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Last month, a picture of grandparents overdosing on heroin with a child in the backseat of their car went viral. The Ohio Police made the picture public to show the graphic reality of the opioid crisis currently gripping the nation.

Though opioid abuse is a problem nation-wide, it more heavily affects certain regions, such as Appalachia and the Great Lakes. Small, economically struggling towns like Ohio’s East Liverpool and West Virginia’s Huntington are two that have been hit especially hard.

With so much of the spotlight on opioids, it can be easy to forget that alcohol and other drugs also cause many deaths nationwide.


Given this recent focus on substance abuse across America, the experts at HealthGrove, a health research site powered by Graphiq, used the most recent data (2014) from the Centers for Disease Control and Prevention to find the 100 counties with the highest rates of substance abuse-related deaths.

COMPLETE COVERAGE: Heroin in America

It is interesting to note that 15 of the 100 counties listed are in Texas. Though Texas’ opioid problems haven’t quite gained the national spotlight, the state is clearly dealing with a widespread issue. People use opioids regularly, and the life-saving, overdose reversal medication Naloxene just recently became available at neighborhood pharmacies to help with the issue.

Like residents in many other states, the primary drug of abuse in Texas is alcohol. Compared to all other states, their number of alcohol-related deaths is relatively low, but in combination with their other substance abuse habits, it likely contributes to the high death rates in the 15 counties on this list.

North Dakota and South Dakota are also both big contributors — these states each have seven and eight counties on the list, respectively.

With that in mind, here are the 100 counties with the highest rates of substance abuse-related deaths.

Arkansas

Baxter County (#84)

  • Population: 40,857
  • Deaths in 2014: 638

Lafayette County (#95)

  • Population: 7,111
  • Deaths in 2014: 110

Monroe County (#59)

  • Population: 7,582
  • Deaths in 2014: 122

Sharp County (#78)

  • Population: 16,906
  • Deaths in 2014: 266

Colorado

Kiowa County (#48)

  • Population: 1,402
  • Deaths in 2014: 23

Sedgwick County (#18)

  • Population: 2,348
  • Deaths in 2014: 42

Florida

Citrus County (#15)

  • Population: 139,377
  • Deaths in 2014: 2,579

Georgia

Turner County (#86)

  • Population: 8,153
  • Deaths in 2014: 127

Illinois

Gallatin County (#91)

  • Population: 5,291
  • Deaths in 2014: 82

Hardin County (#76)

  • Population: 4,129
  • Deaths in 2014: 65

Stark County (#71)

  • Population: 5,813
  • Deaths in 2014: 92

White County (#54)

  • Population: 14,374
  • Deaths in 2014: 233

Iowa

Adams County (#77)

  • Population: 3,875
  • Deaths in 2014: 61

Cass County (#75)

  • Population: 13,448
  • Deaths in 2014: 212

Monana County (#28)

  • Population: 8,996
  • Deaths in 2014: 154

Montgomery County (#97)

  • Population: 10,421
  • Deaths in 2014: 160

Kansas

Clark County (#21)

  • Population: 2,144
  • Deaths in 2014: 38

Comanche County (#12)

  • Population: 1,954
  • Deaths in 2014: 37

Lane County (#42)

  • Population: 1,687
  • Deaths in 2014: 28

Logan County (#25)

  • Population: 2,794
  • Deaths in 2014: 49

Ness County (#47)

  • Population: 3,105
  • Deaths in 2014: 51

Osborne County (#53)

  • Population: 3,756
  • Deaths in 2014: 61

Republic County (#6)

  • Population: 4,803
  • Deaths in 2014: 94

Rush County (#83)

  • Population: 3,197
  • Deaths in 2014: 50

Smith County (#4)

  • Population: 3,769
  • Deaths in 2014: 76

Trego County (#33)

  • Population: 2,902
  • Deaths in 2014: 49

Kentucky

Breathitt County (#69)

  • Population: 13,409
  • Deaths in 2014: 213

Fulton County (#82)

  • Population: 6,265
  • Deaths in 2014: 98

Hickman County (#70)

  • Population: 4,734
  • Deaths in 2014: 75

Owsley County (#65)

  • Population: 4,508
  • Deaths in 2014: 72

Robertson County (#10)

  • Population: 2,197
  • Deaths in 2014: 42

Michigan

Alcona County (#60)

  • Population: 10,454
  • Deaths in 2014: 168

Iosco County (#89)

  • Population: 25,420
  • Deaths in 2014: 395

Iron County (#87)

  • Population: 11,387
  • Deaths in 2014: 177

Ontonagon County (#26)

  • Population: 6,172
  • Deaths in 2014: 108

Roscommon County (#81)

  • Population: 23,955
  • Deaths in 2014: 375

Minnesota

Kittson County (#5)

  • Population: 4,435
  • Deaths in 2014: 87

Missouri

Benton County (#43)

  • Population: 18,806
  • Deaths in 2014: 312

Chariton County (#36)

  • Population: 7,694
  • Deaths in 2014: 129

Hickory County (#57)

  • Population: 9,219
  • Deaths in 2014: 149

Iron County (#93)

  • Population: 10,267
  • Deaths in 2014: 159

Reynolds County (#51)

