States With the Biggest Drug Problem

New Mexico holds dubious No. 1 spot in WalletHub rankings, with Hawaii logging the least drug use
Posted May 4, 2025 1:00 PM CDT
States With the Biggest Drug Problem
Stock photo.   (Getty Images/Moussa81)

There's been some positive movement in the US on fighting drug overdose deaths in recent years, but the war on drugs continues to rage on, particularly in some states. WalletHub looked at all 50 states and the District of Columbia to try to suss out where the problem is most prevalent, using 20 metrics in three main categories: drug use and addiction (share of kids and adults who use, overdose deaths per capita, and the like); law enforcement, meaning such gauges as drug arrests and worker drug-testing laws; and drug health issues and rehab—the availability of substance abuse treatment sites, AA and Narcotics Anonymous meetings, and so on. New Mexico bubbled up as the state with the highest drug use, while Hawaiians apparently are opting to live a clean, drug-free lifestyle. The states with the most and least drug use:

Highest drug use

  1. New Mexico (No. 1 in "Drug Use & Addiction" category)
  2. West Virginia
  3. Nevada (No. 1 in "Drug Health Issues & Rehab" category)
  4. Alaska
  5. District of Columbia
  6. Oklahoma
  7. Missouri
  8. Colorado
  9. Louisiana
  10. Arkansas

Lowest drug use

  1. Idaho
  2. Iowa
  3. North Carolina
  4. Maryland
  5. Minnesota
  6. Florida
  7. Connecticut
  8. Nebraska (last in "Drug Use & Addiction" category)
  9. Utah
  10. Hawaii
See how other states are doing here. (California is selling generic Narcan for just $24.)

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