Association of methamphetamine and opioid use with nonfatal overdose in rural communities.

Importance: Overdoses continue to increase in the US, but the contribution of methamphetamine use is understudied in rural communities. Question How frequently are methamphetamine and opioid use associated with nonfatal overdose in rural communities? Findings: In this cross-sectional, multistate study of rural communities, 79% of people using drugs reported past-30-day methamphetamine use; nonfatal overdose was greatest in people using both methamphetamine and opioids (22%) vs opioids alone (14%), or methamphetamine alone (6%). People using both substances reported the least access to treatment; only 17% of those using methamphetamine alone had naloxone. Meaning::These findings suggest that harm reduction and substance use disorder treatment interventions must address methamphetamine use as well as opioids to decrease overdose in rural communities