Sara Routhier, Managing Editor of Features and Outreach, has professional experience as an educator, SEO specialist, and content marketer. She has over five years of experience in the insurance industry. As a researcher, data nerd, writer, and editor she strives to curate educational, enlightening articles that provide you with the must-know facts and best-kept secrets within the overwhelming worl...

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Eric Stauffer is a former insurance agent and banker turned consumer advocate. His priority is to help educate individuals and families about the different types of insurance they need, and assist them in finding the best place to get it.

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Reviewed by Eric Stauffer
Founder & Former Insurance Agent

UPDATED: Oct 22, 2020

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In 2017, the U.S. Department of Health and Human Services declared the growing opioid epidemic a public health emergency. That year, there were 47,600 deaths from opioids nationwide.

According to the CDC, between 1999 and 2017, the age-adjusted opioid overdose fatality rate grew from 2.9 to 14.9 per 100,000 people, an increase of more than 5X.

Opioids are a class of drugs that include opium, heroin, methadone, synthetic narcotics, and natural and semisynthetic opioids used in pain medication. Research from the CDC shows that synthetic narcotics are even more likely than heroin to lead to overdose and death. These synthetic drugs include fentanyl and tramadol, which are many times more potent than heroin.

Methadone is also a synthetic narcotic but is tracked separately by the CDC. Deaths from synthetic narcotics besides methadone have increased from about 9 percent of opioid deaths in 1999 to about 60 percent of opioid deaths in 2017. While fentanyl is a legal medical drug, illegally manufactured fentanyl is on the rise and is commonly found during police encounters.

Line chart of annual opioid deaths by drug over time

Despite the nationwide increase in opioid-related death rates, not all states have felt the impact equally. Six states—Montana, Hawaii, Oregon, Washington, Nevada, and Oklahoma—actually experienced decreases in opioid death rates between 2007 and 2017. By contrast, the Rust Belt suffered the largest increases in opioid overdose death rates over the same time frame. Michigan, Indiana, Pennsylvania, and Ohio all experienced increases in excess of 300 percent.

Opioid death rate increases by state over ten years with overdose rates in Rust Belt States hit hardest

It’s important to note that economic conditions have a huge impact on opioid usage. Though a state like Hawaii has been one of the places least hit by the current opioid crisis, we found Honolulu to be most at risk to weather a recession. As areas see higher unemployment, they could also see increases in drug and alcohol abuse.

To find which states have suffered the most and the least by the opioid epidemic as well as which opioids are responsible for the most overdoses, our researchers here at analyzed data from the CDC Wonder database, which reports on causes of death related to opioid use.

When comparing the age-adjusted opioid overdose death rate in each state, states in the West have fared better than states in the East, especially the Rust Belt. Interestingly, in the ten states most impacted by the opioid crisis, synthetic narcotics such as fentanyl and tramadol were the opioid category with the highest death rate in 2017. Here are the ten most and ten least impacted states by the opioid crisis.

10 States Most Impacted by the Opioid Crisis

West Virginia State Capitol in Charleston in evening with sidewalk lights and green trees