Special Report

Counties With Worst Drug Problems in Every State

Litigation over America’s opioid crisis has gathered steam in recent months. In a civil suit similar to the suits brought against Big Tobacco 20 years ago, nearly 2,000 towns, cities, and counties are seeking billions of dollars from two dozen drug companies in federal court. The suit alleges the drug industry failed to adequately control the distribution of prescription painkillers and is largely responsible for the country’s opioid epidemic.

Many of the communities most affected by drug addiction and overdose death are low income, rural parts of the country. Often, economic opportunities are more limited in these areas, and social isolation is worse. There are also fewer resources for substance abuse treatment. In nearly every state, there is a county where residents die of drug overdoses at a higher annual rate than the national figure of 18.2 fatalities per 100,000 Americans.

To determine the counties with the worst drug problem in every state, 24/7 Wall St. reviewed the average number of drug-related deaths per 100,000 residents each year during the 2013 to 2017 period with data from the Centers for Disease Control and Prevention’s WONDER web application. Several of the entries on this list are cities, but function as county equivalents in their states, and for this reason are treated as counties by the U.S. Census Bureau and in our analysis. 

One of the biggest predictors of opiate addiction and substance abuse is poverty. In 42 of the 50 counties with the highest overdose rates in their states, the poverty rate is greater than the 14.6% U.S. figure.

Drug addiction and overdose are also linked with other serious public health issues America is facing today, such as obesity, physical inactivity, poor nutrition, and poor access to health care. Consequently, several of the counties on this list also can be found on this list of the worst county to live in every state, and also on this list of the least healthy county in every state.

Opiates were present in 67.8% of the 70,237 fatal drug overdoses in the United States in 2017. Other leading causes of drug overdose death include cocaine, benzodiazepines, psychostimulants such as methamphetamine, and antidepressants. These are the 25 most dangerous drugs.

Click here to see the counties with worst drug problems in every state
Click here to read our methodology