Opioid Crisis in the Rural U.S.

  • Shannon M. MonnatEmail author
Part of the National Symposium on Family Issues book series (NSFI, volume 10)


This chapter describes geographic trends in opioid mortality in the United States and discusses these trends within the broader contexts of declining U.S. rural health and “deaths of despair.” I elucidate macro-level economic and social explanations for the emergence and perpetuation of the opioid crisis. I discuss geographic variation in the crisis and summarize the consequences for rural families and communities. Some promising upstream strategies for addressing the social and economic determinants of the opioid crisis and other substance problems in the hardest-hit rural communities are proposed. Ultimately, the information presented dispels the myth that the opioid crisis is disproportionately rural and demonstrates that the magnitude of the problem varies considerably across different types of rural places. Furthermore, I urge to view the U.S. opioid problem from within the larger context of economic, family, health, and social problems occurring between and within communities along the rural–urban continuum.


Rural opioid misuse Rural opioid mortality Rural health Opioid overdose Social determinants of opioid misuse Deaths of despair Purdue Pharma 


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Authors and Affiliations

  1. 1.Syracuse UniversitySyracuseUSA

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