Which US States Have the Worst Drug Problems?

As the federal government has declared the opioid crisis a national emergency, states are dealing with many drug problems of their own. And some areas are much worse than others.

WalletHub recently released a study comparing drug abuse and risk across the 50 states and Washington, D.C. It scored 22 key metrics related to drugs across three main categories: drug use and addiction, law enforcement and drug health issues and rehab. The scores from these metrics gave each state (plus Washington, D.C.) an overall rank — where first place denoted the biggest problem.

Here are the 10 states WalletHub found to have the most drug problems — followed by the 10 states where drugs are of least concern.

10. New Mexico

New Mexico came in 10th overall (where first is the worst) on the list of states with the worst drug problems. But it wasn’t all bad news. The state actually ranked in the middle of the pack for the drug health issues and rehab category, coming in 29th. But it still was the state with the fewest people receiving substance abuse treatment per 100,000 drug users. Moreover, New Mexico ranked 18th for law enforcement and 12th for drug use and addiction. And within the latter category, it had the fifth-highest percentage of teenage drug users.

9. Colorado

Skyline view of downtown Denver, ColoradoCredit: ShutterViews/Getty Images

Colorado’s best category rank was its 24th-place finish in drug use and addiction. But it still had the fourth-highest percentage of adult drug users in the country. The state came in seventh for law enforcement and eighth for drug health issues and rehab. And within that category, it had the third-highest percentage of adults with unmet drug-treatment needs within the past year.

8. Kentucky

Kentucky had some interesting results. It actually ranked 50th in the drug health issues and rehab category (where first is the worst). And within that category, it was one of the states with the most substance abuse treatment facilities per 100,000 drug users. But Kentucky slipped in the other two main categories, coming in 11th for law enforcement and second for drug use and addiction. It also had the fifth-most overdose deaths per capita.

7. New Hampshire

New Hampshire ranked slightly worse than New Mexico in the drug health issues and rehab category, coming in 28th place. It took 16th for drug use and addiction. But within that category, it actually was one of the states with a low percentage of teenagers who offered, sold or were given an illegal drug on school property. Still, its eighth-place finish in the law enforcement category dropped its overall rank to seventh.

6. Arkansas

Little Rock downtown skyline with the Arkansas River in the foregroundCredit: Davel5957/Getty Images

Arkansas also did average in the drug health issues and rehab category, coming in 34th. But it finished 10th in law enforcement and ninth in drug use and addiction. And within the latter category, it tied (with New Jersey) for the highest percentage of teenagers who offered, sold or were given an illegal drug on school property. And it had the second-most opioid prescriptions per 100 people.

5. Indiana

Indiana was another surprise in the drug health issues and rehab category, coming in 42nd (where first is the worst). But it was among the worst states for law enforcement (fourth place) and drug use and addiction (seventh place). The drug use and addiction category included metrics, such as the share of teenagers and adults who used illicit drugs, the share of children who lived with someone who had a drug or alcohol problem, the number of opioid pain reliever prescriptions per 100 people and overdose deaths per capita.

4. West Virginia

West Virginia fared slightly better than Arkansas in the drug health issues and rehab category, taking 37th place. But within that category, it had a low number of people receiving substance abuse treatment per 100,000 drug users. And West Virginia was among the worst states for the other two main categories. It came in fifth for drug use and addiction — in which it tied for first for the most overdose deaths per capita. And it took third for law enforcement.

3. Missouri

The plaza of the courthouse underneath the St. Louis Arch in St. Louis, MissouriCredit: Medioimages/Photodisc/Getty Images

Missouri had fairly poor showings in the drug use and addiction category (18th place) and the drug health issues and rehab category (17th place). But it was the worst in the country for law enforcement. The law enforcement category included metrics, such as drug arrests per capita, prescription drug monitoring laws and employee drug testing laws.

2. Michigan

Michigan had pretty poor scores for all three main categories. Its best ranking was its 14th-place finish for law enforcement. But it took third for drug use and addiction and seventh for drug health issues and rehab. That category scored metrics, including the share of adults who couldn’t get treatment for illegal drug use in the past year, substance abuse treatment facilities per 100,000 drug users and the share of addiction treatment medication paid by Medicaid.

1. Washington, D.C.

As lawmakers try to combat the opioid crisis, the worst drug problems in the country are right in their own backyard. Washington, D.C., was average for the law enforcement category at 34th place. But it had the second-lowest score for drug health issues and rehab, as well as the lowest score for drug use and addiction. Among the metrics scored, D.C. had the fourth-highest percentage of teenage drug users and the second-highest percentage of adult drug users. But interestingly, it actually had the fewest opioid prescriptions per 100 people. Still, D.C. tied for first (with West Virginia, Ohio and Pennsylvania) for the most overdose deaths per capita, and it had the highest percentage of adults with unmet drug-treatment needs within the past year. D.C. also had the second-fewest substance abuse treatment facilities per 100,000 drug users.

The states where drugs are of least concern

Minneapolis, Minnesota skylineCredit: Davel5957/Getty Images

These are the 10 states that received the best overall scores, according to WalletHub.

  • 10. Iowa
  • 9. Wisconsin
  • 8. South Dakota
  • 7. Utah
  • 6. Nebraska
  • 5. North Dakota
  • 4. Kansas
  • 3. Idaho
  • 2. Hawaii
  • 1. Minnesota

Many of these states stood out in the key metric scores.

In the drug use and addiction category, North Dakota, Iowa and Utah were among the states with the lowest percentages of teenage drug users. North Dakota also had a low percentage of teenagers who offered, sold or were given an illegal drug on school property.

Furthermore, Utah, Iowa and North Dakota had some of the lowest percentages of adult drug users. Hawaii was among the states with the fewest opioid prescriptions per 100 people. And Iowa, North Dakota, South Dakota and Nebraska all were in the bottom five (along with Texas) for the fewest overdose deaths per capita.

In the law enforcement category, North Dakota and South Dakota were among the states with the most drug arrests per capita.

Finally, in the drug health issues and rehab category, Wisconsin, Hawaii and Kansas had low percentages of adults with unmet drug-treatment needs in the past year. North Dakota, Hawaii and Utah were the top three states with the most substance abuse treatment facilities per 100,000 drug users. And Iowa and Minnesota were among the states with the most people receiving substance abuse treatment per 100,000 drug users.

Main image credit: YayaErnst/Getty Images

28 comments

Sara S
Jacob S10 days ago

thanks

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Dennis H
Dennis H17 days ago

Thanks

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Chad Anderson
Chad Anderson19 days ago

Let DC rule itself and come up with real solutions to its problems, instead of being forced to implement ones dictated by Congress.

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Ruth S
Ruth S20 days ago

Thanks.

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Ruth S
Ruth S20 days ago

Sad! Thanks.

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Danuta W
Danuta Watola20 days ago

Thank you for sharing.

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Janet B
Janet B21 days ago

Thanks

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Lizzy O
Past Member 21 days ago

many thanks

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Sherry K
Sherry Kohn21 days ago

Noted

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Carol S
Carol S21 days ago

New Hampshire is a surprise.

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