This issue brief focuses on the opioid crisis in rural and small communities in the United States. It presents evidence on urban-rural differences in overdose mortality across geography and type of opioid. It also graphically shows states with rural populations that have the highest overdose death rates, identifies rural challenges and recommends strategies. 

This is a 2017 Congressional Research Service report describing which federal agencies are funding opioid-related programs.

This report from Johns Hopkins contains specific, proven recommendations for how to most effectively combat the opioid crisis –from allowing physicians to more effectively treat those suffering from addiction; to expanding coverage and accessibility of opioid overdose reversal drugs like naloxone; to changing the way that health care professionals, employers, and advocates talk about addiction to reduce stigma.

This brief from the State Health Access Data Assistance Center examines the United States opioid crisis, analyzing trends in overdose deaths from heroin and other opioids, such as prescription painkillers. Using vital statistics data, it also looks at differences in opioid deaths by age, sex, race/ethnicity and urbanization.

This is a 2015 report compiled by a multidisciplinary team focused on addressing the opioid crisis using three guiding principles: informing action with evidence, intervening comprehensively, and promoting appropriate and safe use of prescription opioids.

This is a comprehensive report that lays out the 56 recommendations made by the commission appointed by the Trump Administration to address the opioid crisis. After giving an overview of the opioid crisis and its wide-ranging impact, recommendations are made in the areas of federal funding, research, opioid addiction and overdose prevention, treatment, and recovery. 

This is an academic paper that analyzes stakeholder interviews to explore strategies to sustain time-limited opioid grants and determine barriers and facilitators. Financing and reimbursement, service integration, and workforce capacity were the most cited barriers, and status in state government structure, public support, and spending flexibility were noted as key facilitators. Strong partnerships were highlighted as essential components in strategies.  

This is a report from the Council of Economic Advisers at the White House that discusses supply and demand factors that have driven the opioid crisis. Initially driving prescription opioid deaths, prescription opioid prices fell in conjunction with expanded government health care coverage and a rising market share of generic opioids. The second wave of the opioid crisis was largely driven by an expansion in the supply of illicit opioids, reducing their prices, along with medical and public health steps implemented to reduce opioid prescribing, likely leading to an increased demand for illicitly manufactured opioids. 

This publicly-available presentation from the Maine Rural Health Research Center (author John Gale) focuses on prevention, treatment, and recovery strategies that rural communities, particularly rural hospitals, can engage in to address the opioid crisis. Additionally, examples of existing programs for each strategy are discussed in the presentation. 

This Council of Economic Advisors report from 2017 estimates the economic cost of opioid overdose deaths using conventional economic estimates for valuing life routinely used by U.S. Federal agencies. It also adjusts for underreporting of opioids in overdose deaths, includes heroin-related fatalities, and incorporates nonfatal costs of opioid misuse. 

This is a report from the Police Executive Research Forum that provides recommendations on how law enforcement can better address the opioid crisis in their communities.  

This is an informative report from the Bipartisan Policy Center that gives an overview of federal opioid funding, and where the money is going in the continuum of care. It also gives a breakdown by state with overviews of several selected states.