The Places Where Opioid Prescriptions Outnumber People

24/7 Wall St. Insights While new public health measures have reigned in the opioid crisis, opioids are still rampant in the U.S. In 2023, there were 83 counties with more opioid prescriptions filled than there were people. The counties with the most opioids per capita are poor communities in the South and Midwest. Also: Discover […] The post The Places Where Opioid Prescriptions Outnumber People appeared first on 24/7 Wall St..

May 6, 2025 - 12:10

The Places Where Opioid Prescriptions Outnumber People

24/7 Wall St. Insights

While new public health measures have reigned in the opioid crisis, opioids are still rampant in the U.S.
In 2023, there were 83 counties with more opioid prescriptions filled than there were people.
The counties with the most opioids per capita are poor communities in the South and Midwest.
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For over 25 years, the opioid crisis has devastated the United States. The opioid crisis has transcended boundaries of race, income, and age to bring harm and deaths of despair to Americans in every part of the country, both in small towns and bustling cities throughout the country. The epidemic has claimed hundreds of thousands of lives, slashed U.S. life expectancy, and costs the nation over $1 trillion annually.

What began with Big Pharma’s misleading marketing campaigns spiraled into a nationwide catastrophe, as doctors – sometimes misled, sometimes complicit – flooded communities with addictive painkillers. While no region has been spared, the heaviest toll has fallen on poor, rural areas where medical oversight is limited, and chronic pain is widespread.

While new legislation and public health measures have managed to reign in crisis in the past several years, opioids are still rampant throughout the country. In 2023, there were 83 U.S. counties where more opioid prescriptions were filled than there were residents. Most of these communities are in the rural South – areas with high poverty, limited access to quality care, and elevated rates of chronic pain. In 43 of the 50 counties with the highest prescribing rates, the poverty rate exceeds the national average of 12.4%.

The consequences are dire. A 2022 study in the American Journal of Psychiatry found that for every 35 additional prescriptions per 100 residents, the odds of addiction rise by 10%. Many patients – cut off from legal opioids or no longer finding relief – turn to street drugs like heroin or fentanyl. And with roughly 80% new heroin users reporting pills as their initiation to opioid use, residents in counties with more opioid prescriptions per capita may be at a greater risk of overdose than in other parts of the country. A look at the data reveals the counties with the most opioid prescriptions per person.

To identify the places prescribing the most opioids, 24/7 Wall St. reviewed opioid prescription data from the Centers for Disease Control and Prevention. Counties were ranked based on opioid prescriptions dispensed per capita in 2023, using prescriber location rather than pharmacy data. Data on drug overdose rates for 2021 to 2023 are from the CDC and include both opioids and non-opioids. Supplemental data on poverty and population are from the U.S. Census Bureau.