It’s no secret that America is facing a major drug addiction crisis. Drug overdose deaths have tripled nationwide since 2000, attributing to over 105,000 deaths in 2023 alone. Today, roughly 51% of Americans admit to having used an illicit drug at least once in their lifetime. In 1979, this number was slightly above 31 percent.
America’s Drug Epidemic
The United States grapples with a significant drug crisis, with marijuana often hailed as America’s most popular drug. Millions of Americans struggle with drug addiction, a complex issue impacting individuals, families, and communities across the country. States like California, New York, and Ohio consistently rank high in terms of drug addiction rates, with the severity of their drug problems earning them the unfortunate title of the drug capitals of the US.
Addiction can affect anyone across the board, regardless of a person’s age, gender, or socioeconomic status. Certain U.S. states encounter more problems with addiction than others based on factors such as prescribing laws, proximity to drug trafficking activity, and available addiction treatment options. Though each state faces its own unique struggles with addiction, America as a whole is working toward a finding solution to curb the drug epidemic and to protect its families and communities from the general suffering brought on by addiction.
Here’s a closer look at 10 states with the biggest drug problem and what these states are doing to combat substance abuse.
1. New Mexico
Per capita, New Mexico has a large number of drug overdose deaths. It also has the highest rate of teens using illicit drugs and the third-highest rate of adults using illicit drugs. Contributing to these challenging numbers is the fact that the state has the second-highest share of adults who don’t get treatment for their drug problems. Plus, the state has fewer policies in place than other states to discourage addiction and help people find recovery.
2. Alaska
In 2023, Alaska saw 357 overdose deaths. This is a 45% increase from 2022, which was the highest increase among all the states. In fact, the national rate for overdose deaths declined between 2023 and 2024, while Alaska’s continued to rise.
In response to these alarming numbers, law enforcement agencies across Alaska are attempting to reduce drug trafficking. The High Intensity Drug Trafficking Area Initiative is working to intercept substances such as fentanyl at the Anchorage International Airport Complex. As agencies across Alaska partner to intercept drugs and keep them out of the communities, the hope is that Alaska’s drug use and overdose rates will decline.
3. Oregon
According to the Oregon Health Authority, overdose deaths in Oregon decreased by 22% between 2023 and 2024. However, WalletHub still ranks Oregon at number three for overall drug use and addiction. And while the CDC ranks Oregon at mid-level among the states for drug overdose mortality, the WalletHub rankings include other factors that keep the state at number three. The ranking includes factors such as arrest rates and employee drug testing laws that also factor into drug use and addiction rates.
4. Nevada
1,528 Nevadans died from overdose in 2024. This is a 0.5% increase from 2023. While that uptick may seem small, most other states experienced a decrease in overdoses during that time. Experts say the Nevada statistics may be attributable to the drug supply in the state as well as overall poor mental health in the region.
Some officials are hoping an increase in education and access to care will help curb these numbers. They are encouraging the use of Narcan and the training of first responders to adjust to the changing needs of the population. The hope is to raise awareness and availability of life-saving treatment.
5. Washington
Washington state experienced a decrease in fatal overdoses between 2023 and 2024. However, the last quarter of 2024 saw a 41.2% increase compared to the third quarter.
As for drug crime in the sate, methamphetamine accounts for a significant portion of cases. However, fentanyl increased from 2020 through 2023, rising to 58% of crime lab cases, then it dropped a bit in 2024. Heroin, on the other hand, is only found in 3% of cases.
As a legal substance in Oregon, marijuana is fairly commonplace in the state. In fact, Oregon harvested more than 12 million pounds of marijuana in 2024. This actually outpaced the demand for the drug, which is used by 32.8% of Oregon adults.
6. West Virginia
One of the factors that put West Virginia on this list is the state’s drug-related crime. Looking at criminal offenses in West Virginia, we find that 47.4% of all offenses committed in the state are related to drugs. Of the various substances potentially involved in these crimes, heroin is the most common.
