America’s Top 10 Most Drugged-Out States

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My fellow Americans, we are a sad bunch. We are fat, we are unhealthy, we are poor and we are in pain—and all this was true before the subprime meltdown and subsequent Great Recession.

Over the last decade, seven million people have lost their jobs and their homes, 24/7 Wall Street recently reminded us, but it’s much worse than that. With each layoff and foreclosure, the lives of countless more dependents are thrown into disorder and disarray. This mass evaporation of wealth means a vast lack of self-worth. Hard to compete in a consumerist society when you can no longer consume.

Out of this new emptiness sprang Donald Trump’s belligerent brand of populism, but before we turned to mean Tweets and Pepe memes, Americans turned to booze and pills to mask their physical and mental pain, or just for a dopamine kick when nothing else was working.

Use of mind-altering drugs hit a 10-year high in 2014. Almost 19 percent of Americans drink alcohol or use some kind of “mood-altering substance” every day, according to recent Census statistics.

But the places that exceed the national average all have something in common: They’re poorer, they’re fatter and they’re unhappier—and with one exception, they’re all places that support Donald Trump.

Here are the 10 states with the highest rates of near-daily use of mood-altering drugs, as per 24/7 Wall Street. Make no mistake, these aren’t party destinations—these are bleak houses indeed.

10. Oklahoma, 21.8 percent near-daily drug use

Obamacare didn’t help Oklahomans that much. Fewer than 85 percent of the state’s residents have health insurance. The lack of preventative care might explain why more than one-third of the state is suffering from obesity and another 11.6 percent has diabetes.

9. Indiana, 21.9 percent near-daily drug use

The average American has an eye-popping 12.7 prescription medications in his or her medicine cabinet. If you have fewer than five, consider yourself lucky—and marvel at how many other people have 20 or more to round out that statistic. Indiana residents have about the average, but about 23.4 percent smoke. Smoking means poor health, and poor health means popping pills.

8. Ohio, 22 percent near-daily drug use

The prescription pill epidemic has hit Ohio like a sledgehammer. More than 3,310 people died from drug overdoses here in 2015, one of the worst rates in the nation. And Ohioans are awash in prescriptions, with almost 18 pill bottles per person.

7. Louisiana, 22.2 percent near-daily drug use

It’s hard to find work on the Gulf Coast. Louisiana has the third-highest unemployment rate in the country, and one of the lowest household income rates. Twenty percent of the state’s residents live in poverty, and the state also has the country’s highest obesity rate. You can’t blame it all on New Orleans’ 24-hour party life.

6. South Carolina, 22.5 percent near-daily drug use

People in South Carolina love their cigarettes and love their food. Almost 23 percent smoke, and 31.7 percent are obese.

5. Alabama, 23.1 percent near-daily drug use

Alabama’s economy dropped like a rock during the Great Recession, with the jobless rate increasing from four percent to six percent.

4. Rhode Island, 23.5 percent near-daily drug use

The lone blue state on the list, Rhode Island residents enjoy relatively high income, but the jobless rate is 5.3 percent, higher than many red states on this list. Rhode Island residents may not turn to pills, but they like to drink and smoke weed, with 63 percent and 19 percent reporting regular alcohol and cannabis use, respectively.

3. Kentucky, 24 percent near-daily drug use

This is tobacco country, and Kentuckians act like it. More than 36 percent of residents say they smoke cigarettes. With the entire state a smoking section, health outcomes are abysmal, and so Kentucky has an eye-popping average of 22 prescriptions per person.

2. Arkansas, 24.9 percent near-daily drug use

Cancer, heart disease, obesity—Arkansas is just not a healthy place. The state has one of the highest premature mortality rates of anywhere in the country.

1. West Virginia, 28.2 percent near-daily drug use

West Virginia runs away with the top spot, and it’s not entirely its own fault. Drug companies absolutely flooded the state with opiates, and with an unemployment rate of six percent, there was a ready market of out-of-work people, some of whom were out-of-work manual laborers.

You may notice all these states have something else in common aside from poor health, low income and high incidence of drug use. They’re also places—with just three exceptions—where marijuana use is outlawed.

Rhode Island, Ohio and Louisiana have limited medical marijuana programs, but other than that, they’re all prohibition states. And Alabama and Oklahoma are where two of the architects of Donald Trump’s current tough-on-drugs policy originate.

Correlation is not causation, and we’re not saying legalization would solve a health crisis overnight. But with more evidence that marijuana availability reduces reliance on prescription painkillers, and some of the biggest fans of strict drug laws hailing from the country’s sickest states, we can’t help but wonder.

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