psychiatrist in eastern Montana, the state with the highest suicide rate in the country, reports Bloomberg.

Why it matters: That's reflective of the availability of mental health care throughout the country, especially in rural areas. There's plenty of need, but not enough providers; in fact, the number of mental health providers has been falling for decades.

Go deeperArrowAug 16, 2019

Wall Street's fear of an opioids settlement

Data:; Chart: Axios Visuals

The stock prices of AmerisourceBergen, Cardinal Health and McKesson plummeted yesterday after Bloomberg reported the drug distributors made an opening offer of $10 billion to settle their portion of the national opioids lawsuit.

Between the lines: That figure was a lot higher than Wall Street had expected for those companies, indicating that other defendants — including opioid manufacturers — likely would pay tens of billions of dollars to avoid going to trial.

Go deeperArrowAug 7, 2019