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Overdose deaths are falling in America because of a 'supply shock': study

https://www.economist.com/united-states/2026/01/08/why-overdose-deaths-are-falling-in-america

#HackerNews #OverdoseDeaths #America #SupplyShock #Study #PublicHealth

2025 WalletHub Drug Use Rankings

Publication (Outlet/Website): The Good Men Project

Publication Date (yyyy/mm/dd): 2025/06/12

Chip Lupo, an analyst from WalletHub, talks about their 2025 report ranking U.S. states by drug problems based on 20 public health, addiction, and enforcement metrics. The study highlights troubling trends, such as New Mexico’s top ranking for drug use, teen substance exposure, and overdose deaths, while Hawaii and Florida rank lowest. Lupo emphasizes the multifaceted nature of the crisis—driven by fentanyl, youth access, and limited treatment infrastructure—and the importance of balanced strategies across healthcare, law enforcement, and prevention. The report underscores the urgent need for coordinated responses to address America’s deepening drug epidemic.

Scott Douglas Jacobsen: Today, we are joined by Chip Lupo, an analyst from WalletHub, to discuss the findings from their new report on drug use by the state. With National Substance Abuse Prevention Week approaching, the timing could not be more critical. The United States saw more than 80,670 drug overdose deaths in the 12 months ending November 2024, and the DEA seized the equivalent of more than 367 million lethal doses of fentanyl that year.

WalletHub’s newly released report ranks the 50 states and the District of Columbia based on 20 key metrics related to drug use, addiction, law enforcement, and health support infrastructure. These range from overdose and arrest rates to opioid prescriptions and the availability of treatment. The goal is to spotlight the most pressing problem areas.

Let us go through the results. Which states are performing well? Which are struggling? And most importantly—why?

Chip Lupo: This is one ranking where number one is not good. The higher a state ranks, the worse its drug problem. According to the report, the five states with the most significant drug problems in 2025 are:

New Mexico
West Virginia
Nevada
Alaska
District of Columbia (Washington, D.C.)

If we examine the top four states (excluding D.C., which is a densely populated urban center with unique governance and demographics), a typical pattern emerges: lower income levels, rural geography, and limited economic opportunities. These factors often correlate with higher levels of substance misuse. In places like New Mexico, which ranks 1st overall, drug use has reached epidemic proportions. It also ranks 1st in Drug Use & Addiction and has the highest percentage of teenagers using illicit drugs, the highest share of teens who tried marijuana before age 13, and the third-highest share of adults using illegal drugs.

Jacobsen: What kinds of factors are measured to determine these rankings?

Lupo: The report includes several key indicators. These capture both illegal drug use and prescription drug misuse, particularly opioids. It also considers:

Overdose deaths per capita
Growth in overdose deaths
Drug arrests per capita
Drug arrests on college campuses
Presence of clandestine drug labs and dumpsites (such as meth labs)
Access to treatment, including programs for pregnant women
Availability of counselling and recovery services
Teen drug use and exposure

Youth drug use is a significant factor. For example, New Mexico has the highest teen usage, and Nevada ranks near the top for teens being offered drugs on school property.

Jacobsen: How about the states at the other end of the spectrum—those doing better?

Lupo: The states with the least severe drug problems, according to our 2025 rankings, are:

Florida
Connecticut
Nebraska
Utah
Hawaii

Hawaii ranks 51st, meaning it has the lowest drug problem overall across our metrics. Florida, at 47th, is exciting—it may surprise some, but that is what the data shows.

Jacobsen: This sounds like a complex and multifactorial issue, and no single policy will fix everything.

Lupo: Absolutely. Addressing drug abuse requires coordinated strategies across law enforcement, healthcare access, and community education. States that succeed tend to invest in all three.

Florida ranks in the bottom 10 across all three of our dimensions: Drug Use and addiction, Law Enforcement, and Drug Health Issues and rehab. To me, that suggests that if there is a drug problem in the state, at least some infrastructure or policy measures are in place—whether through law enforcement or access to treatment—to combat it. That is not always the case in some of the higher-ranked states on our list.

