Posted by: John S Kiernan

Drug abuse has a long and storied history in the United States, and we’ve been “at war” with it since 1971 under the Nixon administration. But no matter who is in office, the federal drug budget continues to increase. It’s moved from $23.8 billion in 2013 to almost $27.5 billion in 2017.

The current administration seems to be taking a hardline approach to drug use. President Donald Trump and Attorney General Jeff Sessions have advocated for strict sentences for drug-related offenses, even as far as the death penalty in some cases.

Given the uncertain future and lack of significant progress to date, it’s fair to wonder where drug abuse is most pronounced and which areas are most at risk in the current political climate. This report attempts to answer those questions by comparing the 50 states and the District of Columbia across 20 key metrics, ranging from arrest and overdose rates to opioid prescriptions and meth-lab incidents per capita. Continue reading for the complete findings, commentary from a panel of researchers and a full description of the methodology used.

1. Main Findings
2. Red States vs. Blue States
3. Ask the Experts: Dealing With Our Drug Problems
4. Methodology

Main Findings

Embed on your website<iframe src="//d2e70e9yced57e.cloudfront.net/wallethub/embed/35150/geochart-drug-use.html" width="556" height="347" frameBorder="0" scrolling="no"></iframe> <div style="width:556px;font-size:12px;color:#888;">Source: <a href="https://ift.tt/2jV6rF5>  

Highest Drug Use by State

Overall Rank (1=’Biggest Problem’)	State	Total Score	‘Drug Use & Addiction’ Rank	‘Law Enforcement’ Rank	‘Drug Health Issues & Rehab’ Rank
1	District of Columbia	62.97	1	22	1
2	Missouri	57.73	16	2	21
3	New Hampshire	55.65	8	6	28
4	Michigan	55.35	10	13	11
5	West Virginia	53.98	6	3	50
6	New Mexico	52.14	14	11	36
7	Indiana	51.69	18	5	32
8	Rhode Island	50.99	2	50	4
9	Kentucky	50.57	12	7	51
10	Pennsylvania	50.54	15	9	47
11	Massachusetts	49.99	11	24	30
12	Colorado	49.58	19	21	24
13	Wyoming	49.14	39	1	19
14	Tennessee	48.78	13	33	18
15	Oregon	48.42	20	28	7
16	Delaware	47.85	17	25	27
17	Alaska	47.72	4	45	16
18	Maine	47.33	7	39	31
19	Arkansas	46.77	29	12	25
20	Maryland	46.70	5	37	40
21	Ohio	46.66	3	38	45
22	Montana	45.96	32	18	10
23	Vermont	45.77	9	48	23
24	Nevada	45.66	21	43	3
25	Connecticut	45.00	22	31	22
26	New York	44.48	34	16	20
27	Illinois	44.38	28	14	41
28	Louisiana	43.77	25	29	17
29	New Jersey	42.53	35	10	42
30	Florida	42.08	23	36	29
31	Arizona	41.79	26	41	15
32	North Carolina	41.51	24	34	34
33	South Carolina	40.76	27	49	2
34	South Dakota	39.37	48	8	6
35	Oklahoma	39.35	30	32	35
36	Mississippi	39.20	37	30	9
37	Texas	39.10	46	15	13
38	Virginia	38.61	43	19	37
39	Georgia	38.44	36	35	12
40	Wisconsin	38.20	40	17	48
41	California	38.08	38	42	5
42	Washington	36.85	31	47	26
43	Idaho	35.43	42	26	44
44	Nebraska	34.64	50	20	14
45	Alabama	34.59	33	51	8
46	Hawaii	33.62	41	40	38
47	North Dakota	33.36	49	4	49
48	Kansas	33.17	45	23	46
49	Utah	30.05	44	44	39
50	Iowa	29.90	51	27	33
51	Minnesota	27.03	47	46	43

 

Red States vs. Blue States

 

Ask the Experts: Dealing With Our Drug Problems

For a better understanding of America’s relationship with drugs and advice on what people can do if they think a friend or family member has a problem, we asked the following questions to a panel of drug-addiction experts. You can find their bios and responses below.

