John S Kiernan, WalletHub Managing Editor
Drug abuse has a long and storied history in the United States, and we’ve been “at war” with it for decades. Yet despite the country’s best efforts to fight it, the problem is still prevalent. There were more than 105,000 drug overdose deaths in the 12-month period ending in October 2023, according to the CDC.
It’s crucial for the government to address this issue and prevent it from getting any worse. The government must also deal with the changing landscape of drug use, as newer drugs like fentanyl become more widespread. In fact, the DEA seized the equivalent of more than 376 million lethal doses of fentanyl in 2023.
To determine where drug abuse is most pronounced and which areas are most at risk, WalletHub compared the 50 states and the District of Columbia across 20 key metrics, ranging from arrest and overdose rates to opioid prescription use and employee drug testing laws.
Highest Drug Use by State
| Overall Rank | State | Total Score | Drug Use & Addiction Rank | Law Enforcement Rank | Drug Health Issues & Rehab Rank |
|---|---|---|---|---|---|
| 1 | New Mexico | 69.89 | 1 | 13 | 2 |
| 2 | West Virginia | 63.56 | 5 | 3 | 18 |
| 3 | Nevada | 56.93 | 11 | 29 | 1 |
| 4 | District of Columbia | 56.61 | 3 | 31 | 3 |
| 5 | Colorado | 56.46 | 16 | 4 | 17 |
| 6 | Missouri | 55.93 | 19 | 6 | 8 |
| 7 | Louisiana | 55.74 | 4 | 23 | 10 |
| 8 | Arkansas | 54.67 | 24 | 2 | 30 |
| 9 | Oklahoma | 53.65 | 12 | 27 | 4 |
| 10 | Michigan | 51.64 | 17 | 16 | 11 |
| 11 | Alaska | 51.33 | 2 | 46 | 5 |
| 12 | Kentucky | 50.00 | 8 | 8 | 50 |
| 13 | Indiana | 49.25 | 20 | 11 | 35 |
| 14 | Tennessee | 48.69 | 7 | 25 | 37 |
| 15 | Wyoming | 48.52 | 42 | 1 | 24 |
| 16 | Mississippi | 48.48 | 22 | 22 | 15 |
| 17 | Vermont | 47.89 | 6 | 45 | 13 |
| 18 | Oregon | 47.36 | 10 | 47 | 9 |
| 19 | Kansas | 45.97 | 27 | 24 | 14 |
| 20 | Arizona | 45.63 | 13 | 37 | 20 |
| 21 | Rhode Island | 45.44 | 18 | 42 | 6 |
| 22 | Maine | 44.81 | 9 | 43 | 27 |
| 23 | Massachusetts | 43.41 | 28 | 21 | 31 |
| 24 | Pennsylvania | 43.30 | 30 | 7 | 47 |
| 25 | Delaware | 42.23 | 21 | 39 | 23 |
| 26 | Montana | 42.17 | 26 | 36 | 19 |
| 27 | Ohio | 42.09 | 14 | 35 | 42 |
| 28 | Georgia | 41.93 | 34 | 32 | 7 |
| 29 | Illinois | 41.71 | 32 | 19 | 41 |
| 30 | New York | 41.36 | 36 | 18 | 32 |
| 31 | Washington | 41.22 | 15 | 49 | 26 |
| 32 | Wisconsin | 41.07 | 40 | 10 | 36 |
| 33 | Texas | 38.98 | 49 | 12 | 16 |
| 34 | South Dakota | 38.74 | 47 | 9 | 28 |
| 35 | South Carolina | 38.72 | 23 | 50 | 22 |
| 36 | New Jersey | 38.54 | 44 | 20 | 29 |
| 37 | California | 38.40 | 33 | 34 | 25 |
| 38 | Alabama | 38.23 | 25 | 51 | 12 |
| 39 | North Carolina | 37.92 | 29 | 26 | 48 |
| 40 | North Dakota | 37.73 | 50 | 5 | 34 |
| 40 | Virginia | 37.73 | 41 | 17 | 43 |
| 42 | New Hampshire | 36.25 | 39 | 14 | 51 |
| 43 | Iowa | 33.79 | 45 | 30 | 21 |
| 44 | Idaho | 33.64 | 43 | 28 | 40 |
| 45 | Minnesota | 33.46 | 38 | 38 | 38 |
| 46 | Connecticut | 33.19 | 35 | 41 | 45 |
| 47 | Maryland | 33.11 | 31 | 44 | 46 |
| 48 | Florida | 32.89 | 37 | 40 | 44 |
| 49 | Nebraska | 30.87 | 51 | 15 | 39 |
| 50 | Utah | 29.52 | 48 | 33 | 33 |
| 51 | Hawaii | 24.08 | 46 | 48 | 49 |
Note: With the exception of “Total Score,” the columns in the table above depict the relative rank of a state, where a rank of 1 represents the worst conditions for that category.
FULL REPORT
