October 31, 2017
2 min read

CDC: Illicit drug use declines among youth, overdose deaths increase in rural areas

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From 2003 to 2014, illicit drug use notably decreased among youth aged 12 to 17 years and illicit drug use disorders decreased in rural areas; however, drug overdose death rates increased in rural areas.

“During 1999 to 2014, annual age-adjusted death rates for the five leading causes of death in the United States (heart disease, cancer, unintentional injury, chronic lower respiratory disease and stroke) were higher in rural (nonmetropolitan) areas than in urban (metropolitan) areas,” Karin A. Mack, PhD, of the National Center for Injury Prevention and Control, CDC, and colleagues wrote. “Many factors influence the rural-urban mortality gap, including socioeconomic differences, health-related behaviors, and access to health care services. Residents of rural areas in the United States tend to be poorer and sicker than their urban counterparts, with rural residents in the South and West experiencing some of the most adverse health outcomes.”

To determine differences in illicit drug use, disorders and overall drug use deaths in metropolitan and nonmetropolitan areas, researchers analyzed National Survey of Drug Use and Health data from 2003 to 2014 for illicit drug use and disorders and from 1999 to 2015 for drug overdose deaths.

From 2003-2005 to 2012-2014, both metropolitan and nonmetropolitan areas experienced significant increases in self-reported past-month illicit drug use; however, prevalence was highest for large metropolitan areas.

Past-month illicit drug use decreased during the study period among respondents aged 12 to 17 years.

Prevalence of past-year illicit drug use disorders decreased among both metropolitan and nonmetropolitan areas from 2003 to 2014.

In 2015, drug overdose deaths were approximately six times more common in metropolitan areas, compared with nonmetropolitan areas (45,059 vs. 7,345).

Drug overdose death rates were higher in metropolitan areas in 1999 (6.4 per 100,000 vs. 4 per 100,000), converged in 2004 and were higher in nonmetropolitan areas in 2015 (17 vs. 16.2).


“The decline in illicit drug use by youth and the lower prevalence of illicit drug use disorders in rural areas during 2012 to 2014 are encouraging signs. However, the rising death rate of drug overdoses in rural areas, which surpassed rates in urban areas, along with persistent limited access to substance abuse treatment services in rural areas is cause for concern,” the researchers wrote. “Educating opioid prescribers on the CDC Guideline for Prescribing Opioids for Chronic Pain and better access to evidence-based substance abuse treatment, including medication-assisted treatment for opioid addiction, are critical steps that can be taken in communities heavily impacted by substance abuse.” – by Amanda Oldt

Disclosures: The authors report no relevant financial disclosures.