The Opioid Crisis: Rural Communities Left Behind

by: Alexa Antin

On October 26, 2017, President Donald Trump declared the opioid epidemic a National Public Health Emergency.[1] More than 90 Americans die each day from overdosing on opioids—including prescription pain relievers, heroin, and synthetic opioids such as fentanyl.[2] Roughly 29% of patients prescribed opioids for chronic pain misuse them.[3] The economic burden of prescription opioid misuse in the U.S. is approximately $78.5 billion per year.[4] Surprisingly, the rate of opioid prescriptions increased in the U.S. after pharmaceutical companies reassured healthcare providers that these drugs were not addictive.[5] As a result, state and local governments across the U.S. have filed civil lawsuits against prescription opioid manufacturers for alleged fraudulent and deceptive marketing practices.[6]

Most recently, New Mexico’s Attorney General, Hector Balderas, filed suit against five of the largest manufacturers of prescription opioids and their related companies, as well as the country’s three largest wholesale drug distributors.[7] Although opioid addiction is a nationwide crisis, small rural communities suffer disproportionately from the epidemic’s disastrous effects. New Mexico’s drug overdose death rate is among the nation’s highest.[8] For example, in Taos County, a small community in New Mexico, there were 47 overdoses in just a four-year period, an overdose rate that is well above the national average.[9] Despite these chilling statistics, New Mexico and other rural areas’ access to the nation’s resources such as improved addiction treatment services and expansive access to opioid antagonists like naloxone is limited.[10] In contrast, larger cities spend millions of federal, state, and municipal dollars to combat the opioid epidemic.[11]

Social problems native to rural New Mexico, including poverty and restricted access to adequate health care, contribute to the state’s rampant drug use and inability to “meet the opioid fight head on.”[12] Despite these obstacles, New Mexico took the lead as the first U.S. state to increase access to antidotes such as naloxone and require all local and state law enforcement agencies to provide officers with antidote kits.[13] New Mexico’s lawsuit follows the start of Project OPEN: Opioid Preventing & Education Network, a new initiative by the state to combat the opioid crisis.[14]

Ultimately, the state hopes to redirect private opioid profits away from manufacturers and towards local communities’ efforts to combat the epidemic.[15] Attorney General Balderas characterized the lawsuit as a crucial first step in “holding these companies responsible for flooding . . . communities with prescription opioids and fueling the opioid epidemic by putting profits over people.”[16] If New Mexico’s lawsuit proves successful, it would benefit not only the state’s but also the nation’s fight against the opioid crisis; particularly, the risk of future suits would pressure national opioid manufacturers to make significant changes to their marketing and prescription practices.

[1] Dan Merica, Trump Declares Opioid Epidemic a Public Health Emergency, CNN, (October 26, 2017),

[2]National Institute on Drug Abuse, Opioid Crisis, National Institute on Drug Abuse, (June 2017),




[6] See, e.g., Morgan Lee, New Mexico Files Suit Against Opioid Makers, Wholesales, U.S. News,  (September 7, 2017),; Yuki Noguchi, 41 States to Investigate Pharmaceutical Companies over Opioids, NPR (September 19, 2017),; Mark Ballard, La. Dep’t of Health Files Suit Against Opioid Manufacturers, The Advocate, (September 27, 2017),

[7]Press Release, State of N.M. Office of the Attorney General, Attorney General Balderas Files Lawsuit Against Opioid Manufacturers and Distributors for Fueling the Opioid Epidemic that is Crippling New Mexico (Sept. 7, 2017),


[9]J.R. Logan, Inside a Small-Town Addict’s Struggle to Get Clean, High Country News, (August 8, 2016),

[10]Andy Baker-White, Emergency Declarations and Opioid Overdose Prevention, ASTHO, (June 8, 2017),

[11]Dave Rodkey, The Call for a National Emergency in Response to the Opiate Epidemic, Jurist, (August 8, 2017),

[12]Logan, supra Note 8.

[13]Susan Montoya Bryan, New Mexico Becomes First US State to Require Officers to Carry Overdose Antidote, STAT, (April 6, 2017),

[14]AG Balderas Combats Opioid Abuse with New Initiative, (January 5, 2017), Las Cruces Sun-News,

[15]Lee, supra note 5.

[16]Press Release, supra note 6.


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