Rural Drug Stats Say One Thing, Trump Says Another

Rural America In These Times October 26, 2017

October 26, 2017—Donald Trump announces a revamped war on drugs.

No part of our soci­ety, young or old, rich or poor, rur­al or urban, has been spared this plague, drug addic­tion,” said Pres­i­dent Trump on Thurs­day, pri­or to offi­cial­ly declar­ing the opi­oid cri­sis a nation­al pub­lic health emergency.

Last year, at least 64,000 Amer­i­cans died from drug over­dos­es — more than gun vio­lence and traf­fic acci­dents com­bined. That’s 175 lost Amer­i­can lives per day,” said Trump, That’s sev­en lives per hour.” In 2015, opi­oid over­dos­es alone killed 33,091 people.

Though he con­veyed an under­stand­ing of the mag­ni­tude of the prob­lem, Trump stopped short of declar­ing the opi­oid cri­sis a nation­al emer­gency (some­thing he said he would do back in August) which would allow states to receive fed­er­al funds like they do in the wake of a nat­ur­al dis­as­ter. This pub­lic health emer­gency dec­la­ra­tion doesn’t offer new funds, but rather directs the Depart­ment of Health and Human Ser­vices (HHS) to pro­vide grant mon­ey where it sees fit.

Pre­scrip­tion train­ing for fed­er­al­ly employed doc­tors, a pub­lic-pri­vate part­ner­ship with drug com­pa­nies for the devel­op­ment of non-addic­tive pain killers and a mas­sive” adver­tis­ing cam­paign aimed at con­vinc­ing kids not to start doing drugs in the first place were among the ini­tia­tives the pres­i­dent pro­posed in his speech. If we can teach peo­ple before they start, it’s real­ly easy not to take them,” said Trump. Unfor­tu­nate­ly, he also reassert­ed the need to build his ridicu­lous wall on the south­ern bor­der to help keep out heroin.

More rea­son­ably, Trump spoke about the need to crack down on the phar­ma­ceu­ti­cal indus­try. We will be bring­ing some major law­suits against peo­ple and against com­pa­nies that are hurt­ing our peo­ple and that will start tak­ing place pret­ty soon,” he said. Though Trump men­tioned expand­ing access to addic­tion treat­ment, his admin­is­tra­tion’s fail­ure to fix (and the deci­sion to instead sab­o­tage) the Afford­able Care Act means med­ical help for many who need it will be all the more dif­fi­cult to get. Insur­ance pre­mi­ums and deductibles are expect­ed to rise sig­nif­i­cant­ly next year. Mean­while, GOP House mem­bers just approved mas­sive cuts to Med­ic­aid. Sen. Bernie Sanders (I‑Vt) was quick to point this out on Twitter: 

Trump is right that the opi­oid cri­sis is a nation­al emer­gency. Unfor­tu­nate­ly, his announce­ment today was noth­ing more than an emp­ty promise. https://t.co/17NIKrgGKu

 — Bernie Sanders (@SenSanders) Octo­ber 262017

Mil­lions depend on Med­ic­aid for opi­oid treat­ment. Trump’s solu­tion is to cut Med­ic­aid by $1 tril­lion. That is a disgrace.

 — Bernie Sanders (@SenSanders) Octo­ber 262017

Trump’s speech comes one week after the Cen­ters for Dis­ease Con­trol and Pre­ven­tion (CDC) released a report that finds the rates of drug over­dose deaths are ris­ing in rur­al areas and now trend­ing high­er than the rate in cities.

Below is a video of the pres­i­den­t’s remarks and a por­tion of that report.

(Video: YouTube / CNN)

CDC reports ris­ing rates of drug over­dose deaths in rur­al areas

Rates of drug over­dose deaths are ris­ing in non­metro­pol­i­tan (rur­al) areas, sur­pass­ing rates in met­ro­pol­i­tan (urban) areas, accord­ing to a new report in the Mor­bid­i­ty and Mor­tal­i­ty Week­ly Report (MMWR) released today by the Cen­ters for Dis­ease Con­trol and Pre­ven­tion (CDC).

