State rankings

Drug Use by State

West Virginia has the highest Total Drug Use Rate in 2023 (6,297 per 100k), followed by District of Columbia (5,826 per 100k) and Kentucky (5,324 per 100k). Nebraska has the lowest (2,459 per 100k).

Health51 states · 16 metricsUpdated Nov 7, 2025Original page
5 sources
51 of 51 states
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Total Drug Use Rate, 2023

Green is better, red is worse (lower is better). Click a place to highlight it.

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All 51 ranked

Best first.

Distribution Median and middle halfThe median is the middle value: half of places are above it, half below. The middle half is the range holding the central 50% of places.More in the glossary →

Each dot is one state; the lines mark the median and the middle half.

Median
4,043 per 100k
Middle half 3,455 per 100k – 4,383 per 100k
Average
3,977 per 100k
51 states
Lowest (best)
2,459 per 100k
Nebraska
Highest (worst)
6,297 per 100k
West Virginia

Over time · 2020–2023

The top 5 in 2023, against the median.

  • Median of all states
  • Nebraska
  • Hawaii
  • South Dakota
  • North Dakota
  • Iowa

Data

Click a column to sort, a row to highlight that place on the charts.

51 states · # = rank by Total Drug Use Rate
#
1Nebraska2,459 per 100k
2Hawaii2,474 per 100k
3South Dakota2,569 per 100k
4North Dakota2,595 per 100k
5Iowa2,705 per 100k
6Texas2,973 per 100k
7Virginia3,126 per 100k
8California3,147 per 100k
9Minnesota3,148 per 100k
10Maryland3,270 per 100k
11Georgia3,289 per 100k
12Kansas3,380 per 100k
13Oregon3,444 per 100k
14New Jersey3,466 per 100k
15Wyoming3,486 per 100k
16New York3,598 per 100k
17Idaho3,602 per 100k
18Arkansas3,621 per 100k
19Illinois3,631 per 100k
20Utah3,722 per 100k
21South Carolina3,960 per 100k
22Montana3,962 per 100k
23Nevada3,969 per 100k
24Florida4,005 per 100k
25Mississippi4,016 per 100k
26Vermont4,043 per 100k
27Maine4,103 per 100k
28Indiana4,105 per 100k
29Washington4,139 per 100k
30Wisconsin4,142 per 100k
31Connecticut4,189 per 100k
32Louisiana4,201 per 100k
33Missouri4,280 per 100k
34Alabama4,299 per 100k
35Rhode Island4,303 per 100k
36Colorado4,304 per 100k
37North Carolina4,305 per 100k
38Michigan4,332 per 100k
39Massachusetts4,434 per 100k
40Pennsylvania4,469 per 100k
41Arizona4,500 per 100k
42Alaska4,541 per 100k
43Delaware4,627 per 100k
44Ohio4,665 per 100k
45Oklahoma4,733 per 100k
46New Hampshire4,925 per 100k
47New Mexico4,967 per 100k
48Tennessee5,162 per 100k
49Kentucky5,324 per 100k
50District of Columbia5,826 per 100k
51West Virginia6,297 per 100k

What correlates with Total Drug Use Rate (2023)?

Pearson r against 2,081 other state metrics sharing at least 31 states. Ranks are read by standing: a better rank counts as higher, whether rank 1 is the best place on a list or the worst. Correlation is not causation.

Higher together

Places that have a higher Total Drug Use Rate tend to score higher on these (or rank better)

  1. Drug Deaths Per 100kHealthiest States
    r = +0.81 · very strong · n = 51
    Plot
  2. Opioid Death RateOpioid Epidemic by State
    r = +0.75 · very strong · n = 51
    Plot
  3. Substance Abuse ScoreMost Unhealthy States in the U.S.
    r = +0.60 · strong · n = 49
    Plot
  4. Age-Adjusted Depression RateDepression Rates by State
    r = +0.60 · strong · n = 49
    Plot
  5. Crude Depression RateDepression Rates by State
    r = +0.59 · strong · n = 49
    Plot
  6. Confidence Interval (High End)Most Depressed States
    r = +0.57 · strong · n = 50
    Plot

Opposite directions

Places that have a higher Total Drug Use Rate tend to score lower on these (or rank worse)

  1. Total Happiness ScoreSaddest States
    r = −0.63 · strong · n = 50
    Plot
  2. Male Life Expectancy (HALE)Life Expectancy by State
    r = −0.60 · strong · n = 51
    Plot
  3. Life Expectancy, Both Sexes (HALE)Life Expectancy by State
    r = −0.59 · strong · n = 51
    Plot
  4. Female Life Expectancy (HALE)Life Expectancy by State
    r = −0.56 · strong · n = 51
    Plot
  5. Total Happiness ScoreHappiest States
    r = −0.55 · strong · n = 50
    Plot
  6. Emotional Physical Well Being RankSaddest StatesA rank: rank 1 is the best
    r = +0.54 · strong · n = 50
    Plot

Quick answers

Which state has the highest Total Drug Use Rate?
West Virginia has the highest Total Drug Use Rate in 2023, at 6,297 per 100k, followed by District of Columbia (5,826 per 100k) and Kentucky (5,324 per 100k).
Which state has the lowest Total Drug Use Rate?
Nebraska has the lowest Total Drug Use Rate in 2023, at 2,459 per 100k.
What is the median Total Drug Use Rate across US states?
The median is 4,043 per 100k across the 51 US states with data in 2023.
Where does this drug use by state data come from?
Rankodex compiles it from World Population Review and the primary sources it cites: 2021-2022 National Survey on Drug Use and Health - SAMHSA; 2018-2019 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) - SAMHSA; World Drug Report 2022 - United Nations Office on Drugs and Crime; Global Burden of Disease - IHME.