Drug overdose death rates continue to rise in the United States (1–3), with significant urban–rural differences in rates by sex, age, and types of drugs involved (4). This report uses the most recent mortality data from the National Vital Statistics System (NVSS) to examine urban–rural differences in drug overdose death rates for all drugs and by selected types of opioids and stimulants.

Data from the National Vital Statistics System, Mortality ● From 1999 through 2019, the rate of drug overdose deaths increased from 6.4 per 100,000 to 22.0 in urban counties and from  4.0 to 19.6 in rural counties.

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