Geographic Trends in Opioid Overdoses in the US From 1999 to 2020

The US opioid crisis has evolved over time.  Wave 1, in approximately 2000, was prompted by doctors overprescribing opioid painkillers, which was associated with mass addiction. Wave 2 involved heroin; OODs from heroin escalated in 2007 and surpassed those from prescription opioids by 2015. Wave 3 involved illicit synthetic opioids, such as fentanyl, the use of which escalated after 2013. Further evidence suggests a fourth wave, complicated by the addition of stimulants and the COVID-19 pandemic. To inform prevention and mitigation strategies, this cross-sectional study examined trends in OOD rates in urban and rural US counties during the 4 waves.  JAMA Netw Open. 2022;5(7):e2223631. doi:10.1001/jamanetworkopen.2022.23631 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2794742

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