Bensley KMK, Kerr WC, Barnett SB, et al. - This study was undertaken to investigate if positive screens for opioids with other substances are more prevalent among rural vs urban suicide deaths. Between 2012 and 2015, researchers applied data from all states reporting opioid‐related overdose suicides in the National Violent Death Reporting System. During the study period, there were 3,781 opioid‐overdose suicide decedents (42% female) tested for all three substances. Urban decedents were more likely to test positive for opioids alone, while rural decedents were more to likely test positive for opioids and benzodiazepines. The results demonstrate that rural suicides are correlated with elevated opioid and benzodiazepine positive screens. These data imply the need for rural‐focused interventions to support appropriate co‐prescribing, better health education for providers about risks correlated with drug mixing, and more linkages with mental health services.