Rural America countryside. Road and wild horses.

How Rural America Became the Next Victim of the Opioid Epidemic

Addiction is not a new struggle. We’ve dealt with this problem as far back as the history books go, and probably further than that.

Addiction is a difficult factor of human nature. It’s something that’s gnawed at us, silently, from the darkest corners of the deepest shadows for thousands of years. But while addiction has likely always been around, sometimes it is around with far more force and prevalence than other times. Now is one of those times.

Mired as we are in an addiction epidemic labeled a “National Public Health Emergency,” we can’t help but notice the factors that make this wave of addiction different than previous ones.

For one thing, addiction in the 21st-century is a huge problem for rural America. Rural America has been hit just as hard if not harder than urban America by this two-decade-long drug problem. And given that rural communities have never really had to contend with addiction problems before, this came as quite a blow for them.

Opioid Misuse Touched Down in Rural America

Depressed farmer.

The U.S. Department of Agriculture published a short piece on the rising presence of drug abuse in rural farming communities.

The USDA also announced its dedication to doing everything they possibly could to approach the opioid crisis with dedicated urgency.

The USDA article quoted two datums that are especially relevant. First, the USDA cited the Centers for Disease Control and Prevention on how overdose deaths in rural areas have risen so high that they surpassed overdose deaths in urban areas.

The second datum the USDA article also quoted came from the National Farmers Union and the American Farm Bureau who stated that the opioid struggle has directly impacted about 74% of farmers.

Statistics – The Creation of a Rural Epidemic

The Progressive Farmer published some concerning statistics in a research paper on opioid addiction in rural America.

According to their research, there are 15 states which are more than 50% rural. In those states, 2,854 people died from opioid drug overdose deaths in 2013. By 2016, 4,162 people died from opiate overdoses. That’s a 46% increase in just three years.

Nineteen states in the U.S. have more rural areas than the national average. In those states, 9,633 people died from opioid overdoses in 2013. But by 2016, the number of people in those same states who died from opiate overdoses rose to17,365. That is a nearly 50% increase in drug deaths.

The Centers for Disease Control and Prevention was mentioned in the Progressive Farmer article, stating, “In 1999, the drug overdose death rate for urban areas was higher than in rural areas at 6.4 per 100,000 residents, compared to 4.0 in rural areas. By 2015, rural overdose death rate per 100,000 residents spiked to 17.0 compared to the urban rate of 16.2. From 2000 to 2014, there was a 200% increase nationally in the rate of overdose deaths involving opioid pain relievers and heroin.”

When rural residents struggle with a drug habit and they do try to get help for it, they have a difficult time because 92% of addiction treatment centers are located in major urban areas, seemingly out of reach to many rural Americans.

The Rural Health Information Hub offered up an excellent chart on the relative likelihood of people living in rural communities to misuse drugs as opposed to individuals in urban areas.

History and simple public agreement have always settled on the idea that individuals in rural communities are not as likely to use drugs as individuals in other communities. Such is no longer the case.

According to the chart at Rural Health Information Hub:

  • For young people ages 12-20 in rural areas, 37.8% use alcohol, as opposed to 34.3% in urban areas. The same is true for binge drinking.
  • Cigarette smoking is also considerably more likely in rural areas than it is in urban areas.
  • Methamphetamine is another drug which has increased in rural America over urban areas. According to the chart, 0.7% of rural residents use methamphetamine, as compared to 0.04% percent or urban residents.

The facts and statistics are all there. The U.S. drug epidemic has touched down in rural America.

But why? And what can we do about it?

“In general, people who live in rural areas of the United States tend to be older, poorer, and sicker than those living in urban areas. Differences in socio-economic factors, health behaviors, and access to health care services contribute to these differences.”
Dr. Rita Noonan
Dr. Rita Noonan 

Dr. Rita Noonan wrote an article on rural drug addiction. Her report was published by the Centers for Disease Control and Prevention. According to Dr. Noonan, “In general, people who live in rural areas of the United States tend to be older, poorer, and sicker than those living in urban areas. Differences in socio-economic factors, health behaviors, and access to health care services contribute to these differences. From 1999 to 2015, the opioid death rates in rural areas have quadrupled among those 18-25 years old and tripled for females.”

Dr. Noonan hit the nail on the head. People in rural areas get injured more often, they sometimes have poorer health, and they’re cut off from big cities which provide residents with access to alternative pain relief methods which make opioids obsolete. The result? People in rural America are more likely to self-medicate on opioid pain relievers to cope with their pain.

Helping Addicts in Rural America

We have to make addiction treatment available for struggling addicts in rural areas. Addicts have a difficult time finding qualified addiction treatment centers to go to. Most are far away, and several are expensive.

But that does not mean that we can just give up on addicts in rural areas. We have to help them overcome their habits. We can do this by working with them to help them find qualified, affordable recovery centers. No one should have to walk with a drug habit on their shoulders. It’s not fair to them or their family members.

Everyone deserves a fighting chance at getting better from a drug habit. Once done, newly recovered individuals can go back home to their families and work with them to spread the word of drug-free living throughout their communities. Such is how you overcome a drug problem for good. You help those addicted overcome their habit, and then you guarantee that addiction does not come back into the community by instilling prevention efforts within that community.


Reviewed by Claire Pinelli, ICAADC, CCS, LADC, RAS, MCAP



After working in addiction treatment for several years, Ren now travels the country, studying drug trends and writing about addiction in our society. Ren is focused on using his skill as an author and counselor to promote recovery and effective solutions to the drug crisis. Connect with Ren on LinkedIn.