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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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.