Drug Addiction, a Growing Crisis in Urban America

Updated on: April 7, 2025 BY: Longbranch Recovery Staff

Central Park in downtown NYC

Drug addiction is so widespread that it is a serious problem for both rural America and urban centers. Indeed, rural America saw an unprecedented surge in drug overdose deaths in the first 15 years of the 21st century. Some rural areas were so overrun by drug addiction that much of rural America had higher per capita overdose rates than urban areas.

That is changing now, but not for the better. Drug overdoses continue to be high in rural America. They do not reduce drug overdose at the same time are increase in urban areas. A recent CDC report shows that in the past four years alone, urban drug overdose deaths have grown rapidly, now overtaking rural America in terms of per capita overdose.

One of the main reasons for the surge in overdose deaths in urban areas appears to be the introduction of illegal fentanyl and other synthetic opioids into cities, particularly as a heroin substitute. And while correlation does not imply causality, this change in drug use trends is worth investigating further.

As drug use trends change and the types of drugs used become more deadly, community members, families, friends, coworkers, and public health leaders and policymakers need to push even harder for addicts to receive treatment as soon as possible.

What is fentanyl and why is it so dangerous?

Pharmaceutical Fentanyl is a synthetic opioid, a highly effective drug that is approved for the treatment of severe pain. Fentanyl was originally intended to treat cancer pain and help palliative care patients. Fentanyl is 50 to 100 times stronger than morphine and about ten times stronger than heroin. While fentanyl can be abused and abused by patients with a legitimate prescription for it, most of the recent spikes in fentanyl overdose have been linked to illegally manufactured fentanyl.

Opioid Overdose Deaths by Opioid Type.
Source: https://www.sciencedirect.com/science/article/pii/S0955395919300180?via%3Dihub

Drug trafficking organizations know how to make an illegal version of fentanyl. It is a chemical substance similar to fentanyl in pharmaceutical grade but made in secret drug laboratories. This illegal fentanyl is to blame for tens of thousands of deaths in recent years, including the recent surge in overdose deaths in American cities.

According to the CDC, fentanyl deaths rose 16% from 2018 to 2019, with the number of deaths in 2019 12 times higher than in 2013. That’s an increase of 1,200% in just six years. More than 36,000 people died of synthetic opioid overdoses in 2019, making it the deadliest drug in the United States.

Studying the Trend – The CDC’s Report on Urban and Rural Drug Overdose Deaths

In March 2021, the CDC released a data report from the National Center for Health Statistics that provided evidence of a worrying increase in drug overdose deaths in American cities. The highlights of the report are as follows:

  • From 1999 to 2019, the rate of drug overdose deaths in urban counties rose from 6.4 per 100,000 to 22.0 per 100,000.
  • From 1999 to 2019, the rate of drug overdose deaths in rural US increased from 4.0 per 100,000 to 19.6 per 100,000.
  • From 2016 to 2019, drug overdose death rates in urban communities exceeded overdose death rates in rural counties (per capita). From 2006 to 2016, drug overdoses per capita were higher in rural counties than in urban counties.
  • From 2015 to 2019, a surge in the illicit supply of fentanyl in American cities led to a devastating surge in fatal overdoses. In 2019, the fentanyl overdose rate in urban counties was 11.9 deaths per 100,000 population. In rural counties, the fentanyl overdose rate was 4.6 deaths per 100,000 population in the same year.
Entrance to the emergency room

Dr. Holly Hedegaard and Dr. Merianne Rose Spencer, the authors of the data letter, summarized their findings by saying: “The rates of deaths from drug overdose with heroin or cocaine were consistently higher in urban areas than in rural areas throughout the period. The rates of drug overdose deaths with synthetic opioids other than methadone (medicines such as fentanyl, fentanyl analogues, and tramadol) were similar or slightly higher in rural areas than in urban areas through 2014. The pattern changed from 2015 to 2019 with higher rates in urban counties than rural counties. ”

There seems to be a pattern here. Wherever fentanyl use increases, be it one year in rural communities or the next year in urban communities, deaths from overdose are increasing. This is worrying for many reasons. For one thing, one might speculate that the number of overdose deaths per capita in urban counties should be lower than in rural areas, as addicts in such areas have better access to health services, emergency medical care and addiction treatment. But even with all of these factors, fentanyl is so powerful, so addicting, and so much stronger than other opioids very easy to overdose and die from. This type of drug requires a special treatment program to safely detox patients.

Another study examines rising fentanyl overdoses in western cities

The Centers for Disease Control and Prevention is not the only organization ringing the alarm bell about rising fentanyl overdose deaths in US cities. The diary, Elsevier Public Health Emergency Collection, released a report in September 2020 highlighting the increase in fentanyl overdoses in urban counties west of the Mississippi River.

That report found that in Denver County, CO; Harris County, TX; King County, WA; Los Angeles County, California; and Dallas-Fort Worth, TX, death rates from synthetic opioids like fentanyl rose 371% from 2017 to 2019. In addition, this report also confirmed CDC data showing that fentanyl is also found in other drugs such as heroin, stimulants, and prescription drugs.

Treatment of Drug Addiction – Get rid of Drugs in Urban and Rural America

Whether you live in a city or in the country, fentanyl addiction puts your life at risk every day. Fentanyl kills. It’s much stronger than heroin or prescription opioid pain relievers. Still, addicts often take fentanyl like heroin or pain relievers. Their bodies are quickly overwhelmed by the drug, they overdose and they die.

Fentanyl is dangerous and deadly if used incorrectly stop use as soon as they start. This is why it is so important that fentanyl addicts get help through treatment and that their family members and loved ones help them find treatment.

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