10 states with most, least drug use

New Mexico is the most at-risk state for drug use, according to an April 29 ranking from personal finance website WalletHub.

The list was created to determine where drug use is most pronounced and which areas are most at risk by comparing the 50 states and Washington, D.C. across 20 metrics in three categories: drug use and addiction, law enforcement and drug health issues and rehabilitation.

Metrics included overdose deaths per capita and substance abuse treatment facilities per 100,000 people using illicit drugs. WalletHub calculated each state’s weighted average across all metrics to determine its overall score, with the state ranked No. 1 having the most significant drug problem based on the data analyzed.

The U.S. saw the largest decrease in drug overdose death rates ever recorded in 2024, exceeding the record set in 2018. The rate declined 26.2% between 2023 and 2023, from 31.3 to 23.1 per 100,000, according to CDC data. A separate CDC report found Vermont, Rhode Island and New York had the largest decreases in predicted drug overdose deaths between August 2024 and August 2025.

Here are the 10 states most and least at risk for drug use, per WalletHub:

10 most

1. New Mexico

2. Arkansas

3. Alaska

4. Nevada

5. Missouri

6. West Virginia

7. Colorado

8. Washington, D.C.

9. Oklahoma

10. Mississippi

10 least

42. Nebraska

43. Connecticut

44. Hawaii

45. Ohio

46. Virginia

47. Iowa

48. Maryland

49. Minnesota

50. Florida

51. Utah

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