While the state did see a decrease in the number of overdoses in 2023, the opioid epidemic continues to hit this state hard. Unemployment and tough socioeconomic conditions have been a historical contributing factor to the issue. However, with the record-breaking 41% reduction in overdose deaths the state recently saw in the summer of 2025, officials hope the tide may be turning for West Virginians.
7. District of Columbia
As of 2023, D.C.’s drug overdose death rate was higher than the overall U.S. rate. In fact, it was 94% higher. This rate increased 14 of the last 24 years. Since 2018, it has increased 71%.
WalletHub ranks the District of Columbia number five for drug use, but it stands at number seven for overall drug addiction and drug use. Looking at recent statistics, we find that 406 D.C. residents died from drug overdose in 2024, which is actually a 37% drop compared to 2023. Officials attribute the drop in part to greater accessibility to naloxone. So, while this decrease in overdoses is a positive sign, overall drug use, addiction, and drug crimes may not be decreasing.
8. Oklahoma
In Oklahoma, fatal overdoses have risen since 2013. Recently, the state experienced an increase from 1,267 overdoses in 2022 to 1,375 fatal overdoses in 2023. Meth and fentanyl appear to be major players in these overdoses. The state is also seeing increases in cocaine trafficking and overdoses.
Oklahoma officials are bracing for this new poly-drug crisis, which they say is fueled by organized crime, increased youth exposure to marijuana, and violent crime. Also attributing to the issue is Oklahoma’s location with a vast highway system used by drug trafficking organizations from Mexico. Their distribution pipelines which stretch through the state are a challenge for law enforcement and continue to flood the state with new supplies of drugs.
9. Vermont
Despite a decline in opioid overdose deaths in recent years, Vermont remains in the top 10 states for most drug addiction and drug use. Between 2023 and 2024, the state experienced at 22% decrease in opioid overdose deaths. Public health officials attribute this improvement to prevention and treatment efforts. For example, Vermont offers a statewide naloxone distribution program which distributed more than 70,000 doses of the life-saving antidote in 2024.
As in D.C., the reduction in fatalities due to drug overdose offers a positive report; however, the rate of drug use and addiction may not be decreasing. Instead, life-saving measures have improved. As a result, Vermonters are still experiencing high levels of substance abuse.
10. Louisiana
While Louisiana ranked 10th for drug use and addiction, it came in fourth for opioid prescriptions, fifth for overdose deaths per capita, and ninth for highest drug use. WalletHub also ranked Louisiana’s cities as among the least healthy in the nation, based on 41 indicators including fruit and vegetable consumption and the cost of medical visits.
On a positive note, the state experienced a drop in drug overdose deaths between 2023 and 2024, decreasing by 35.2%. As with other decreases across the nation, experts attribute much of this decrease to the wider availability of naloxone.
How America is Helping its Most Drug-Addicted States
In recent years, the federal government has issued grants to each state to help the nation combat drug abuse — specifically opioid addiction. Some states received more funding than others, based on existing resources, treatment facilities, and opioid overdose statistics. These funds will mainly be used to improve prescription drug monitoring programs and expand access to addiction treatments and prevention efforts.
Drug rehab centers offers treatments that can help those who suffer from substance abuse overcome addiction as a whole. Detox treatments help patients overcome chemical dependency, while counseling, support groups, and similar therapies address underlying psychological causes of addiction. Addiction treatments are often customized for each individual patient based on the severity of their addiction and the substance being used.
While some states face higher rates of addiction, particularly to alcohol use disorder, resources and effective treatment are available everywhere.
Evidence-based treatment approaches like cognitive behavioral therapy (CBT) can help manage cravings and address underlying issues that contribute to substance use.
Family therapy can also be a crucial component, helping mend relationships and providing support for both the individual and their family members.
Remember, addiction is a chronic but treatable disease. Don’t wait for a life-threatening situation to seek help. Reach out to a healthcare professional for a personalized treatment plan that can put you or your loved one on the road to recovery.