Objectives The number of deaths due to all drugs and opioids has increased dramatically in Georgia within the last decade. However, the disparities in drug overdose deaths across the state remains a concern. Certain geographic areas may be adversely affected by this public health epidemic. While many studies have explored national trends of drug overdoses, few have specifically considered the epidemic in Georgia. This research examines the impact of rural versus non-rural county status on overdose death rates in Georgia due to all drugs and opioids. Methods We used county-level drug overdose death data from the Georgia Department of Public Health's Online Analytical Statistical Information System, along with other demographic data gathered from other sources. The analysis data sample included 2703 observations from all 159 counties in Georgia from 1999 to 2015. We used panel multivariate linear regression models to determine the impact of rural and non-rural county status on drug overdose death rates in Georgia due to all drugs and opioids. Key findings Descriptive data show that overdose death rates due to all drugs and opioids increased overtime in both rural and non-rural counties. Regression results indicate that rural counties in Georgia experienced a 23.5% decrease in overdose death rate due to all drugs compared with non-rural counties between 1999 and 2015 (P < 0.05). While rural counties also experienced a lower rate of opioid overdose deaths (18.7%) compared with non-rural counties, it was not statistically significant. Conclusions Although increasing drug overdose death rate is a significant public health concern in Georgia, rural counties in the state experienced a lower rate of drug overdose deaths compared with non-rural counties. Interventions targeted towards reducing drug overdose deaths both in rural and in non-rural counties are needed to address this public health priority in Georgia.