Note: This is the first in a series of emails looking at the ever-changing ways the opioid crisis hits rural Americans.

Over the course of 2015, enough opioids had been prescribed in the United States to keep every single American medicated 24 hours a day for three weeks.

Beginning in the 1990s, we experienced a "multi-system failure of regulation" where pharmaceutical companies encouraged – and even incentivized – doctors to start prescribing the brand new opioid painkiller, OxyContin.

Because the industry itself, not outside regulators, advises doctors on evaluating and mitigating the risk of these drugs, pharmaceutical execs had free rein to prioritize profits over public health. Purdue Pharma, owned by the secretive billionaire Sackler family, pushed the use of the drug for a growing number of less serious conditions and marketed it as less addictive than other types of opioid medications.

As addiction to and the abuse of prescription opioids increased over the last two decades, it fueled an inevitable explosion of abuse of illegal counterparts like heroin. Most recently, the rise in powerful synthetic opioids such as fentanyl entering the illegal drug market has increased the death toll even higher.

And throughout it all, rural communities have been bearing the brunt of this addiction. In California, Connecticut, North Carolina, Vermont, and Virginia, drug overdose deaths were significantly higher in rural counties than urban ones. Across Appalachia, the rate of fatal overdoses was 72% higher than in non-Appalachian counties by 2017. One national survey even found up to 74% of farmers say they've been personally affected by the opioid crisis.

Let that sink in: The greed-fueled opioid crisis has touched three out of every four farmers.

After over a half a million overdose deaths since 1999, far too many families and communities have struggled to recover from these losses. And that damage will take years to heal – if it ever does at all.

For now, we know for sure that it'll take decades of deliberate and compassionate policy decisions to try to undo the destruction opioid addiction has caused in our rural communities and tribal lands and to prevent future tragedies.

Anthony Daniels
Alabama House Minority Leader

Anthony Daniels is the House Minority Leader in Alabama and represents the state’s 53rd district. Daniels is the descendant of sharecroppers who later purchased their own land in Midway, Alabama, where his family has continued to plant on the same land. A graduate of Alabama A&M University, Daniels has a bachelors and masters degree in education and special education. Daniels owns and operates two small businesses with his wife, Dr. Teneshia Daniels.

J.D. Scholten
Iowa State Representative
A 5th generation Iowan, J.D. Scholten Iowa’s 4th District Representative who ran a creative, grassroots campaign that drew national attention for how Democrats can compete in rural areas. In 2018, his campaign lost by just 3% — fewer than 11K votes— in a district with 70,000 more registered Republicans than Democrats, and where Trump won by 27% in 2016. J.D. Is currently running for Iowa State House District 1 and continues to advocate for Americans in small towns across Iowa.

Founded by former U.S. Senator Heidi Heitkamp (D-ND), the One Country Project is dedicated to reopening the dialogue with rural communities, rebuilding trust and respect, and advancing an opportunity agenda for rural Americans. Our mission is to ensure rural America’s priorities and values are heard, understood, well-represented and reflected in policy in Washington.
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