When people think of Florida, they often picture Miami, South Florida, or the I-95 corridor, where drugs are known to move up and down through distribution networks. So, I found Florida’s low ranking surprising. But at the same time, it is encouraging—it shows that measures are being implemented to prevent escalation or provide treatment options, which some of the worst-ranked states do not do well at all.

In those higher-ranked states, we often see abysmal performance in law enforcement and treatment access. That could be due to a lack of facilities, insufficient funding, or limited affordability. Sometimes, individuals may choose not to seek help, even when services are available.

Jacobsen: Is there a significant difference in drug use between red and blue states? Or maybe between younger and older users?

Lupo: The difference between red and blue states is relatively small. Red states average around 27%, while blue states average about 24.5%, so the gap is not that large. It is more useful to look at individual state-level conditions rather than broad political labels.

And yes, some red states have legalized marijuana, which complicates the picture. That must be considered when analyzing these rankings. Legalization could potentially open the door to increased access, higher potency products, or greater exposure, possibly leading to higher rates of use or associated crime.

Also, the marijuana being sold today—especially where it’s legalized—is far more potent than in past generations. This is not your uncle’s low-grade marijuana. Today’s products are significantly stronger, and that increases risks, particularly among inexperienced or younger users.

Jacobsen: Are there contextual or regional factors that explain why teenagers are being offered illegal drugs at school more often in some states than others—say, California compared to Connecticut, South Dakota, or Massachusetts?

Lupo: That is a great question. One possible explanation is the effectiveness—or lack thereof—of school drug education curricula. If those programs are underdeveloped, outdated, or inconsistently implemented, students may not get the message.

One particularly striking metric is the share of children living with someone who has a problem with alcohol or drugs. This does not mean the child is misusing substances, but they are being exposed to substance abuse in their home environment. And that kind of exposure can have long-term consequences. It starts at home—and a household with drug problems is not a stable or protective environment for children.

Jacobsen: I hear ongoing debates about harm reduction versus prohibition and the philosophical spectrum between them. How does that affect your methodology?

Lupo: That is a thoughtful point. In our scoring system, we assign equal weight (25 points each) to Law Enforcement and Drug Health Issues & Rehab to reflect both philosophical approaches. But the most significant weight—50 points—goes to Drug Use & Addiction because that is the most direct expression of the problem.

Within that category, the single most heavily weighted metric is overdose deaths per capita, which we weight quadruple. And that is deliberate. The opioid crisis, especially with fentanyl, has devastated communities across the country. So yes, this epidemic influences the decision to prioritize that metric.

I think so, Scott because when we’re talking about fentanyl, we are almost dealing with a separate issue. I do not believe most teenagers—or even many adult users—are actively trying to score fentanyl, so to speak. It is often something that is unknowingly laced into other drugs—whether illegal street drugs or counterfeit prescription medications. That is what makes it so dangerous.

The overdose deaths per capita metric, which we gave quadruple weight, captures the sheer devastation that fentanyl has contributed to in recent years. It reflects the tremendous volume of fentanyl that has entered the U.S. drug supply.

The following two most heavily weighted metrics in the Drug Use & Addiction category are:

The share of teenagers who used illicit drugs in the past month (double weight)
The number of opioid pain reliever prescriptions per 100 people (also double weight)

These essentially represent two separate demographics. Teenagers are more commonly using illicit recreational drugs, while opioid prescriptions typically affect adults unless a teenager undergoes surgery or a serious injury. So, they speak to different facets of the epidemic.

Jacobsen: That distinction makes sense. It reflects the need to address both youth exposure and adult prescription practices.

Lupo: While these are different aspects of the broader issue, they are both widespread and, therefore, deserve equal weight in our ranking model. The point is to capture the multifaceted nature of drug use and addiction.

Also, to clarify, the data sources we used are all mainstream and reputable. They include the U.S. Census Bureau, Bureau of Labor Statistics, Centers for Disease Control and Prevention, Federal Bureau of Investigation, Substance Abuse and Mental Health Services Administration, U.S. Drug Enforcement Administration, and Centers for Medicare & Medicaid Services.

