Purpose The opioid overdose epidemic continues to devastate the United States through dangerous variations and combinations of drugs. In Iowa’s population of over 3 million people, there were 137 overdose deaths involving opioids in 2018. While Iowa’s opioid related overdose deaths remain lower than the national average, there is concern that the rurality of Iowa could contribute to increases in opioid involved deaths. In August 2019, the University of Iowa Injury Prevention Research Center (UI IPRC) began collaborative efforts with Iowa stakeholders to identify policy priorities to address rural opioid concerns and identify ways to reach policymakers with these priorities.

Methods In September 2019, the UI IPRC convened over 30 stakeholders across Iowa representing more than a dozen fields including groups with rural and farming interests. We reviewed evidenced-based strategies, identified what Iowa was doing to address rural overdose issues, proposed policy and program changes, and identified priorities. An online survey was sent to participants to vote on their top five priorities.

Results The five stakeholder priorities included developing holistic treatment and recovery resources, improving communication strategies between stakeholders, considering polysubstance drug use during surveillance and prevention efforts, improving naloxone access and distribution, and combating stigma. The UI IPRC will disseminate a report describing the unique characteristics of Iowa’s rural drug issues, including the rise in polysubstance overdose deaths, and the five stakeholder priorities to Iowa policy makers beginning in the 2020 legislative cycle. In addition, the UI IPRC will also publish an op-ed highlighting the priorities.

Conclusions/Significance Upon identifying the priorities, it is clear there are still gaps in surveillance, prevention, and treatment efforts with regards to licit and illicit drugs in Iowa. In order to prevent further drug related mortality in Iowa, it is crucial to continually identify policy priorities and actively disseminate recommendations to Iowa policy makers.