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Data: CDC Wonder; Chart: Andrew Witherspoon/Axios

We tend to talk a lot about how the opioid epidemic has ravaged small towns and rural areas. And it certainly has done that. But over the past few years, the crisis has hit harder in big cities, and hardest in those big cities' suburbs.

Between the lines: Toward the beginning of the epidemic, when prescription painkillers were the primary driver of overdose deaths, the death rate was higher in rural areas than in cities or suburbs.

  • Suburbs now have the highest death rate, and have seen a bigger increase over time than big cities, small cities or rural areas.
  • Deaths in cities and suburbs began to surpass rural areas around 2013 — the same timeframe in which synthetic opioids like fentanyl started killing more people than heroin or prescription drugs.

Go deeper: The opioid epidemic is a global issue

Go deeper

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