This paper explores the reasons that nonmedical prescription opioid misuse is higher in rural areas compared with urban areas. The authors hypothesize that reasons are related to increased sales of prescription opioids in rural areas, out-migration of upwardly mobile young adults, tighter social networks, and socioeconomic distress.
Keyes, K.M., Cerdá, M., Brade, J.E., Havens, J.R., Galea, S. (2014). Understanding the Rural–Urban Differences in Nonmedical Prescription Opioid Use and Abuse in the United States. American Journal of Public Health, 104(2), e52-259.