"The Opioid Hydra: Understanding Overdose Mortality Epidemics and Syndemics Across the Rural‐Urban Continuum," co-authored by Lerner Chair Shannon Monnat, was published in Rural Sociology.

The authors found that counties with high rates of prescription opioid overdoses are less populated and more remote, older and mostly white, have a history of drug abuse, and are former farm and factory communities that have been in decline since the 1990s. Overdoses in these places exemplify the "deaths of despair" narrative. By contrast, heroin and opioid syndemic counties tend to be more urban, connected to interstates, ethnically diverse, and in general more economically secure. The urban opioid crisis follows the path of previous drug epidemics, affecting a disadvantaged subpopulation that has been left behind rather than the entire community. 10/29/19