Special Report

This Is the Georgia County With the Worst Drug Problem

The U.S. has experienced a massive surge in drug addiction, and consequently fatal overdoses, in recent years. In 1999, the National Institute on Drug Abuse reported an age-adjusted rate of 6.1 fatal overdoses per 100,000 Americans. By 2019, that figure had more than tripled to 21.6 fatal drug overdoses per 100,000 people.

While this problem has affected every part of the country, certain areas struggle with an outsized share of drug overdose deaths. To determine the county with the worst drug problem in every state, 24/7 Tempo reviewed the annual average number of drug-related deaths per 100,000 residents in all U.S. counties and county equivalents from 2015 to 2019, using data from the Centers for Disease Control and Prevention.

Addiction and drug use are complicated and multifaceted issues that touch Americans nationwide and at all socioeconomic levels. Still, the counties that have the worst drug problems tend to have certain characteristics in common, including relatively lower income, higher unemployment, and higher poverty. This is the poorest county in every state.

Haralson County is due west of Atlanta, along the Georgia border with Alabama. The area reported 28 drug deaths per 100,000 residents, double the annual rate of drug deaths in the state.

Drug overdoses are one of the leading causes of death for Americans under 50, and areas with higher addiction rates tend to have very high premature death rates. Haralson County is no exception, reporting 575 deaths before age 75 per 100,000 residents — one of the highest premature death rates in Georgia, and well beyond the U.S. rate of 340 per 100,000 people.

As Americans have looked for answers as to how the drug problem in the country has gotten so severe, much of the blame has been placed on large pharmaceutical companies — particularly Purdue Pharma. The company began selling the painkiller OxyContin in 1996. Since then, the company has paid over $10 billion to settle a litany of lawsuits that claimed Purdue deceived patients and doctors about the risks of becoming addicted to the drug when advertising it. These are America’s most hated companies.

State County Counties in state Annual drug deaths per 100,000 Annual drug deaths per 100,000 (state) Poverty rate Poverty rate (state) Median household income Median household income (state)
Alabama Jefferson County 67 37.9 18.1 16.0% 16.7% $53,901 $50,536
Alaska Juneau Borough 29 27.9 18.7 7.7% 10.7% $88,390 $77,640
Arizona Gila County 15 38.4 23.5 21.6% 15.1% $43,524 $58,945
Arkansas Lincoln County 75 32.6 14.7 20.0% 17.0% $46,596 $47,597
California Lake County 58 55.9 14.1 18.6% 13.4% $47,040 $75,235
Colorado Huerfano County 64 59.5 18.1 15.8% 10.3% $38,137 $72,331
Connecticut Windham County 8 37.9 29.6 11.4% 9.9% $66,550 $78,444
Delaware New Castle County 3 37.4 35.2 11.4% 11.8% $73,892 $68,287
Florida Brevard County 67 40.5 23.1 11.8% 14.0% $56,775 $55,660
Georgia Haralson County 159 28.0 14.3 14.9% 15.1% $48,550 $58,700
Hawaii Honolulu County 5 16.0 15.5 8.3% 9.4% $85,857 $81,275
Idaho Shoshone County 44 34.9 15.1 19.4% 13.1% $39,386 $55,785
Illinois Winnebago County 102 41.5 20.0 15.6% 12.5% $54,489 $65,886
Indiana Fayette County 92 74.9 24.7 19.0% 13.4% $46,175 $56,303
Iowa Polk County 99 17.7 10.8 10.4% 11.5% $67,637 $60,523
Kansas Saline County 105 19.0 12.7 11.5% 12.0% $52,200 $59,597
Kentucky Gallatin County 120 77.8 33.3 14.8% 17.3% $52,167 $50,589
Louisiana Washington Parish 64 70.2 23.9 24.4% 19.2% $37,570 $49,469
Maine Washington County 16 42.5 27.6 18.9% 11.8% $41,347 $57,918
Maryland Baltimore city 24 93.5 34.8 21.2% 9.2% $50,379 $84,805
Massachusetts Bristol County 14 47.0 32.9 11.3% 10.3% $69,095 $81,215
Michigan Wayne County 83 43.0 27.0 22.3% 14.4% $47,301 $57,144
Minnesota Mille Lacs County 87 30.8 13.8 12.4% 9.7% $56,135 $71,306
Mississippi Hancock County 82 31.9 12.7 18.5% 20.3% $48,119 $45,081
Missouri St. Louis city 115 65.2 23.7 21.8% 13.7% $43,896 $55,461
Montana Silver Bow County 56 21.9 13.5 17.4% 13.1% $45,718 $54,970
Nebraska Scotts Bluff County 93 17.7 8.3 13.6% 11.1% $49,745 $61,439
Nevada Nye County 17 36.0 22.8 16.4% 13.1% $47,300 $60,365
New Hampshire Hillsborough County 10 42.5 34.2 7.8% 7.6% $81,460 $76,768
New Jersey Camden County 21 48.8 27.4 12.2% 10.0% $70,451 $82,545
New Mexico Rio Arriba County 33 79.9 26.3 24.0% 19.1% $39,952 $49,754
New York Sullivan County 62 37.2 19.0 15.2% 14.1% $57,426 $68,486
North Carolina Jones County 100 43.3 21.3 24.5% 14.7% $38,158 $54,602
North Dakota Williams County 53 15.3 10.4 6.1% 10.7% $87,161 $64,894
Ohio Scioto County 88 70.3 37.4 22.6% 14.0% $41,330 $56,602
Oklahoma Johnston County 77 38.1 19.4 20.9% 15.7% $41,332 $52,919
Oregon Curry County 36 26.4 16.3 12.4% 13.2% $48,440 $62,818
Pennsylvania Philadelphia County 67 55.5 35.4 24.3% 12.4% $45,927 $61,744
Rhode Island Providence County 5 33.6 30.4 15.2% 12.4% $58,974 $67,167
South Carolina Horry County 46 32.0 20.5 15.0% 15.2% $50,704 $53,199
South Dakota Minnehaha County 66 12.2 8.6 10.0% 13.1% $61,772 $58,275
Tennessee Cheatham County 95 54.2 27.9 10.6% 15.2% $61,913 $53,320
Texas Tyler County 254 23.2 10.9 16.5% 14.7% $44,497 $61,874
Utah Carbon County 29 45.1 21.5 16.8% 9.8% $51,158 $71,621
Vermont Windham County 14 37.8 22.1 13.7% 10.9% $51,985 $61,973
Virginia Hopewell city 133 41.6 17.0 23.6% 10.6% $39,030 $74,222
Washington Grays Harbor County 39 27.7 17.4 14.4% 10.8% $51,240 $73,775
West Virginia Cabell County 55 120.1 50.0 22.3% 17.6% $40,028 $46,711
Wisconsin Milwaukee County 72 36.0 19.1 19.0% 11.3% $50,606 $61,747
Wyoming Carbon County 23 28.9 14.5 12.4% 11.0% $60,161 $64,049