U.S. drug overdose deaths had been most common in Appalachia and other rural areas in recent years, but they are back to being more concentrated in big cities, according to a government report Friday.
The Centers for Disease Control and Prevention found that both urban and rural overdose death rates have been rising, but the urban rate shot up more dramatically after 2015.
That probably is due to a shift in the current overdose epidemic, said Dr. Daniel Ciccarone, a drug policy expert at the University of California, San Francisco.
The epidemic was initially driven by opioid pain pills, which were often as widely available in the country as in the city. But then many drug users shifted to heroin and fentanyl, and the illegal drug distribution system for those drugs is more developed in cities, Ciccarone said.
Another possible explanation: rising overdose deaths among blacks and Hispanics, including those concentrated in urban areas, he added.
“Early on, this was seen as an epidemic affecting whites more than other groups,” he said. “Increasingly, deaths in urban areas are starting to look brown and black.”
