States That Have The Highest Drug Abuse Rates

US States With The Highest Drug Abuse Rates

It was in 1971 that President Richard Nixon declared a “war on drugs”. This attempt to deal with the use of illegal drugs in the United States has been about as effective as Prohibition was in the 1920s.

Drug abuse has only gotten worse, particularly since the COVID-19 pandemic. There were over 100,000 deaths due to drug overdose in the one-year period that ended in April of 2021. This was a 28.5% increase from the same period in 2020.

Why does the problem persist? One clue might be found if we look at the US states with the highest drug abuse rates.

The District of Columbia

The place that has the highest rates of drug and alcohol addiction is actually not a state – it’s our nation’s capital.

Here are some of the troubling statistics:

  • One in ten DC residents have an alcohol use disorder, which is twice the national average
  • One in eight have a substance abuse disorder, also twice the national average
  • Opioid overdoses in our capital have doubled between 2018 and 2020
  • In 2020, 94% of opioid cases in DC involved fentanyl, which is also found in most heroin in DC

Alcohol, marijuana, cocaine, and PCP are the most commonly abused drugs used in D.C. Some experts think the city’s large population of politicians and others with high-stress jobs may lead to higher addiction rates.


Alcohol is the most commonly abused substance in Vermont, with the state having higher drinking rates than the country as a whole.

The most common drugs, aside from alcohol, are opioids, heroin, and marijuana. Since the year 2000, there has been an eight-fold increase in those seeking treatment for opioid addiction. In 2021, fatal overdoses due to illegal drug use were up 38% annually in Vermont.

The lack of addiction treatment facilities in the state may be part of the problem.

State officials also point to the high level of drug trafficking as Vermont lies on the route from Montreal in Canada to large East Coast cities such as Boston and New York.


Colorado is one of the US states with the highest drug abuse rates. It actually ranks first in the country in teen drug abuse rates.

The pandemic has created spikes in drug overdose rates in the state. From May 2019 to May 2021, there was an increase of 50%. The Colorado Department of Public Health and Environment states that the deaths are being driven by fentanyl.

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Data reveals that prescription painkillers are a factor in overdose deaths as well, and that addiction rates are highest in Denver. Marijuana is legal in the state and some blame its use as a gateway drug for high teen addiction rates.

However, perhaps thanks to pot being legal in the state, there are a plethora of treatment options available including many treatment centers.


Overdose deaths in the state set a record in 2021. The number of deaths increased by 15% from 2020. According to the state’s health officials, more than 82% of overdoses involved fentanyl. The Department of Health and Social Services worries that the pandemic has made problems worse.

Heroin addiction is considered to be driven by painkiller use. People who were on prescription drugs often turn to heroin when they can no longer get the medications. Fentanyl is often mixed with street heroin.

One report states that 80% of heroin users in the state started with prescription pain killers.

Rhode Island

While Rhode Island is the smallest state in the country, is ranks third in overall adult drug use and fifth when it comes to teen drug use. It also ranks second when it comes to adults who seek treatment but can’t get it.

Opioids played the largest role in the state when it came to drug deaths. Fentanyl was number two, with cocaine and alcohol coming in third and fourth. Often, a combination of drugs were discovered.

As in the rest of the country, COVID-19 played a role in terms of spikes in overdose rates. Prior to the pandemic, addiction rates were actually on the decline in the state.

As with many states dealing with drug addiction, Rhode Island’s largest city, Providence, has the highest rates of overdose deaths.

Common Factors

Analyzing the data, there are certain commonalities apparent:

  • The COVID-19 pandemic. Drug overdose deaths nationwide have spiked during this time.
  • The prevalence of Fentanyl. This opioid is considered 100 times stronger than morphine. It is often added to street drugs and users often don’t realize until its too late that they are taking it.
  • Need for treatment programs
  • Prevalence of overdoses in more populated areas

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