Jacobsen: Were there any sources you considered including but left out for one reason or another?

Lupo: Not particularly. The list we used is comprehensive and in line with expectations for a report like this. We had coverage from federal health agencies, law enforcement databases, and public health organizations. The core data set is solid.

Jacobsen: Is there anything else that stood out in the Drug Health Issues & Rehab dimension?

Lupo: Yes, a couple of things. One crucial factor is that some states—New Mexico included—have no employee drug testing laws. That means companies can implement testing independently, but the state does not require or regulate it in any standardized way. No law in New Mexico defines substance abuse during pregnancy as a crime.

Another key point is that New Mexico ranks poorly in the share of adults who needed but did not receive treatment for illicit drug use. That could be due to limited treatment centers per capita, affordability issues, or even personal reluctance to seek help.

New Mexico is about middle-of-the-road in terms of substance abuse treatment facilities per 100,000 people, so the treatment infrastructure is not nonexistent. That suggests affordability, access, or public awareness might be the limiting factors.

Jacobsen: All right, that was a great chat.

Lupo: Sounds good, Scott.

Jacobsen: Excellent. Thanks so much. Take care.

Lupo: You got it. Talk soon.

Last updated May 3, 2025. These terms govern all In Sight Publishing content—past, present, and future—and supersede any prior notices. In Sight Publishing by Scott Douglas Jacobsen is licensed under a Creative Commons BY‑NC‑ND 4.0; © In Sight Publishing by Scott Douglas Jacobsen 2012–Present. All trademarks, performances, databases & branding are owned by their rights holders; no use without permission. Unauthorized copying, modification, framing or public communication is prohibited. External links are not endorsed. Cookies & tracking require consent, and data processing complies with PIPEDA & GDPR; no data from children < 13 (COPPA). Content meets WCAG 2.1 AA under the Accessible Canada Act & is preserved in open archival formats with backups. Excerpts & links require full credit & hyperlink; limited quoting under fair-dealing & fair-use. All content is informational; no liability for errors or omissions: Feedback welcome, and verified errors corrected promptly. For permissions or DMCA notices, email: scott.jacobsen2025@gmail.com. Site use is governed by BC laws; content is “as‑is,” liability limited, users indemnify us; moral, performers’ & database sui generis rights reserved.

#drugEpidemic #fentanylCrisis #overdoseDeaths #treatmentAccess #youthExposure

U.S. overdose deaths fell 27% in 2024, a new 1-year record
An estimated 80,000 people died from overdoses last year, according to provisional Centers for Disease Control and Prevention data released Wednesday, a 27 per cent drop from 2023.
#death #health #record #USNews #DrugOverdose #OVERDOSEDEATHS
https://globalnews.ca/news/11180067/us-overdose-deaths-2024-1-year-record/

A discussion I recorded some months ago about the incredibly important safe consumption sites.. the Ontario governments plan to shut them down is a humanitarian disaster and people will die because of it.

https://youtu.be/i_z1_k7ki5o

#opoidcrisis #safeconsumption #harmreduction #ottawa #vancouver #onpoli #dougford #canpoli #overdosedeaths

‘Something has to change’: Mother fights for better addiction care after son’s death
A Nova Scotia woman whose son died from a drug overdose says the province's health-care system failed him, and is calling for better mental health and addiction support.
#globalnews #Health #CodeCriticalNS #NSHealth #OVERDOSEDEATHS
https://globalnews.ca/news/10403037/code-critical-nova-scotia-drug-overdose-death/

Community drug alert issued for Waterloo Region
After six overdose-related deaths in 12 days, the Waterloo Region Integrated Drug Strategy issued a community drug alert for the area.
#globalnews #Canada #KitchenerWaterloonews #Opioids #OVERDOSEDEATHS
https://globalnews.ca/news/10244336/community-drug-alert-issued-for-waterloo-region/

...
Addendae (cont'd)

1000s of Canadian drug users dying as government red tape limits help
Most overdoses in Canada involve smoking, but system remains focused on injection
https://www.cbc.ca/news/canada/safe-inhalation-sites-canada-1.6903281

[report] Opioid- & Stimulant-related Harms in Canada (June 2023)
https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants
https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants/maps

In 2022 >7,300 Canadians died of apparent opioid overdoses;
87% of those deaths occurred in British Columbia, Alberta & Ontario.

