In 2017, drug overdoses killed almost as many Americans as car crashes and guns combined. https://time.com/5612549/opioid-crisis-nurses/ I think this has a much to do with the economics in many rural areas as it does with drugs. Drug overdoses can be seen as a form of suicide (or a slow suicide), and that is often due to hopelessness. Many of these rural people weathered 10 years through the Recession, with only low-paying, low quality jobs available. Meanwhile housing costs were soaring in the cities and it was difficult for them to move there for work. (Switching out a property with spacious land for a tiny yardless apartment would have resulted in a big change in lifestyle also) Drugs are only the mechanism through which this has happened, facilitating the deaths. The underlying cause is economic. Some regions of the country have been much harder hit than others. related thread: gun deaths have now exceeded car deaths - but that's only due to spike in suicides
