These States Have the Biggest Drug Problems in America

While some drugs can save us, others cost lives. Drug use isn’t limited by city or state boundaries, but trends do show that some areas suffer from substance abuse more than others. The latest WalletHub research looked at issues surrounding drug use in the U.S. and found that the following 15 states have the biggest drug problems.

15. Massachusetts

Mobile methadone clinic parked in Massachusetts
A mobile methadone clinic in Massachusetts | David L. Ryan/The Boston Globe via Getty Images

The most populated New England state is among the top 10 states for opioid overdose deaths (over twice the national rate). However, Massachusetts ranks among the lowest for both the number of opioid prescriptions per capita and the related rate of overdose deaths involving opioid prescriptions. This means the bulk of Massachusettsans who die of opioid overdose did not have a prescription. The state also ranks second in the U.S. for the fewest drug arrests per capita.

Next: Narcotics in Nashville

14. Tennessee

Five-year-old Derrick Slaughter attends a march against the heroin epidemic.
Five-year-old Derrick Slaughter attends a march against the heroin epidemic. | Spencer Platt/Getty Images

Tennessee ranks third in the U.S. for the highest rate of opioid prescriptions.  Like many states on this list, the number of overdose deaths in the Volunteer State, especially those involving synthetic opioids like fentanyl, has risen considerably over the last several years.

Next: Don’t envy NV.

13. Nevada

South Florida Pharmacy Suspected As Pill Mill
Law enforcement agents stand outside “pill mill.” | Joe Raedle/Getty Images

Nevada is the first state on the list where meth is a larger problem than the more publicized opioid crisis. Between 2015 and 2018, the Sagebrush State saw the number of amphetamine overdoses rise by over 30%. During that same period, the number of opioid overdoses decreased. To compound the meth problem, Nevada has the fewest substance abuse treatment facilities per 100,000 drug users of any state.

Next: Both opioids and meth are major problems here.

12. Oregon

Susan Stevens lost her daughter, Toria, to a drug overdose at age 19. Now she is dedicated to making a difference.
Susan Stevens shows a prescription her daughter filled the day before she died. | Eamon Queeney/For The Washington Post via Getty Images

With the fifth fewest treatment facilities per 100,000 drug users, Oregon provides relatively few resources to treat substance abuse. Conversely, it has the highest percentage of adult drug users and the third highest percentage of teen users in America. These facts create a troubling position for the Beaver State.

Next: The smallest state has the highest percentage of teen drug users.

11. Rhode Island

Activists Call For Reallocating Some Of NYPD's Opioid Crisis Budget To Recovery Programs
Activists denounce inadequate response to the overdose crisis. | Drew Angerer/Getty Images

Rhode Island is among the states with the fewest drug arrests per capita. However, those who are arrested for drugs here can participate in a one-of-a-kind program that offers inmates medicine for opioid addiction. This may prevent a relapse or overdose when they return to society.  In 2016, the program’s first year, the state saw a drop in overdoses among the recently incarcerated. 

Next: Breaking Bad — but better

10. New Mexico

Man cleans up a makeshift heroin camp
A man cleans up a makeshift heroin camp. | Bastiaan Slabbers/NurPhoto via Getty Images

In New Mexico’s defense, it had the sixth worst drug problem in 2018, so ranking 10th this year is an improvement. Let’s just hope it isn’t due to other states getting worse. As the acclaimed AMC series Breaking Bad showed, meth is a serious problem in the Land of Enchantment, though it isn’t immune to the opioid crisis either. Unfortunately, New Mexico sees the fewest residents receiving substance abuse treatment (per 100,000 drug users) of all states.

Next: Mile high problems

9. Colorado

Boston Students Protest Used Needles On School Grounds
Students protest the problems associated with opiate addiction. | Dina Rudick/The Boston Globe via Getty Images

In 2017, more Coloradans died from overdoses than any year ever, due in part to a dramatic rise in heroin-related deaths. The Centennial State is also the third highest concerning the percentage of adults with unmet drug treatment needs. This means a lot of Coloradans need help with drug abuse but aren’t getting it.

