Few if any communities in the United States have escaped the opioid crisis, and in 2020, opioid overdose deaths rose sharply across the entire country. But the crisis plays out differently from place to place and over time. In some states, the crisis is more profound in rural communities while in other states, it’s more of a problem in cities. The drugs in question vary from prescription opioids like oxycodone to heroin to, most recently, fentanyl, which is 50 to 100 times stronger than morphine and a primary driver of the rise in overdose deaths since 2013. And the demographics of the most affected populations change over time as well.