A Shifting Epidemic: Rural Areas Were Ground Zero Of Opioid Crisis, But Cities Now Outpace Those Death Rates

The Associated Press: Cities Now See More Overdose Deaths Than Rural Areas 
U.S. drug overdose deaths, which have been concentrated in Appalachia and other rural areas for more than a dozen years, are back to being most common in big cities again, according to a government report issued Friday. The report by the Centers for Disease Control and Prevention said the urban overdose death rate surpassed the rural rate in 2016 and 2017. Rates for last year and this year are not yet available. But experts, citing available data, say the urban rate is likely to stay higher in the near future. (Stobbe, 8/2)

The Wall Street Journal: U.S. Drug Epidemic Becoming More Urban
For years, death rates from drug overdoses rose faster in rural America, as supply chains of opioids and other drugs expanded and abuse took off. But urban overdose death rates overtook those of rural counties in 2016, the analysis by the Centers for Disease Control and Prevention showed. The findings reflect the effects of bootleg synthetic opioids such as fentanyl on a large, older cohort of longtime drug users in urban areas, some experts said. Fentanyl, a potent opioid with 50 times the strength of heroin, is a major culprit in a skyrocketing number of deaths from drug use since 2014, according to the CDC. (McKay and Kamp, 8/2)

In other news on the opioid epidemic —

Pioneer Press: Minnesota DHS Overpaid Tribes By $25.3 Million For Substance Abuse Treatment 
The Minnesota Department of Human Services overpaid tribal governments $25.3 million for treatments covered under Medicaid, according to internal memos obtained by the Pioneer Press. DHS officials learned this spring that they overpaid the Leech Lake Band of Ojibwe and the White Earth Nation for therapy used to treat substance abuse disorder, the memos state. The agency reimbursed the tribes for in-person visits with health care providers when the patients actually were self-administering the medication at home. (Faircloth, 8/1)

The Star Tribune: Minnesota Overpaid $25M To Two Tribes For Substance Abuse Treatment 
Legislative Auditor James Nobles said Thursday that his office — an independent, nonpartisan arm of the Legislature — is exploring the cause of the overpayments, when they began, why they were not discovered earlier and who was responsible. He said DHS notified his office of the overpayments about 10 days ago. The alleged overpayments were made to the Leech Lake Band of Ojibwe and the White Earth Nation to provide Suboxone, a medication used to treat opioid dependency, he said. (Serre and Howatt, 8/1)

CNN: State Of Oklahoma Tells Judge To Deliver Record $17.1 Billion Verdict Against Johnson & Johnson
In its final filing of a case being watched around the country, the state of Oklahoma implored a judge to deliver a record $17.2 billion verdict against Johnson & Johnson for flooding the state with opioids. It said the drug company created a crisis that killed more than 6,000 Oklahomans, destroyed families and wreaked havoc on communities."The source of this crisis is the flood of prescription opioids that has inundated Oklahoma for the past two decades," attorneys for the state wrote in its more than 700-page court filing. "It was brought into being by the pharmaceutical industry, including Defendants. The harm it has wrought, and the threat it continues to pose to the health, safety and welfare of the State, make it the worst nuisance Oklahoma has ever known." (Drash, 8/1)

Boston Globe: Kennedy Family Announces Death Of Saoirse Hill, Granddaughter Of Ethel Kennedy
Saoirse Kennedy Hill, the 22-year-old granddaughter of Robert F. Kennedy, died of an apparent overdose Thursday at the Kennedy compound, according to her family and law enforcement officials. A statement released by Kennedy Hill’s family Thursday night confirmed her death without providing a cause. A source familiar with the investigation said she died at the home of her grandmother, Ethel Kennedy, the 91-year-old widow of Robert F. Kennedy. (McDonald, Saric and Browning, 8/1)