Next: Derby State distress

8. Kentucky

Ohio Rust Belt Struggles With Opioid Addiction And Poverty
Medical workers aid a woman who overdosed on heroin. | Spencer Platt/Getty Images

In 2017, Kentucky had nearly twice the national rate of opioid-related deaths, with 27.9 deaths per 100,000 people. Like Tennessee, it prescribes opioids at one of the highest rates in the U.S. The Bluegrass State in the top five for the most substance abuse treatment facilities per 100,000 drug users. Unfortunately, addiction runs rampant despite all the resources.

Next: In this state, methamphetamines aren’t the big concern.

7. New Hampshire

Drug overdose in New Hampshire
Ambulance responds to an overdose in New Hampshire. | Don Emmert/AFP/Getty Images

The Granite State has one of the five highest rates of death involving opioids in the country.  Moreover, New Hampshire saw over a huge rise in deaths involving synthetic opioids from 2013 to 2017 (from 30 deaths to 374). Fortunately, deaths involving heroin and prescription opioids saw a slight decrease during the same time period.

Next: Southern charm … and harm

6. Arkansas

Opioid Support Group Learn to Cope
Joanne Peterson (L), founder of the opioid support group, Learn to Cope, listens to speakers. | Craig F. Walker/The Boston Globe via Getty Images

Arkansas’ opioid prescription rate is the second highest in the U.S. Like many rural areas, though, meth is often an equal or greater threat here. In recent years Arkansas became a top state for meth use and related arrests. No matter the drug, however, the state faces a serious problem.

Next: This state does not call drug abuse during pregnancy a crime.

5. Indiana

Testing for fentanyl use
A fentanyl strip tests for drugs | Andrew Lichtenstein/Corbis via Getty Images

Indiana has moved up in the drug-related rankings in recent years. A major factor: It’s home to the highest number of illegal drug labs. It also has one of the higher opioid prescription rates and has seen overdose-related deaths increase considerably in recent years.

Next: Country roads, take me to rehab.

4. West Virginia

Testing for fentanyl use at halfway house
Halfway house administers drug tests. | Andrew Lichtenstein/Corbis via Getty Images

West Virginia is tied with Washington D.C., Ohio, and Pennsylvania for the most overdose deaths per capita. Both synthetic opioid- and heroin-related deaths have risen here since 2013. It also has the third-fewest amount of residents receiving substance abuse treatment out of all states.

Next: “Show me” the drugs.

3. Missouri

Learn To Cope, Supports Family Of Opiate Addicts
Parents of a drug-addicted child hold literature at support group. | Essdras M Suarez/The Boston Globe via Getty Images

The Show Me State currently has the most drug-related arrests in the country. Its rural areas see drug users more involved with meth than opioids. Missouri also holds the unenviable record for the most meth labs per capita.  

Next: Great Lakes, greater struggles

2. Michigan

Naloxone, a drug given to people experiencing an opioid overdose
Naloxone treats narcotic overdoses. | Bernard Weil/Toronto Star via Getty Images

With financial, economical, and health-related problems — just look at Detroit or Flint — it’s little wonder that Michigan’s drug problems have worsened. Two years ago, Michigan ranked 10th on this list. Last year, they were fourth. So things aren’t exactly improving.

Next: The state with the most drug problems also has the fewest opioid prescriptions (per 100 people).

1. District of Columbia

Bed in the detox ward
A patient’s bed in the detox ward | Spencer Platt/Getty Images

Some things, unfortunately, don’t change. The District of Columbia has ranked first in the nation for drug problems for the last three years. It ties for the most overdose deaths per capita, and it also has a higher percentage of adults with unmet drug treatment needs than any of the 50 states.