Drug over­dos­es are the lead­ing cause of injury death in the Unit­ed States, result­ing in approx­i­mate­ly 52,000 deaths in 2015. This report ana­lyzed trends in illic­it drug use and dis­or­ders from 2003 – 2014 and drug over­dose deaths from 1999 – 2015 in urban and rur­al areas. In 1999, drug over­dose death rates for urban areas were high­er than in rur­al areas (6.4 per 100,000 pop­u­la­tion ver­sus 4.0 per 100,000). The rates con­verged in 2004, and in 2006 the rur­al rate began trend­ing high­er than the urban rate.

In 2015, the most recent year in this analy­sis, the rur­al rate of 17.0 per 100,000 remained slight­ly high­er than the urban rate of 16.2 per 100,000.

Urban and rur­al areas expe­ri­enced sig­nif­i­cant increas­es in the per­cent­age of peo­ple report­ing past-month illic­it drug use. … The new find­ings also show an increase in over­dose deaths between 1999 and 2015 among urban and rur­al res­i­dents. This increase was con­sis­tent across sex, race, and intent (unin­ten­tion­al, sui­cide, homi­cide or undetermined).

The drug over­dose death rate in rur­al areas is high­er than in urban areas,” said CDC Direc­tor Bren­da Fitzger­ald, M.D. We need to under­stand why this is hap­pen­ing so that our work with states and com­mu­ni­ties can help stop illic­it drug use and over­dose deaths in America.”

Trends* in preva­lence of past-year illic­it drug use dis­or­der among per­sons report­ing past-year illic­it drug use, by sex and res­i­den­tial area. (Source: Nation­al Sur­vey of Drug Use and Health, Unit­ed States, 2003 – 2014)

Here are some addi­tion­al find­ings from the CDC study: 

  • The per­cent­age of peo­ple report­ing past-month use of illic­it drugs declined for youth ages 12 – 17 over a 10-year peri­od but increased sub­stan­tial­ly in oth­er age groups.
  • The per­cent­age of peo­ple report­ing past-month use of illic­it drugs was high­er for urban areas dur­ing the study period.
  • When past-month illic­it drug use was exam­ined by annu­al house­hold income, respon­dents with an annu­al house­hold income less than $20,000 had the high­est preva­lence across all three geo­graph­ic groups. Per­sons liv­ing in large met­ro­pol­i­tan areas with a house­hold income of less than $20,000 expe­ri­enced the largest increase in past-month illic­it drug use dur­ing the study peri­od (37.6%), fol­lowed by non­metro­pol­i­tan res­i­dents with a house­hold income of $20,000 – $49,999 (29.8%).
  • Amer­i­can Indians/​Alaska Natives had the high­est drug over­dose death rates in 2015 (met­ro­pol­i­tan: 22.1 per 100,000; non­metro­pol­i­tan: 19.8 per 100,000)
  • The per­cent­age change increase in age-spe­cif­ic drug over­dose deaths from 1999 to 2015 was high­er for non­metro­pol­i­tan areas than met­ro­pol­i­tan areas for per­sons aged 12 years and old­er, with the largest increase in drug over­dose deaths (411%) among those aged 18 – 25 years. For those aged 26 – 34 years, non­metro­pol­i­tan drug over­dose death rates in 2015 were high­er than met­ro­pol­i­tan rates.
  • Most over­dose deaths occurred in homes, where res­cue efforts may fall to rel­a­tives who have lim­it­ed knowl­edge of or access to life-sav­ing treat­ment and over­dose fol­low-up care. Con­sid­er­ing where peo­ple live and where they die from over­dose could improve inter­ven­tions to pre­vent overdose.
  • 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.
  • Under­stand­ing dif­fer­ences in illic­it drug use, illic­it drug use dis­or­ders, and drug over­dose deaths in urban and rur­al areas can help pub­lic health pro­fes­sion­als to iden­ti­fy, mon­i­tor and pri­or­i­tize responses.
Age-adjust­ed rates* for drug over­dose deaths, by sex and res­i­den­tial area. (Source: Nation­al Vital Sta­tis­tics Sys­tem, Unit­ed States, 1999 – 2015)

For data, tools and resources on opi­oid over­dose pre­ven­tion, vis­it CDC’s Opi­oid Over­dose web site. For more infor­ma­tion on rur­al health top­ics, visit CDC’s Rur­al Health.

This blog’s mis­sion is to pro­vide the pub­lic ser­vice of help­ing make the issues that rur­al Amer­i­ca is grap­pling with part of nation­al discourse.
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