A new report underscores the disparities in America’s ongoing drug crisis, with West Virginia leading the nation in overdose death rates while Texas ranks near the bottom.
The report, conducted by Stone Injury Law Firm using data compiled from the CDC, reveals that West Virginia ranked first, with over 80 drug overdose deaths per 100,000 residents, the highest rate in the country by a wide margin. In total, 1,335 people in West Virginia lost their lives to overdoses in 2022 alone.
West Virginia’s high overdose rate may be due to the ongoing opioid epidemic that have raptured areas like Appalachia. The drug crisis has hit Appalachia especially hard, with overdose death rates among adults aged 25–54 in 2022 running 64% higher than the national average, per the Appalachia Regional Commission.
Tennessee ranked second overall with 56 deaths per 100,000 residents, and Delaware placed third at 55.
Despite Delaware’s smaller population, its high overdose rates also reflect the growing impact of the opioid epidemic and other drug-related fatalities across smaller Northeastern states.
Louisiana (54.5) and Maine (54.3) rounded out the top five for states with the most drug overdoses.
Meanwhile, Texas – the second-most populated state – reported one of the lowest per capita rates, at 18.2 overdose deaths per 100,000 residents. That’s despite nearly 5,000 fatal overdoses statewide in 2022.
South Dakota had the lowest rate at 11.3 deaths per 100,000, with only 95 overdose deaths recorded, the lowest raw number in the country.
A few other Southern and Midwestern states, including Nebraska and Iowa, also ranked among the lowest in per capita overdose deaths, even as large metropolitan areas within them face their own struggles with fentanyl and other new synthetic opioids.
In contrast, Northeastern states continue to see persistently high overdose mortality rates, often tied to the rise of synthetic opioids, difficult economies or low job opportunities, as well as “healthcare challenges.”
“These statistics reveal alarming disparities in drug overdose rates across the country. The fact that West Virginia’s rate is more than seven times higher than South Dakota’s highlights the need for tailored approaches to address the ongoing drug crisis that America faces,” a spokesperson for Stone Injury Lawyers said in a statement.
Health officials warn that while overall overdose numbers remain alarmingly high across the country, state-by-state differences show a complex mix of drug supplies as well as availability of treatment and rehabilitation services.
For example, Narcan, or Naloxone, is a life-saving medication that can quickly reverse the deadly impact of opioid overdoses.
More than 2.1 million Narcan prescriptions were dispensed from retail pharmacies across America in 2023, according to new data from the CDC. The overall national dispensing rate doubled from 0.3 to 0.6 per 100 people between 2019 and 2023 alone, reflecting bigger efforts to make the life-saving opioid overdose reversal medication more widely available.
However, Narcan dispensing rates vary sharply by state.
In 2023, Wyoming led the nation with 2.5 prescriptions per 100 people, followed by Arkansas (1.9), New Mexico (1.6), Rhode Island (1.4), and Kentucky (1.3). States with the lowest rates, all at 0.3 per 100 people, included Georgia, Iowa, Minnesota, New Hampshire, South Dakota, and Texas.