#Canada #addiction #opioid #PublicHealth #OverdoseDeaths

North Vancouver paramedic remembered for volunteer patrols to reverse overdoses in Downtown Eastside
Ryan Vena helped save many lives as he navigated his own recovery from addiction

https://www.cbc.ca/news/canada/british-columbia/ryan-vena-remembered-for-life-saving-work-1.6880471

1200s if not 1000s of people in British Columbia are alive & well today thanks to Ryan Vena, as loved ones mourn the death of a man who took it upon himself to respond to overdoses in the Downtown Eastside years before he became a paramedic.

#Vancouver #DTES #hero #OverdoseDeaths #RyanVena

Referenced link: https://medicalxpress.com/news/2023-04-medications-opioid-addiction-incarcerated-individuals.html
Discuss on https://discu.eu/q/https://medicalxpress.com/news/2023-04-medications-opioid-addiction-incarcerated-individuals.html

Originally posted by Phys.org / @physorg_com: http://nitter.platypush.tech/medical_xpress/status/1646917497340190732#m

RT by @physorg_com: Offering medications for #opioidaddiction to incarcerated individuals leads to decrease in #overdosedeaths, study shows @The_BMC @jamanetworkopen https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2803897 https://medicalxpress.com/news/2023-04-medications-opioid-addiction-incarcerated-individuals.html

How #xylazine increases overdose risk, and why #Narcan can still save a life. Xylazine, commonly referred to as tranq, is a drug adulterant – a substance intentionally added to a drug product to enhance its effects.
#opioidcrisis #tranq #overdosedeaths
https://theconversation.com/what-is-xylazine-a-medical-toxicologist-explains-how-it-increases-overdose-risk-and-why-narcan-can-still-save-a-life-199482?utm_source=twitter&utm_medium=bylinetwitterbutton

Global News BC: Growing concern as animal tranquilizer xylazine makes its way into B.C. drug supply https://globalnews.ca/news/9569187/xylazine-b-c-drug-warning-tranquilizer/ #globalnews #britishcolumbia #news #animaltranquilizer #xylazineoverdose #xylazinewarning #OverdoseCrisis #OVERDOSEDEATHS #xylazinedeath #OpioidCrisis #toxicdrugs #Fentanyl #Overdose #Xylazine #Health #Crime #Drugs

Global News BC: Almost 7 lives lost from toxic drugs a day as B.C. overdose deaths surpass 200 for January https://globalnews.ca/news/9534100/b-c-overdose-january/ #globalnews #britishcolumbia #news #overdosedeathstoxicdrugs #BCpublichealthemergency #bctoxicdrugcrisis #BCoverdosecrisis #toxicdrugsupply #OVERDOSEDEATHS #toxicdrugs #Politics #Canada #Health

#overdose #overdosedeaths #overdoseawareness

Global News BC: 2,300 British Columbians died from toxic drug supply in 2022 https://globalnews.ca/news/9448976/british-columbia-toxic-drug-deaths-2022/ #globalnews #britishcolumbia #news #decriminalization #DrugdeathsinBC #OVERDOSEDEATHS #Illicitdrugs #drugdeaths #toxicdrugs #Overdoses #Health

Men who took classes in high school that prepared them for blue-collar occupations where jobs and wages later shrank have an increased risk of overdose death in adulthood.

https://www.ncbi.nlm.nih.gov/pubmed/35164593

#NICHDImpact #BlueCollar #SES #OverdoseDeaths #Overdose #Income #Class

Claim Journal News: Walgreens, Teva Accused of Fueling Opioid Addiction in Quest for New Markets https://www.claimsjournal.com/news/national/2022/04/26/310101.htm #TevaPharmaceuticalIndustriesLtd #opioidlitigation #overdosedeaths #publicnuisance #NationalNews #Settlement #Walgreens #lawsuit

#overdosedeaths

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