Mapped: The states hit hardest by America’s drug epidemic

For years, annual drug overdose deaths in the U.S. had surpassed six figures.

In 2022 alone, the death toll linked to the public health crisis eclipsed 110,000 – almost double the number of U.S. service members killed throughout the entire Vietnam War.

That is until last fall, when the Centers for Disease Control and Prevention announced that drug overdose fatalities had plummeted, fueled by a decrease in deaths involving synthetic opioids such as fentanyl.

But America’s drug crisis hasn’t gone away — while overdose mortality rates are continuing to decline, with less than 81,000 deaths in the 12 months recorded up to November 2024, those numbers are still vastly higher than a decade ago.

A new study has revealed which states have the highest rates of drug abuse in the U.S. – with New Mexico ranking number one.

Personal finance website WalletHub compared all 50 states and Washington D.C. in three categories: drug addictions and usage, law enforcement, and drug health issues and rehab.

The report analyzed data from the U.S. Census Bureau, the CDC, and the Drug Enforcement Administration, among other federal agencies, and the states were given a score on a 100-point scale – ranked from best to worst.

New Mexico was ranked the worst, followed by West Virginia, Nevada, Alaska and the District of Columbia. Oklahoma, Missouri, Colorado, Louisiana and Arkansas made up the rest of the top 10, per the study.

Hawaii, however, was the state deemed to have the best handle on its drug problem, followed by Utah, Nebraska, Connecticut, and Florida.

New Mexico topped the list in individual metrics, ranking first for teenage drug users, third for drug users and seventh in the overdose tally.

There are major substance abuse concerns amongst teenagers in the state, according to the analysis. New Mexico has been found to have the highest proportion of teens using illicit drugs and the highest share of young people reporting they had tried marijuana before the age of 13.

West Virginia, the state deemed to have the second-worst substance abuse problem, has the most drug overdose fatalities in the U.S. The number of deaths in West Virginia is more than nine times greater than in Nebraska, which has the fewest.

81 deaths

from drug overdoses in West Virginia, per 100,000 people

Those battling drug addiction in the states ranked worst may find it difficult to get the help they need, with a few substance abuse treatment centers and professionals working in mental health for the size of the population.

Signs are displayed at a tent during a health event, June 26, 2021, in Charleston, West Virginia, offering Naloxone, a drug that reverses the effects of an opioid overdose (Copyright 2022 The Associated Press. All rights reserved.)

Residents in Nevada, ranked third worst on the list, have the poorest access to substance abuse treatment facilities and counselors per capita, the analysis found. The gambling capital was the single worst state for drug health issues and rehabilitation.

Dr. Jennifer Murphy, an associate professor and chair of criminal justice at Pennsylvania State University, says that enhanced access to treatment, not punishment, is key to combating America’s drug crisis.

“We need to enact more policies that give individuals the opportunity to engage in harm reduction and treatment services,” she said. “We need to make these services low-barrier and easy to access so people can get the help that they need.”

And sometimes it’s a far wider issue. Gene Heyman, a senior lecturer at Boston College’s Department of Psychology and Neuroscience, says that “the most powerful correlate of drug overdose deaths” is “intergenerational income mobility,” meaning the extent to which an individual is able to have a better life and income than their parents. In places where adult children earn less than their parents, areas that have lost industries such as the Midwest ‘rust belt’ and West Virginia and Kentucky coal mining counties, drug overdoses are higher.