The Opioid Epidemic: A Geography in Two Phases

by David McGranahan and Timothy Parker

The United States is experiencing a drug overdose mortality epidemic marked by the introduction and spread of opioids across rural and urban areas. The epidemic’s effect on adults of prime working age (ages 25-54) has been substantial, with the mortality from drug overdoses more than tripling between 1999 and 2018—from 11.3 to 36.5 deaths per 100,000 people.

Keywords: Drug overdose, chronic pain, opioids, rural, epidemic, prescription painkillers, physical disability, fentanyl, heroin, mortality, economic hardship

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