1. What are the most effective measures state and local authorities can take to combat the opioid epidemic?
2. Why do American doctors over-prescribe pain medication? To what degree is this responsible for the current epidemic?
3. What should family or friends do if they suspect someone has a drug problem?
4. Do you think Naloxone – the drug used to counteract overdoses – should be readily available to anyone who requests it?
5. Should the federal government require all rehab facilities to accept Medicaid as a form of payment? What other steps should Federal officials take to improve access to treatment?

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• Peter A. Clark Chair, Saint Joseph's University
• Theodore C. Friedman Chairman, Department of Internal Medicine, Endowed Professor of Cardio-Metabolic Medicine, Professor of Medicine-Charles R. Drew University of Medicine & Science
• Ingrid Walker Associate Professor, American Studies, School of Interdisciplinary Arts & Sciences, University of Washington, Tacoma
• David Herzberg Associate Professor, University at Buffalo, The State University of New York
• Darren Urada Research Psychologist, UCLA Integrated Substance Abuse Programs
• John Harvin Assistant Professor in the Department of Surgery at McGovern Medical School at UTHealth in Houston & Surgeon at Red Duke Trauma Institute at Memorial Hermann-Texas Medical Center

Peter A. Clark Chair, Saint Joseph's University

What are the most effective measures state and local authorities can take to combat the opioid epidemic?

A. I think one of the most effective ways to address the opioid crisis is what Philadelphia, Seattle, NYC and San Francisco are attempting to do by creating safe injection sites. Philadelphia is looking at the Insite model out of Vancouver. I am heading a research project that has 3 medical residents from the Mercy Health System of Philadelphia, 4 medical Students from the Philadelphia College of Osteopathic Medicine (PCOM) and 4 undergraduates from Saint Joseph's University. The residents are examining the medical aspects, the PCOM students are evaluating the Vancouver site and the SJU students are proposing what the Comprehensive User Engagement Site (CUES) might look like in Philadelphia. The Site hopefully would entail the following:

1. Trained staff (PA/Nurse Practitioner)
2. Safe Injection Booths
3. Needle Exchange Program
4. Naloxone/Narcan medications
5. Wound Care
6. HeP-C/HIV testing and counseling
7. Counseling for Rehab/Detox by individuals in recovery.

We see 4 areas of concern at the moment:

1. Education of potential neighborhood sites
2. Insurance coverage for the site
3. How to legally deal with the Federal Crack House Statute
4. Identifying groups to pay for and run the CUES.

B. A second option is the creation and oversight of a database to monitor compliance with procedures and policies. consistent with the Pennsylvania Guidelines for Pain Management in Non-Cancer Patients and the Pennsylvania Guidelines for Emergency Department Paint Treatment Guidelines. You might want to look at what St. Luke's University Health Care Network is doing in Bethlehem, Pa.

Why do American doctors over prescribe pain medication? To what degree is this responsible for the current epidemic?

I think many physicians were duped by the pharmaceutical industry in the early 90's about the non-addictive aspects of opioids. They were trained that opioids were the best way to handle not only end-of-life pain but also chronic pain. Unfortunately, pharmaceutical companies like Purdue Pharmaceuticals lied about the addictive nature of OxyContin and as a result many people became addicted. In 2006 studies were released that NSAIDs were far more effective for chronic pain than opioids but that generation of physicians were convinced about the positive aspects of opioids and continued to treat. I think the only way to correct this problem is to aggressively educate the medical students and medical interns/residents of this generation about effective pain management. I think Big Pharma, the medical profession and even JCAHO (making pain the 5th vital sign) are responsible for the opioid epidemic in certain ways.

What should family or friends do if they suspect someone has a drug problem?

