Document Type

Policy Brief

Publication Date



opioid, substance use disorder, rural, hospital, emergency department, polypharmacy, older adults, MRHRC


Increased rates of acute opioid poisoning and related emergency department (ED) visits in the United States have occurred at the same time as rural EDs face a number of resource constraints. Researchers at the Maine Rural Health Research Center conducted this study to gain insight about rural ED visits for acute opioid poisoning and how they compare with urban ED visits. The authors used data from the 2006 and 2013 Nationwide Emergency Department Sample to examine rural and urban opioid-related visits (ORVs) to EDs, including rate change over time, and the outcomes of these ED visits (treatment and release, inpatient admission, transfer, and death).

Study findings showed that ORVs as a proportion of total visits increased in rural and urban EDs between 2006 and 2013; rural ORV rates were lower than urban rates in both time periods, however this difference narrowed because of somewhat higher rural increases. Additionally, rural ORVs were more likely than those in urban areas to be by patients 65 and older and to involve concurrent use of benzodiazepines. One fifth of ORVs by rural residents occurred in urban EDs and rural EDs were more likely to transfer patients to another hospital.

More research is needed to understand the impact of rural residents’ treatment in urban EDs or other facilities on short- and long-term outcomes for patients who experience an ORV.

For more information on this study, please contact Dr. Erika ZIller,


This study was supported by the Federal Office of Rural Health Policy (FORHP), Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services (HHS) under cooperative agreement #U1CRH03716. The information, conclusions and opinions expressed in this brief are those of the authors and no endorsement by FORHP, HRSA, or HHS is intended or should be inferred.

Funding Organization

Federal Office of Rural Health Policy

Grant Number




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