From 1999 to 2017, the number of Americans killed by opioid overdoses increased nearly 600 percent, from 8,048 deaths annually to 47,600, according to the National Institute on Drug Abuse. In 2017, opioid overdoses accounted for 67 percent of all deaths from drug overdoses of any kind in the U.S. That year, for the first time, opioids killed more Americans than car accidents.

Dr. Joel Rice, psychiatrist at Grand Ronde Recovery, says rural Americans are especially vulnerable to the risk factors that lead to opioid abuse. Rural communities tend to have a lot of working-class people who suffer injuries at work or in their personal lives, and many suffer with depression from lack of economic opportunities.