I think family and friends need to meet individuals where they are, offer help in getting treatment, and help them stay alive until they are ready to enter treatment. I think to say just stop taking drugs is unrealistic. It is like telling a newly diagnosed diabetic to stop all sugar or someone who is clinically depressed to be happy. This will not work. The opioid epidemic is a public health issue and a social justice not a legal issue. We need to get these individuals into treatment facilities not prisons. I believe these individuals are the most vulnerable in society. They live on the margins of society and are looked upon by many as disposal people. This is wrong. These are our brothers and sisters, aunts and uncles, cousins and even our sons and daughters. They cannot be abandoned. They must be helped to see there is hope through treatment.

Do you think Naloxone -- the drug used to counteract overdoses -- should be readily available to anyone who requests it?

I do believe Naloxone should be available because it saves lives. I will attach a paper I co- authored a number of years ago on this topic.

Should the federal government require all rehab facilities to accept Medicaid as a form of payment? What other steps should Federal officials take to improve access to treatment?

I believe the federal government must see this crisis as a public health issue not a legal issue. We need to take the monies were have spent and are spending on criminalizing opioid addicts and put it instead into rehabilitating them. These are our fellow citizens and they are sick and hurting. If this was a crisis where our water supply was threatened by bacteria and killing people or our food supply was killing Americans, we would declare it a national emergency and put the needed funds toward the solution of the problem. Drugs are killing over 64,000 Americans a year and all we hear is silence. The President has declared the opioid crisis a national emergency but has not put the needed funds toward creating solutions. This is denying Americans the basic rights of life, liberty and the pursuit of happiness.

Theodore C. Friedman Chairman, Department of Internal Medicine, Endowed Professor of Cardio-Metabolic Medicine, Professor of Medicine-Charles R. Drew University of Medicine & Science

What are the most effective measures state and local authorities can take to combat the opioid epidemic?

Fund treatment programs for opioid abusers. Fund programs to address mental health issues. Have other modes for treating pain. Group pain visits.

Why do American doctors over prescribe pain medication?

Patients ask for them, they don't want pts to have pain.

To what degree is this responsible for the current epidemic?

Good portion. Doctors should be more familiar with non-opioid treatments for pain including, exercise, antidepressants, acupuncture

What should family or friends do if they suspect someone has a drug problem?

Try to find out the underlying cause. Refer family member for treatment.

Do you think Naloxone -- the drug used to counteract overdoses -- should be readily available to anyone who requests it?

Absolutely.

Should the federal government require all rehab facilities to accept Medicaid as a form of payment? What other steps should Federal officials take to improve access to treatment?

No - but there should be funded local treatment and rehab programs for Medicaid patients more funding for research. Better access to mental health programs.

Ingrid Walker Associate Professor, American Studies, School of Interdisciplinary Arts & Sciences, University of Washington, Tacoma

What are the most effective measures state and local authorities can take to combat the opioid epidemic?

The opiate crisis is an overdose crisis, first and foremost. People are dying because of opiate overdose. There are multiple reasons that figure has spiked in the last few years. The predominant reasons are: some people who use opiates were driven from using prescription opiates to black market drugs (both pills and heroin). Drugs purchased the black market are increasingly adulterated with much stronger synthetic opiates, like fentanyl. It's easier to produce than opium, and so it has been a primary ingredient in the drugs that people are buying in unregulated markets. People who used heroin even before this crisis have also suffered overdose because the product they have become accustomed to is suddenly much, much stronger.

Stopping overdoses through harm reduction is possible; other countries have succeeded in doing this. It can involve a set of options:

1. Safe consumption sites (SCS) for users who lack housing
2. Drug checking to stop users from consuming adulterated substances
3. Addressing secondary needs (housing, substance abuse treatment, health care, and employment).

Safe Consumption Sites / SCS: These are sites that have medical monitoring of use and, often, check drugs so that users will not use an adulterated product. The medical professionals can offer clean needles (to keep the spread of disease in check) and are equipped with naloxone should drug-checking not be an option. The administration of naloxone stops an overdose. Keeping people from overdosing in the first place allows us to both step the tide of deaths while municipalities work on coordinating secondary issues such as housing and treatment options.

