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New Report Outlines How Appalachian Counties Can Do More with Less to Combat Opioid Epidemic

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WASHINGTON – The nation’s opioid epidemic has disproportionately impacted Appalachia’s 420 counties, imposing adverse effects on county residents and government. At the turn of the millennium, the opioid overdose death rate for Appalachian counties was roughly equal to the rest of the country. But by 2017, the death rate for opioid overdoses in Appalachian counties was an astounding 72 percent higher than non-Appalachian counties.

A new report by the National Association of Counties (NACo) and the Appalachian Regional Commission (ARC) lays out the role of counties in reversing this staggering regional trend. The report, Opioids in Appalachia: The Role of Counties in Reversing a Regional Epidemic, describes how Appalachian counties are forced to do more with less.

County governments in Appalachia operate with 35 percent less per capita revenue than their non-Appalachian counterparts. As leaders of their communities, Appalachian county officials are well-positioned to drive local efforts to overcome this crisis. Counties are pursuing community-based solutions and partnerships with the public, private and non-profit sectors to address the underlying exacerbating factors of addiction.

“The opioid epidemic is like nothing we’ve seen before, and it has wreaked havoc on communities across the country, especially in Appalachia,” said NACo Executive Director Matthew Chase. “The good news is that county leaders are tackling the crisis head on. This report provides compelling insights and tools that will ultimately save lives.”

“As those on the frontlines, local officials understand well the tragic toll this crisis exacts on their communities,” said ARC Federal Co-Chair Tim Thomas. “Collaborative efforts like this help give those leaders the tools and information they need to develop local solutions. My hope is that this effort will be a benefit to local officials as they work to address this pervasive challenge.”

By the numbers:

  • In Appalachian counties, there are 84 opioid prescriptions per 100 residents compared to 58 per 100 residents in non-Appalachian counties.
  • Appalachian counties report 24 deaths by opioid overdose per 100,000 residents. This compares to just 14 deaths per 100,000 residents in non-Appalachian counties, a stark 72 percent difference.
  • The Appalachian region generally has fewer resources than other counties. In 2012, Appalachian counties generated 35 percent less revenue per capita (or, $650) than non-Appalachian counties, and spent 38 percent – or approximately $711 – less per resident than non-Appalachian counties.
  • Socioeconomic factors have aggravated the opioid epidemic in Appalachian counties, such as the low 3 percent growth in the labor force between 2000-2017 and the 2017 poverty rate of 15 percent.

The report includes seven case studies: Ross County, Ohio; Mercer County, W.Va.; Allegany County, Md.; Wilkes County, N.C.; Campbell County, Tenn.; Lincoln, McDowell, Mingo and Wayne Counties, W.Va.; and Perry County, Ky. Based on those case studies and data collected from all 420 counties in Appalachia by the NACo Counties Futures Lab, the report offers recommendations of action for county leaders to better combat this national crisis at home.

Read the full report here.


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