How Drug of Choice Differs Across the United States

PJ Haarsma
|
October 25, 2021

Drug abuse or addiction is a huge problem in the United States. According to the 2018 National Survey on Drug Use and Health report, 164.8 million people aged 12 or older (60.2%) had used substances like illegal drugs, alcohol, or tobacco in the past month. Within that time, 47 million people smoked cigarettes, and 139.8 million drank alcohol. The survey adds that 19.4% of the population had used an illicit drug in the past year, with marijuana accounting for 15.9% of use. Prescription drugs misuse came second with 3.6%.  

Sadly, the drug problem causes addiction, physical and psychological problems, and in some cases, death. In 2019 alone, there were about 71,000 drug overdose deaths in the country, and the trend seems to be holding up. While the drug use problem is rampant in the country, it’s important to note that not all states are struggling with the same types of substances. Different states have different drug problems, each with varying severity. This article will look at how drug of choice differs across the United States.

Alcohol

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The legal drinking age in the US is 21 years old and is strictly enforced. However, statistics show that young adults in the country are also indulging in alcohol use. The National Institute on Alcohol Abuse and Alcoholism pointed out that most states had a 2.35 gallons per capita alcohol consumption in 2016, which exceeds the country’s goal of 2.1.

Currently, New Hampshire is the state with the highest alcohol consumption per capita of 4.67 gallons. This is over double the country’s set goal. But Statista notes that the state has lower rates of binge drinking than other states. States like Iowa, Wisconsin, North Dakota, and South Dakota have the highest rates of binge drinking. Binge drinking is the consumption of 4 or more drinks within 2 hours for women and five or more drinks with 2 hours for men. It is the most common form of excessive drinking and is linked to severe risks.

Utah is on the other end of the spectrum, with the lowest alcohol consumption per capita of 1.34 gallons. This is mainly attributable to the strict alcohol regulations in the state. Utah is one of the nine states with per capita less than 2.1 gallons.  

Alcohol consumption per capita in the US ranked

Highest alcohol use per state

  • New Hampshire (4.67 gallons)
  • Washington (3.77 gallons)
  • Delaware (3.52 gallons)
  • Nevada (3.42 gallons)
  • North Dakota (3.16 gallons)

Lowest alcohol use per state

  • Georgia (1.90 gallons)
  • Oklahoma (1.85 gallons)
  • Arkansas (1.78 gallons) 
  • West Virginia (1.74 51 gallons)  
  • Utah (1.35 gallons)

Marijuana

The federal government classified marijuana as a schedule I drug, along with others like cocaine and heroin. However, 18 states and the country’s capital have legalized marijuana use for adults, while 36 states, including the US Virgin Islands, Guam, District of Columbia, Northern Mariana Islands, and Puerto Rico, allow for comprehensive public medical marijuana programs. Consequently, the states with fewer marijuana restrictions tend to have higher use rates. In fact, states like Washington, Oregon, Colorado, and Alaska are among the top 12 states with the highest use rates.

Currently, cannabis use among US adults in 2018-19 was highest in the District of Columbia, with about 27% of adults using the drug. South Dakota has the least marijuana use, with about 11.13%, according to Statista:

Marijuana use across the US states ranked

States with the highest marijuana use

  • District of Columbia 27.42%
  • Vermont 27.04%
  • Oregon 26.99%
  • Colorado 26.32%
  • Washington 25.58%

States with the lowest marijuana use

  • Virginia 12.23%
  • Texas 12.19%
  • Louisiana 12.15%
  • Mississippi 12.09%
  • South Dakota 11.13%

Prescription opioids and heroin

After pharmaceutical companies reassured the medical community that pain relievers wouldn’t cause addiction, healthcare providers started prescribing these drugs at greater rates in the late 1990s. This led to vast misuse of both opioid drugs before it became apparent that they could indeed be highly addictive. According to NSDUH’s 2020 survey, 10.1 million people misused prescription opioids in the past.

Studies show that prescription drugs are gateway drugs, leading people to use street drugs like heroin, fentanyl and cocaine. Prescription drugs have low opioid levels and are often used as pain-relievers. But chronic pain patients may need to take these drugs for a longer time, exposing themselves to the risks of drug addiction, and tolerance. So many chronic patients end up taking more pills each day, which can be expensive or inaccessible. As a result, they turn to alternatives like fentanyl and heroin to achieve the desired effect and avoid withdrawal symptoms.

The escalating use of prescription opioids for pain management has contributed significantly to the opioid epidemic. Opioid is widely used across the US, but it disproportionately affects the states of West Virginia, Maryland, New Hampshire, and Ohio. According to the National Institute of Health, these states had the highest rate of fatal opioid overdoses, with 42.4, 33.7, 33.1, and 29.6 per 100,000 people, respectively. Hawaii, Iowa, Texas, and California had the least overdoses, accounting for 4.1, 4.8, 4.8 ad 5.8 per 100,000, respectively.

Aside from the overdose cases, opioids, alongside other drugs like heroin, are primarily used in populous states and those that serve as entry points. A survey based on HHS and the Substance Abuse and Mental Health Services Administration’s ranked states by opioid misuse rates, and these were the findings:

Opioid use across the US states ranked

States with the highest opioid use

  • Alabama 5.3%
  • Oregon 5.3%
  • Kentucky 4.8%
  • Colorado 4.7%
  • Kansas — 4.7%

States with the lowest opioids use

  • New York 2.8%
  • Wyoming 2.7%
  • Illinois 2.5%
  • Nebraska 2.4%
  • South Dakota 2.4%

Other substances

While some states use specific substances more than others, the reality is that Americans are using alcohol or drugs and, sometimes, a combination of both. Alcohol and nicotine are legal and loosely regulated. The fact that they are affordable and easily accessible makes them a drug of choice for many people. Despite these, alcohol and nicotine carry a risk for addiction and even death.

Prescription medications are also technically legal. And since the doctors issue them, some Americans abuse them assuming it’s safe. But prescription drugs are highly addictive and can serve as a gateway to other drugs like heroin and fentanyl. Besides, these drugs account for 30% of emergency room admissions.

And with the growing cases of mental illness across the country, many are self-medicating with cocaine, marijuana, or alcohol. Unfortunately, these mind-altering substances offer temporary relief but may lead to addiction and other health-related issues.

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Americans use drugs and alcohol for various reasons. Some do so as a social activity, like after work or during holidays, while others use it to fit in. Availability, experimenting, self-medicating, feeling good, etc., are common reasons people use drugs across the country. But there are other risk factors like having family members who abuse substances that predispose one to use.

 Drug of choice may differ from state to state due to availability, state laws, and influence. But all in all, the drug is still a problem irrespective of the type of drug. If you or someone close to you is addicted to drugs, it is best to seek substance abuse treatment. Many treatment approaches exist to help you lead a drug-free life.

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