Secondary issues include access to: addiction treatment, mental and physical health care, housing, and employment. It becomes hard to engage these needs if we haven't helped create stability for drug users. For example, getting people who want drug treatment into treatment is often thwarted by a 1-3 week waiting period. When someone has decided to try to enter treatment, waiting even a day can change that decision. If people are using on the street, it's because they don't have a stable housing situation. Asking them to be abstinent from drug use to enter public housing is a high bar if they suffer drug abuse disorder (addiction). There are solutions, but they require these public services to work in coordination to understand these thresholds.

Why do American doctors over prescribe pain medication? To what degree is this responsible for the current epidemic?

It's hard to know what current prescription rates are for pain medication, but we do know that the US uses the vast majority (between 70-80%) of the world's painkillers. For Hydrocodone alone, it's almost 99%. So clearly we are prescribing and taking a lot of pain medication. The question is why? We also know that the pharmaceutical industry has promoted some drugs more than others. OxyContin, for example, was promoted to doctors as less or non-addictive. So it's possible that a confluence of a reliance on pharmaceutical solutions combined with prescription-forward practices has led to more people using opiates. At the same time, and this is significant, we've failed to have less dangerous solutions to chronic pain management. It is an area in which we don't meet patient need because opiates are not great solutions for many kinds of chronic pain.

What should family or friends do if they suspect someone has a drug problem?

A "drug problem" could have a wide variety of causes. Direct communication, but especially listening, with a family member of friend is critical. A drug problem could mean self-medication to ameliorate the effects of a physical or mental illness, depression, or other causes. It could mean a response to an episodic crisis. In other words, not all "drug problems" are the same. I suggest finding out what's going on, then working with the person to support her/him/them and to find a professional option (therapy? treatment? other?).

Do you think Naloxone -- the drug used to counteract overdoses -- should be readily available to anyone who requests it?

Yes, making Naloxone widely available would stop the overdose deaths and allow us to think through the complexities of each drug user's circumstances and need. If we could make it over the counter, for example, it would address the steep cost for a single dose ($40-80), and that's with insurance. The very people who need access to Naloxone probably don't have insurance and are unlikely to spend limited funds on the antidote to the drug they seek. Harm reduction is a critical step in solving this problem.

Should the federal government require all rehab facilities to accept Medicaid as a form of payment? What other steps should Federal officials take to improve access to treatment?

Drug abuse treatment is big business. It will be challenging to get providers to accept Medicaid for a variety of reasons, not the least of which is the price tag. Some treatment facilities charge $20-60,000 a month. But making more treatment available to more of the public is critical. However, and this is key, treatment cannot be forced or punitive. So having spaces where people who use drugs learn to trust others (such as safe consumption sites) and to see them as allies is an important part of this process. Research shows that treatment that is not elective has an even higher failure rate than treatment entered voluntarily.

The federal government has to decriminalize drug use. If they do that, more municipalities would begin to take bolder steps. It would eliminate the black market, which is the source of the overdose crisis. Drug abuse disorder is an issue we have to address as a culture: why are people turning to pain killers so disproportionately? What is going on in their lives that this is an option? We can talk about drug abuse disorder as a brain disease, but it does not explain the spike in drug use and overdose. There are environmental and cultural causes to this crisis - and we had better start to discuss them if we hope to make lasting changes.

David Herzberg Associate Professor, University at Buffalo, The State University of New York

What are the most effective measures state and local authorities can take to combat the opioid epidemic?

The most effective evidence-based measures fall under the category of "harm reduction" and involve establishing or expanding access to medication assisted treatment (buprenorphine, methadone) and safe injection facilities. This provides a stable, predictable, affordable supply of opioids to people with addiction, reducing the risk of OD and enabling them to maintain, build, or re-build families, careers, social networks, etc., while also putting them in regular contact with health professionals who can minimize drug-related harms and other health issues and, importantly, who are also available to help if and when the person decides they want to stop using drugs. Other forms of "rehab" that aim solely or immediately at abstinence (i.e., getting people with addiction to stop using drugs altogether) do sometimes work for some people, but research has shown their overall success rate to be *dramatically* lower. Medication assisted treatment is the only approach that research has proven to significantly raise overall survival rates (by as much as 50% or more) among people with addiction. In fact, abstinence-based programs can actually increase the risk of overdose, because relapse is so common, and at the moment of relapse a person's opioid tolerance is much lower than is "normal" for a person with addiction. In sum, addiction is a life-threatening illness, and state and local authorities should respond to it as such, by making the most effective, research-proven treatment available to the people suffering from it.

