Abstract
The purpose of this chapter is to outline the history and development of the opioid crisis; to identify impacts to rural America; to elaborate on the implications to individuals, families, and communities; and to identify resources for these communities. The level of use, misuse, and impact of opioids on communities has caught national attention and has been labeled a national crisis. The opioid epidemic has hit rural communities especially hard with community members citing opioid abuse as the biggest problem in their communities. To better understand the current epidemic, it is important to understand historical trends in relation to opioids and opioid related substances; the War on Poverty; the recession of 2007; job loss; and the shifting of urban/rural divide politically, financially, and economically. The flooding of opioids into these communities impacted every system, with layered consequences.