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underserved areas. In addition, the Department of Health and Human Services is taking efforts to address other challenges faced by impoverished communities that have a high degree of substance use. Regional Partnership Grants are designed to identify child welfare practices that can mitigate the impact of parental substance use; funding for these grants recently increased by $100 million in the Bipartisan Budget Act of 2018. iii The Maternal, Infant, and Early Childhood Home Visiting iii For more information on Regional Partnership Grants, see https://ncsacw.samhsa.gov/technical/rpg-i.aspx. Program is identifying interventions to prevent opioid use disorder among parents and its detrimental effects on children. The Administration for Children and Families is in the process of identifying interventions to increase economic self-sufficiency of individuals eligible for the Temporary Assistance for Needy Families program who are affected by opioid use disorder. This study affirms the importance of these and other efforts at the federal and state levels to increase access to prevention, treatment, and other support services for individuals with opioid use disorder in impoverished areas. While more research is needed to better understand how economic opportunity and substance use interact at the community level, action to address the risks and consequences of the opioid epidemic in communities simultaneously facing economic challenges need not wait. REFERENCES 1. Rudd RA, Aleshire N, Zibbell JE, Gladden RM. Increases in Drug and Opioid Overdose Deaths — United States, 2000–2014. Atlanta, GA: Centers for Disease Control and Prevention; 2016. https://www.cdc.gov/mmwr/preview/mmwrhtml /mm6450a3.htm. Accessed April 25, 2018. 2. Hedegaard H, Warner, Margaret, Miniño AM. Drug Overdose Deaths in the United States, 1999-2016. Hyattsville, MD: National Center for Health Statistics; 2017. https://www.cdc.gov/nchs/data/databriefs/db294 .pdf. 3. Jones CM. The paradox of decreasing nonmedical opioid analgesic use and increasing abuse or dependence — An assessment of demographic and substance use trends, United States, 2003–2014. Addict Behav. 2017;65:229- 235. doi:10.1016/j.addbeh.2016.08.027 11 4. Han B, Compton WM, Jones CM, Cai R. Nonmedical Prescription Opioid Use and Use Disorders Among Adults Aged 18 Through 64 Years in the United States, 2003-2013. JAMA. 2015;314(14):1468-1478. doi:10.1001/jama.2015.11859 5. Han B, Compton WM, Blanco C, Crane E, Lee J, Jones CM. Prescription Opioid Use, Misuse, and Use Disorders in U.S. Adults: 2015 National Survey on Drug Use and Health. Ann Intern Med. 2017;167(5):293. doi:10.7326/M17-0865 6. Paulozzi, Leonard J., Franklin G, Kerlikowske RG, Jones CM, Ghiya N, Popovic T. CDC Grand Rounds: Prescription Drug Overdoses — a U.S. Epidemic. Atlanta, GA: Centers for Disease Control and Prevention; 2012. https://www.cdc.gov/mmwr/preview/mmwrhtml /mm6101a3.htm. Accessed April 25, 2018. 7. Hollingsworth A, Ruhm CJ, Simon K. Macroeconomic conditions and opioid abuse. J Health Econ. 2017;56:222-233. doi:10.1016/j.jhealeco.2017.07.009 8. Weiss AJ, Elixhauser A, Barrett ML, Stiener CA, Bailey MK, O’Malley L. Opioid-Related Inpatient Stays and Emergency Department Visits by State, 2009-2014. Rockville, MD: Agency for Healthcare Research and Quality; 2016. 9. Krueger AB. Where Have All the Workers Gone? An Inquiry into the Decline of the U.S. Labor Force Participation Rate. Washington, D.C.: Brookings Institute; 2017. 10. Federal Reserve System. Report on the Economic Well-Being of U.S. Households in 2017. Washington, D.C.: Board of Governors of the Federal Reserve System; 2018. 11. CDC. Annual Surveillance Report Of DrugRelated Risks And Outcomes. United States: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2017:83. https://www.cdc.gov/drugoverdose/pdf/pubs/20 17-cdc-drug-surveillance-report.pdf. 12. Rossen LM, Opioid Misuse and Use Disorder Data for Figure 1 come from the 2016 National Survey on Drug Use and Health, a nationallyrepresentative survey sponsored by the Substance Abuse and Mental Health Services