Why do American doctors over prescribe pain medication? To what degree is this responsible for the current epidemic?

It's not clear that American doctors still over prescribe pain medication, although they certainly did in the recent past, and it was a major contributor to the current crisis. Most but not all of the factors contributing to over-prescribing can be traced to pharmaceutical companies, which undertook a multi-level campaign to market opioids at the turn of the 21st century. This involved far more than simple advertisements. Opioid manufacturers invested in "astroturf" patient advocacy organizations demanding effective treatments for pain and they invested in professional organizations devoted to the study and treatment of pain. They also exploited Reagan-era deregulation to get new opioids like OxyContin approved as "less addictive" - a foolish finding that would never have been established previously in the 20th century. Overall, the marketing campaign was able to rewrite professional and hospital guidelines for treating pain so that vastly more people suffering from pain received opioid medications.

It is important to note that many, many people really do suffer from pain, and insisting that the medical system take pain seriously is not a bad thing. Nor is it necessarily wrong to use opioids to treat pain. The problem was in convincing physicians, and patients, that opioids used for pain were essentially unproblematic and could be used with relatively little caution. Opioids can be used safely, and definitely have some role to play in a multi-modal response to the problem of pain. But this was not the type of use that drug companies promoted.

Should the federal government require all rehab facilities to accept Medicaid as a form of payment? What other steps should Federal officials take to improve access to treatment?

There is treatment, and there is treatment. The federal government should only fund and improve access to treatments that have been proven successful at saving the lives of people suffering from addiction (i.e., for now, medication assisted treatment). No subsidies should be provided to programs that tell a good story but do not provably deliver on the bottom line - that is, saving lives. But in the midst of a public health crisis, YES, we should definitely invest our collective resources into making effective treatments more available. The government should expand the availability of buprenorphine maintenance, while keeping a close regulatory watch on those who profit from buprenorphine (drug industry, prescribers, pharmacies, etc.) to ensure that this does not become a secondary contributor to the crisis. In fact, personally, I believe the feds should limit or even eliminate the sale of these drugs for profit - the danger is too high, they should be made available solely on a not-for-profit basis. The feds can also ease barriers to establishing safe injection facilities, or even establish a temporary network of such facilities. The feds are also the best authority to ensure that access to effective treatments such as these are available not just in wealthy areas, but in the poorer areas where the health crisis is increasingly becoming prevalent.

Darren Urada Research Psychologist, UCLA Integrated Substance Abuse Programs

What are the most effective measures state and local authorities can take to combat the opioid epidemic?

We have to attack this from all sides. To combat the spread of opioid use, we need to safely reduce use of prescription opioid medications. To reduce deaths, we need to provide easy access to naloxone, a medication that can reverse opioid overdoses.To address the needs of people with opioid use disorders we need to provide medication-assisted treatment with FDA-approved medications that work (methadone, buprenorphine, extended release naltrexone). Local Opioid Safety Coalitions,groups of community stakeholders who work together to solve the epidemic in their own communities, are an effective way to make progresson all of these fronts.

Why do American doctors over prescribe pain medication? To what degree is this responsible for the current epidemic?

Until recently, American doctors were told that opioid pain medications only caused dependence in a very small percentage of patients, which turned out to be very wrong. They were also trained to prioritize the treatment of patient pain, and opioids initially seemed like an easy way to do that. Even that turned out to be flawed in many cases, however, because opioid pain medications are not very effective for chronic pain. There are other factors, but these well-meaning but misplaced understandings played an initialrole in fueling the epidemic.

What should family or friends do if they suspect someone has a drug problem?

The research is very clear that for opioid use disorders, medication assisted treatment provides people with the best chance of surviving and reclaiming their lives. This is what I would recommend to my own family member or friend.