  • Population: 6,565
  • Deaths in 2014: 107

St. Clair County (#88)

  • Population: 9,457
  • Deaths in 2014: 147

Montana

Daniels County (#19)

  • Population: 1,793
  • Deaths in 2014: 32

Nebraska

Brown County (#64)

  • Population: 2,941
  • Deaths in 2014: 47

Chase County (#29)

  • Population: 3,978
  • Deaths in 2014: 68

Dundy County (#31)

  • Population: 1,886
  • Deaths in 2014: 32

Fillmore County (#32)

  • Population: 5,661
  • Deaths in 2014: 96

Furnas County (#58)

  • Population: 4,888
  • Deaths in 2014: 79

Jefferson County (#72)

  • Population: 7,335
  • Deaths in 2014: 116

Rock County (#40)

  • Population: 1,443
  • Deaths in 2014: 24

Thayer County (#92)

  • Population: 5,230
  • Deaths in 2014: 81

Webster County (#38)

  • Population: 3,658
  • Deaths in 2014: 61

Nevada

Nye County (#56)

  • Population: 42,282
  • Deaths in 2014: 685

New Mexico

DeBaca County (#30)

  • Population: 1,825
  • Deaths in 2014: 31

Sierra County (#3)

  • Population: 11,325
  • Deaths in 2014: 230

North Dakota

Eddy County (#7)

  • Population: 2,377
  • Deaths in 2014: 46

Griggs County (#23)

  • Population: 2,319
  • Deaths in 2014: 41

Logan County (#46)

  • Population: 1,944
  • Deaths in 2014: 32

McIntosh County (#8)

  • Population: 2,801
  • Deaths in 2014: 54

Nelson County (#2)

  • Population: 3,045
  • Deaths in 2014: 65

Pierce County (#80)

  • Population: 4,404
  • Deaths in 2014: 69

Ransom County (#45)

  • Population: 5,446
  • Deaths in 2014: 90

Oklahoma

Jefferson County (#34)

  • Population: 6,292
  • Deaths in 2014: 106

Okfuskee County (#85)

  • Population: 12,186
  • Deaths in 2014: 190

Oregon

Curry County (#37)

  • Population: 22,335
  • Deaths in 2014: 373

Pennsylvania

Sullivan County (#74)

  • Population: 6,339
  • Deaths in 2014: 100

South Dakota

Douglas County (#94)

  • Population: 2,973
  • Deaths in 2014: 46

Fall River County (#11)

  • Population: 6,845
  • Deaths in 2014: 130

Gregory County (#96)

  • Population: 4,217
  • Deaths in 2014: 65

Hutchinson County (#49)

  • Population: 7,200
  • Deaths in 2014: 118

McPherson County (#22)

  • Population: 2,429
  • Deaths in 2014: 43

Perkins County (#35)

  • Population: 3,033
  • Deaths in 2014: 51

Walworth County (#50)

  • Population: 5,511
  • Deaths in 2014: 90

Tennessee

Benton County (#100)

  • Population: 16,145
  • Deaths in 2014: 247

Decatur County (#24)

  • Population: 11,666
  • Deaths in 2014: 205

Hancock County (#67)

  • Population: 6,657
  • Deaths in 2014: 106

Texas

Armstrong County (#99)

  • Population: 1,955
  • Deaths in 2014: 30

Coleman County (#14)

  • Population: 8,430
  • Deaths in 2014: 158

Delta County (#62)

  • Population: 5,238
  • Deaths in 2014: 84

Eastland County (#98)

  • Population: 18,176
  • Deaths in 2014: 279

Foard County (#1)

  • Population: 1,275
  • Deaths in 2014: 31

Hall County (#55)

  • Population: 3,147
  • Deaths in 2014: 51

Hamilton County (#79)

  • Population: 8,199
  • Deaths in 2014: 129

Hardeman County (#17)

  • Population: 3,928
  • Deaths in 2014: 71

Haskell County (#39)

  • Population: 5,769
  • Deaths in 2014: 96

Marion County (#44)

  • Population: 10,149
  • Deaths in 2014: 168

Menard County (#16)

  • Population: 2,147
  • Deaths in 2014: 39

Real County (#63)

  • Population: 3,371
  • Deaths in 2014: 54

Sabine County (#66)

  • Population: 10,350
  • Deaths in 2014: 165

San Augustine County (#52)

  • Population: 8,610
  • Deaths in 2014: 140

Stonewall County (#20)

  • Population: 1,403
  • Deaths in 2014: 25

Virginia

Bath County (#73)

  • Population: 4,563
  • Deaths in 2014: 72

Bristol City (#9)

  • Population: 17,184
  • Deaths in 2014: 331

Galax City (#13)

  • Population: 7,014
  • Deaths in 2014: 132

Lancaster County (#27)

  • Population: 11,044
  • Deaths in 2014: 192

Martinsville City (#61)

  • Population: 13,711
  • Deaths in 2014: 220

Northampton County (#68)

  • Population: 12,121
  • Deaths in 2014: 193

West Virginia

Mingo County (#90)

  • Population: 25,716
  • Deaths in 2014: 399

Wisconsin

Adams County (#41)

  • Population: 20,215
  • Deaths in 2014: 336
Sabrina Perry, HealthGrove |
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