Lorne Cross, MD

Addiction Treatment
How the Rural Opioid Crisis Differs from the Urban One

How the Rural Opioid Crisis Differs from the Urban One

As the opioid epidemic continues to rages across most of the United States, lawmakers and other concerned parties remain somewhat clueless as to how to effectively battle the problem. Part of finding a solution is determining the cause, and unfortunately, there’s not a one-size-fits-all answer. According to a new working paper by Shannon Monnat, a Syracuse University sociologist and the Institute for New Economic Thinking, in both urban and rural communities, opioid supply and economic distress are two key factors in predicting opioid deaths but not in equal measures. While addiction doesn’t discriminate in terms of the underlying physiological processes, it does in the sense that the factors that force people into communities at a higher risk of drug addiction aren’t random.


Drug mortality rates are highest in large metro areas, but that doesn’t mean rural areas aren’t experiencing the issue too. In rural counties, the average rate of overdose deaths for 2014 to 2016 is 6.2 fewer deaths per 100,000 people. However, some rural counties, like Central Appalachia, Southwest Pennsylvania and Central Florida, are experiencing higher than average rates while others have lower than average rates, like New York and the Mississippi Delta.


Besides drug availability and economic distress, other economic characteristics like population loss, family distress, and heavy reliance on mining and service industries also contribute to higher mortality rates. When controlling for supply-side factors, a study found that economically distressed areas aren’t more likely to have overdose deaths because they have greater access to opioids. Economic distress in and of itself is a strong determinant of overdose deaths in rural areas. While in urban areas, drug availability is a better determining factor.


This study has significant implications for policymakers attempting to pass legislation to curb the epidemic. If the local economy is struggling, putting limits on opioid prescriptions and trying to stop the sale of fentanyl may do little to actually decrease the rate of overdose deaths.


The opioid epidemic started in the most economically vulnerable parts of the country, and it’s still there that it continues to thrive. Opioids numb both physical and mental pain, meaning areas that have been experiencing an economic and social decline for decades are primed to be the perfect target for addiction.

About Lorne Cross

Lorne Cross, MD is a healthcare professional from Portland, Oregon, who specializes in Addiction Medicine. It’s no secret that the United States is facing an opioid crisis. There are more lives lost to overdose deaths each year than were lost in the entire Vietnam War, and new data shows that opioids now kill more people each year than breast cancer. Understanding and treating the opioid crisis is of utmost importance to this country, and Dr. Cross has chosen to specialize in Addiction Medicine and focus all of his professional attention on this critical problem.

As the Medical Director of the Willamette Valley Treatment Center, Dr. Cross is the leader of a team that provides Medication Assisted Treatment to patients with Opioid Use Disorder. Lorne Cross, MD also serves as the Medical Director of a new Opioid Treatment Program in the Yamhill County Jail. Focusing on the treatment of opiate addiction, rather than punishment, can help to prevent relapse, decrease the rate of overdose deaths, and help to lower recidivism in the jail population, putting inmates on the right path upon release. Giving patients a path to recovery ultimately sets them up for more success in their futures.

Dr. Cross is hopeful as he looks into the future of treatment opportunities for opiate addiction. He sees the expansion of treatment into jails and prisons as a necessary step towards treating the opioid crisis and preventing unnecessary overdose deaths. Treating addiction with a rehabilitative approach is one of the best ways to reach out to those who truly need it most.

  • Senior Medical School Class Officer
  • Scholastic Honors Program Graduate
  • John Philip Sousa Award 1988

Years' Experience in Healthcare

Years Serving as a Major in the U.S. Army Reserve

Published Research Articles

From the time he was a child, Lorne Cross, MD was always fascinated by medicine and the natural sciences. By the time he reached college he knew he wanted to attend medical school and pursue his medical degree. He graduated in the top third of his class from Loma Linda University School of Medicine and completed his medicine internship and his anesthesiology residency at Loma Linda University Medical Center. Loma Linda University is a coeducational health sciences university located in California. He is also a Magna Cum Laude graduate of the Scholastic Honors Program at Southwestern Adventist College, where he earned his Bachelor of Science in Biology. Southwestern Adventist College is a small college, with an undergraduate enrollment of around 800 students, located in Texas.

Outside of work, Lorne Cross, MD likes to maintain an active and healthy lifestyle. He is an avid cyclist and bicycle racer, while actively pursuing many other sports. Outside of spending time exercising, he also loves to travel to new locations and spend time with his two teenage children and family.