Do you think Naloxone -- the drug used to counteract overdoses -- should be readily available to anyone who requests it?

Absolutely, it should be available to anyone. It should also be carried by first responders and anyone else who interacts with people at high risk of overdose. We now havelibrarians administering naloxone.Librarians. If that's what it takes to save lives, it's what we need to do.

Should the federal government require all rehab facilities to accept Medicaid as a form of payment? What other steps should Federal officials take to improve access to treatment?

Medicaid is already a common source of payment, but the kinds of treatment it covers varies from state to state. Federal officials should continue to allow states to innovate and test new models, and encourage states to adopt models that work.

California is in the midst of Medicaid demonstration waiverthat aims to provide an expanded, full continuum of care for substance use disorder treatment services whilerequiring better matching between patient needs and services,enabling more local control and accountability,andfacilitatingcoordination with other systems of care. California is also expanding use of medication assisted treatment into primary care. New York is transitioning behavioralhealth services (mental health and substance use disorder treatment) into managed health care, uniting it with the rest of thehealth care system.

The common thread that runs through all of these efforts is that patients with substance use disorders should be able to access treatment through,or at least in coordination with, the larger health care system. Relatively few people who need treatment recognize that need and voluntarily seek care in specialty treatment programs (colloquially referred to as "rehab"). These programs tend to be "siloed off" from the rest of the health care system and there is a heavy stigma associated with them. Virtually everybody has contact with the larger health care system, however, and that is where we can and must initially identify substance use disorders and provide services. Substance use disorders are health issues. They have a profound impact on peoples' health, and often the health of people around them. We need get better at treating them that way.

John Harvin Assistant Professor in the Department of Surgery at McGovern Medical School at UTHealth in Houston & Surgeon at Red Duke Trauma Institute at Memorial Hermann-Texas Medical Center

What are the most effective measures state and local authorities can take to combat the opioid epidemic?

From a medical perspective, I am not sure the local, state, or federal authorities are going to be the most effective in addressing the medical community's contribution to the opioid epidemic. Certainly many states have implemented rules to make the prescribing of opioids more difficult and that will help decrease prescriptions, but that will also interfere with the patient-physician relationship. What is really needed is cultural change in the United States regarding pain management. This change would be best led by physicians and clinical researchers. For decades, opioids have been touted as a safe treatment strategy for all sorts of pain - low back pain, post dental procedure pain, minor surgery to name a few. Patients became used to getting them for all kinds of ailments. Physicians became used to prescribing them for all kinds of ailments. In reality, opioids carry a real risk of long term abuse and there are excellent non-opioid medications that effectively treat pain, like acetaminophen and NSAIDs.

This can be done. Trauma surgeons and anesthesiologists from McGovern Medical School at UTHealth in Houston, in affiliation with the Red Duke Trauma Institute at Memorial Hermann Hospital-Texas Medical Center, have changed the culture of pain management in injured patients. These patients have severe acute pain. By setting realistic expectations of pain control, prescribing large amounts of effective, non-opioid pain medications, and educating providers and patients on safe opioid use, we have decreased our opioid use significantly and rarely provide intravenous opioids for pain control. We can do even better.

The most effective way that local, state, and federal authorities can help to address this crisis is to fund research - research on addiction, pain management strategies using non-addictive drugs, mental health and substance abuse, and even the genetics of addiction.

Why do American doctors over prescribe pain medication? To what degree is this responsible for the current epidemic?

It's a cultural thing. Over decades, American physicians and patients became accustomed to the use of opioids for minor pain. The responsibility for creating this culture reaches every aspect of the health care system. Pharmaceutical companies pushed opioids as an appropriate and safe treatment for all sorts of pain. Believing that they were safe and appropriate for all sorts of pain, physicians prescribed them in a genuine effort to treat patients' pain and to have satisfied patients. Patients, having been told opioids were safe and getting used to receiving opioids from physicians, became accustomed to receiving them for all sorts of ailments. State and federal regulation on opioid prescribing were weak in the U.S. compared to other countries. Accrediting bodies mandated that pain was a vital sign, equating adequate pain control and patient satisfaction to quality of care and, eventually, linking it to reimbursement. Insurance companies readily covered the opioid prescriptions for patients. All these factors contributed to a vicious cycle of opioid normalization, the current culture of pain management, and our opioid crisis.

Do you think Naloxone -- the drug used to counteract overdoses -- should be readily available to anyone who requests it?

I believe naloxone should be available over the counter. It has been around for decades and is available over the counter in other countries. As with all medications, however, education will need to be provided to ensure that people know how to use it appropriately.

Methodology

In order to determine which states have the biggest drug problems, WalletHub compared the 50 states and the District of Columbia in three overall categories: 1) Drug Use & Addiction, 2) Law Enforcement and 3) Drug Health Issues & Rehab.

Those categories include a total of 20 relevant metrics, which are listed below with their corresponding weights. Each metric was graded on a 100-point scale, with a score of 100 representing the biggest drug problem.

We then determined each state and the District’s weighted average across all metrics to calculate its overall score. This total score was the basis for our final ranking. So the state ranked 1st in this study has the biggest drug problem, based on the data at hand, while the state ranked 51st has the smallest drug problem.

Drug Use & Addiction – Total Points: 50

• Share of Teenagers Who Used Illicit Drugs in the Past Month: Triple Weight (~11.54 Points)
• Share of Teenagers Who Tried Marijuana Before Age 13: Full Weight (~3.85 Points)
• Share of Teenagers Offered, Sold or Given an Illegal Drug on School Property in the Past Year: Full Weight (~3.85 Points)
• Share of Adults Who Used Illicit Drugs in the Past Month: Triple Weight (~11.54 Points)
• Number of Opioid Pain Reliever Prescriptions per 100 People: Full Weight (~3.85 Points)
• Number of Methamphetamine Lab Incidents (population adj): Full Weight (~3.85 Points)Note: The square root of the population was used to calculate the “Number of Residents” in order to avoid overcompensating for minor differences across states.
• Overdose Deaths per Capita: Double Weight (~7.69 Points)
• Overdose Deaths Growth (2016 vs 2015): Full Weight (~3.85 Points)

Law Enforcement – Total Points: 25

• Drug Arrests per Capita: Full Weight (~6.25 Points)
• Drug Arrests on College Campuses per 1,000 Students: Full Weight (~6.25 Points)
• Prescription Drug Monitoring Laws: Full Weight (~6.25 Points)
  • 1 – States with a prescription drug monitoring law that requires doctors to consult an opioid prescription database before prescribing painkillers.
  • 0.5 – States with a prescription drug monitoring law that does not require doctors to consult an opioid database.
  • 0 – States with no prescription drug monitoring laws.
• Maternity Drug Policy (Is Substance Abuse During Pregnancy a Crime?): Full Weight (~6.25 Points)
• States with Employee Drug Testing Laws: Full WeightNotes: 0- Currently Not Available; 1- Authorized

Drug Health Issues & Rehab – Total Points: 25

• Share of Adults Who Needed but Didn’t Receive Treatment for Illicit Drug Use in the Past Year: Double Weight (~10.00 Points)
• Substance Abuse Treatment Facilities per 100,000 People (12 Years and Older) Using Illicit Drugs: Full Weight (~5.00 Points)
• Admissions to Substance Abuse Treatment Services per 100,000 People (12 Years and Older) Using Illicit Drugs: Double Weight (~10.00 Points)
• Naloxone Availability without Individual Prescription: Full Weight
• Share of Addiction Treatment Medication Paid by Medicaid: Full Weight
• Narcotics Anonymous & Alcoholics Anonymous Meetings Accessibility: Full Weight
• Substance Abuse & Behavioural Disorder Counsellors per Capita: Full Weight

 

Sources: Data used to create this ranking were collected from U.S. Census Bureau, Centers for Disease Control and Prevention, Federal Bureau of Investigation, Substance Abuse and Mental Health Services Administration, U.S. Drug Enforcement Administration, Project Know, the Pew Charitable Trusts and Pro Publica.

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